Many people like to make false claims about artificial, or non-nutritive, sweeteners like aspartame and sucralose, usually blaming them for causing a whole host of conditions from cancer to causing weight gain. The problem is that those claims are not supported by real science.
A new systematic review and meta-analysis (considered the top of the hierarchy of biomedical research) show that artificial sweeteners don’t cause changes to the hunger hormones (which, as you might suspect, controls our desire to consume food) or blood glucose levels.
As readers of my articles know, I like to critique these new articles on health or nutrition. The results are enlightening and should dismiss some of the negative claims made about these non-nutritive sweeteners.
Artificial sweeteners systematic review
In a paper published on 20 February 2023 in the respected journal Nutrients, John L Sievenpiper, Division of Endocrinology and Metabolism, Department of Medicine, St. Michael’s Hospital, Toronto, Canada, and colleagues reviewed 36 clinical trials that examined the effect of artificial sweeteners on human subjects. They looked at studies that included healthy individuals along with those who have type 2 diabetes.
Without getting into the weeds of statistical analysis, here are the researchers’ key findings:
- Drinking a beverage with non-nutritive sweeteners (including acesulfame potassium, aspartame, cyclamate, saccharin, stevia, and sucralose), was no different from drinking water in terms of the effect on 2-hour post-meal levels of blood glucose and “hunger” hormones, insulin, glucagon-like peptide 1 (GLP-1), gastric inhibitory polypeptide (GIP), peptide YY (PYY), ghrelin, leptin, and glucagon. These hormones work in complicated feedback loops to induce and suppress hunger. It has been claimed that artificial sweeteners somehow affect these hormones causing one to actually get hungrier after consumption. The science debunks that particular myth.
- However, drinking a sugar-sweetened beverage, however, had a different effect on post-meal levels of glucose and hunger hormones. Of course, we could assume that drinking a sugared beverage would raise glucose levels, but they also have an effect on hunger hormones which could lead to further food consumption.
This study debunks two of the most common claims about artificial sweeteners with respect to diets.
- It debunks the “sweet uncoupling hypothesis” which proposed that low-calorie sweeteners affect sweet taste by separating sweet taste from calories. The claim is that the body becomes “confused” by the lack of calories and it induces some sort of hormonal change. In fact, this study shows that beverages with non-nutritive sweeteners are no different to the body than drinking water.
- Also, it debunks the claim that you consume more when no-calorie or low-calorie sweeteners are taken with calories (called coupling). However, the results of this systematic review and meta-analysis show that there is no change in hormone levels which might impact hunger and desire for food.
This study supports the idea that artificially sweetened beverages have no benefits themselves, but if they replace a sugar-sweetened beverage, that will obviously reduce caloric intake.
The authors concluded that:
The available evidence suggests that NNS (non-nutritive sweeteners) beverages sweetened with single or blends of NNS have no acute metabolic and endocrine effects, similar to water. These findings provide support for NNS beverages as an alternative replacement strategy for SSBs in the acute postprandial setting.
As I continue to mention, systematic reviews and meta-analyses are the most valuable pieces of scientific research as a part of science-based medicine. These types of research remove bias and often include only the best studies done to provide evidence supporting or rejecting a claim.
Given that, this study gets 5 out of 5 stars. I think that, at least with respect to the complex hunger system of humans, artificial sweeteners have no effect. Drinking a Diet Coke is just like drinking water, at least with respect to hunger. This research debunks the claims that are made over and over again that artificial sweeteners cause people to be hungry. It doesn’t.
- Zhang R, Noronha JC, Khan TA, McGlynn N, Back S, Grant SM, Kendall CWC, Sievenpiper JL. The Effect of Non-Nutritive Sweetened Beverages on Postprandial Glycemic and Endocrine Responses: A Systematic Review and Network Meta-Analysis. Nutrients. 2023 Feb 20;15(4):1050. doi: 10.3390/nu15041050. PMID: 36839408; PMCID: PMC9965414.