An interview with Professor Hugo Laviada-Molina about the conclusions of the 1st Latin American Scientific Forum on Low/No Calorie Sweeteners (LNCS)
With the objective of reviewing the latest scientific evidence on the safety, health effects, and role of low/no calorie sweeteners in sugar reduction, the 1st Latin American Scientific Forum on Low/No Calorie Sweeteners was held in Mexico in November 2025, bringing together 25 scientific experts from across Latin America and internationally. The proceedings and conclusions of the Forum have since been published in Nutrición Hospitalaria.1 We spoke with Prof. Hugo Laviada-Molina from the University Marista of Merida, Yucatan, Mexico, about the Forum, the key findings and conclusions presented in the published paper, and the main take-home messages for health professionals.
What prompted the organisation of the 1st Latin American Scientific Forum on Low/No Calorie Sweeteners, and what were the main objectives that the experts set out to address?
In Latin America, we have various groups of researchers who have undertaken different studies on LNCS from a range of perspectives. It was important to have a meeting point, firstly to learn about the work being carried out in countries that share similar challenges and a common culture. Secondly, it was important to be able to establish collaborative networks to promote the study of these additives by bringing to the table what each researcher in our region can contribute to the others.
The Forum reviewed a large body of evidence on low/no calorie sweeteners. What would you say was the most important scientific takeaway from the discussions?
I think the most important takeaway is that low/no calorie sweeteners should not be viewed simply as either “good” or “bad”. Their effects depend very much on how they are used and, especially, on what they replace in the diet.
The evidence reviewed at the Forum indicates that approved low/no calorie sweeteners are considered safe when consumed within the established acceptable daily intake levels. From a health perspective, the strongest evidence comes from studies in which they replace sugar. And that is the intended use of these additives. In this context, particularly when low/no calorie sweetened beverages replace sugar-sweetened beverages, clinical trials generally show neutral or modestly beneficial effects on body weight and cardiometabolic health.
So, perhaps the simplest message is: the question is not only whether someone consumes a low/no calorie sweetener, but what they would be consuming instead. They are not a magic solution, but they can be a useful tool for reducing sugar and calorie intake as part of an overall healthy diet.
One of the key topics discussed was the difference between findings from randomised controlled trials (RCTs) and observational studies. How should healthcare professionals interpret these apparently conflicting findings when evaluating the collective evidence on low/no calorie sweeteners?
This was one of the most interesting discussions at the Forum. At first sight, the evidence can appear contradictory. Randomised controlled trials generally show neutral or modest benefits when low/no calorie sweeteners replace sugar, while some observational studies have reported associations with obesity, diabetes or cardiovascular disease. But we need to remember that these studies answer somewhat different questions. In an RCT, researchers actively compare one option with another — for example, replacing a sugar-sweetened beverage with a low/no calorie sweetened beverage. This makes it easier to assess cause and effect.
Observational studies look at what people choose to consume in real life. The difficulty is that people at higher risk of obesity or diabetes may be more likely to choose diet products in the first place. We call this reverse causality: the higher health risk may lead to greater sweetener use, rather than the sweetener causing the higher risk. Importantly, when observational studies use better methods to avoid this bias and specifically examine the replacement of sugary drinks with low- or no-calorie alternatives, their findings become much more consistent with those of clinical trials.
So, healthcare professionals should consider the whole body of evidence, but also the strengths and limitations of each type of study. We should not assume that an association observed in a population necessarily means that the sweetener caused the outcome.
Why is reducing free sugars intake such an important public health priority across Latin America, and what role can low/no calorie sweeteners play in supporting sugar reduction efforts?
Reducing free sugars is especially important in Latin America because sugar consumption remains very high, while the region also faces a major burden of obesity, type 2 diabetes and other derived noncommunicable diseases. Data discussed at the Forum showed that a large proportion of the Latin American population consumes more free sugars than recommended. Sugar-sweetened beverages are particularly important because they are one of the major sources of added sugars in the region. The Forum’s proceedings paper reports that around 70% of the population studied in eight Latin American countries exceeded the WHO recommendation of less than 10% of energy from free sugars.
Low/no calorie sweeteners can play a practical role here. When they replace sugar in foods and beverages, they can contribute to reduce sugar and calorie intake while maintaining sweetness. This may make sugar reduction easier and more acceptable for some people. But again, they should be viewed as one tool, not the solution. Water and unsweetened foods and beverages remain important choices. However, for people who regularly consume sugary products, replacing them with low/no calorie alternatives can be a useful step towards reducing sugar intake as part of a healthier dietary pattern.
What were the main research priorities identified by the Forum, and what next steps are needed to strength the evidence based and inform future nutrition policy in Latin America?
One of the clearest conclusions of the Forum was that we do not simply need “more research”; we need better and more relevant research, particularly research conducted in Latin America.
Several priorities were identified. We need to understand whether different low/no calorie sweeteners have different effects rather than treating them all as a single group. We also need better studies on the gut microbiome, glucose metabolism and cardiometabolic health, particularly in people with prediabetes, diabetes or metabolic syndrome.
Another important priority is research in populations that are currently underrepresented, including children, adolescents and pregnant or breastfeeding women. We also need to study low/no calorie sweeteners as they are actually consumed — in mixtures and in real foods and beverages — not only as individual compounds under experimental conditions.
For Latin America specifically, we need much better information about how much sugar and how many low/no calorie sweeteners people actually consume, and how intakes change following policies such as front-of-pack labelling and food reformulation.
Finally, the Forum highlighted the need to build a Latin American research network. By sharing data, harmonising methods and developing multicentre cohorts and clinical trials, countries in the region could generate their own high-quality evidence rather than relying almost entirely on studies from Europe and North America. Ultimately, the goal should be to provide policymakers and healthcare professionals with evidence that is scientifically rigorous but also relevant to the social, cultural and nutritional realities of Latin America.