Non-Nutritive Sweeteners: Evidence on their Association with Metabolic Diseases and Potential Effects on Glucose Metabolism and Appetite

Abstract

There is ongoing debate concerning non-nutritive sweeteners, their usage, and their effects on metabolism. The association between non-nutritive sweeteners consumption, development of metabolic diseases, and changes in appetite-regulating hormones is not clear. The aim of this article is to present an overview of non-nutritive sweeteners and to examine the scientific evidence of their effects on glucose metabolism and appetite-regulating hormones. Some observational studies suggest an association between non-nutritive sweeteners consumption and development of metabolic diseases; however, adiposity is a confounder frequently found in these studies. Results of the available clinical trials are heterogeneous and not comparable because of major differences between them. Future controlled studies evaluating specific non-nutritive sweeteners, with an appropriate sample size, including a uniform study group, with sufficient exposure time, and considering adjustment for confounder variables, such as anthropometric characteristics, previous consumption of non-nutritive sweeteners, and coexistence of significant metabolic comorbidities, are needed. (REV INVES CLIN. 2017;69:129-38)

Ibero–American Consensus on Low- and No-Calorie Sweeteners: Safety, Nutritional Aspects and Benefits in Food and Beverages

“…This implies that subjects who are already obese or overweight (or its risk factors, or genetic predisposition to obesity or diabetes) consume more foods and drinks sweetened with LNCS in order to reduce or mitigate their condition, and not the reverse. In a recent review published by Romo-Romo et al (2017) [ 96 ], prospective cohort studies were condensed. The authors observed an attenuation of the association of LNCS with obesity and metabolic diseases, once the analysis includes adjustments of variables related to adiposity [ 96 ].…”

“…In a recent review published by Romo-Romo et al (2017) [ 96 ], prospective cohort studies were condensed. The authors observed an attenuation of the association of LNCS with obesity and metabolic diseases, once the analysis includes adjustments of variables related to adiposity [ 96 ]. For this reason, Romo-Romo et al concluded that “evidence from prospective observational studies indicates that there might be a relationship between the consumption of LNCS sweetened beverages and metabolic disease development”.…”

“…For this reason, Romo-Romo et al concluded that “evidence from prospective observational studies indicates that there might be a relationship between the consumption of LNCS sweetened beverages and metabolic disease development”. However, they pointed out that “one possible explanation for the attenuation or loss of the associations after adjusting for adiposity, is that people who consume more LNCS sweetened beverages are more likely to gain weight and therefore tend to consume LNCS as a strategy for weight loss and reduce their energy intake” [ 96 ]. In this situation, there could be other genetic, social, family or lifestyle factors that can produce an impact on the development of these diseases rather than the intake of LNCS.…”

Effects of Non-Nutritive Sweeteners on Energy Intake, Body Weight and Postprandial Glycemia in Healthy and with Altered Glycemic Response Rats

“…Worldwide NNS consumption has increased and Mexico exhibits a high proportion of nutritional products containing NNS [ 3 ]. The three most popular NNS are sucralose, aspartame and stevia; the first two being from synthetic origin (artificial) and the latter from natural sources [ 4 , 5 ].…”

The timing of ingestion may influence the effect of nonnutritive sweeteners on cardiometabolic health: a potentially overlooked factor

“…Furthermore, dissociation between sweet taste and energy or plasma glucose may occur. 5,6 Hypoglycemia could occur in the condition of long-term fasting, possibly with the concomitant effect of incretins. We consider that the mechanisms of hypoglycemia, increased consumption of food and obesity may contribute, at least in part, to the conflicting and unexpected results of many clinical studies.…”