Abstract:
Non-nutritive sweeteners (NNSs) are consumed to reduce intake by providing a sweet taste with little to no energy. Despite regulatory approval and extensive use, uncertainty remains about their long-term role in weight management and health, and about whether exposure to sweet taste itself, independent of energy, influences these outcomes. This narrative review synthesizes evidence from three recent European consortia: SWEET, SWITCH and Sweet Tooth, which together provide complementary data from acute, short- and long-term randomized controlled trials. The studies examined the effects of NNSs and dietary sweet taste exposure on body weight, health-related biomarkers, sweet taste preference, and eating behavior. Across studies, replacing sugars with NNSs appeared to support weight loss maintenance, while NNS consumption and dietary sweet taste exposure showed no adverse changes in body weight, glucoregulatory and endocrine biomarkers, cardiometabolic risk factors, gut microbiota, or liver enzymes. Likewise, neither NNS use nor different dietary sweet taste exposure altered sweet taste liking, appetite sensation, energy intake, or food choice. However, interpretation should consider the characteristics of the included studies, including selected populations, intervention context, outcome heterogeneity, and the fact that several behavioral and biomarker outcomes were secondary or exploratory. Overall, the reviewed evidence suggests that replacing sugar intake with NNSs may support weight management strategies, while differences in habitual dietary sweet taste exposure per se appear largely neutral with respect to health-related biomarkers and sweet taste preferences.
Summary:
This narrative review synthesises evidence from three large European research consortia (SWEET, SWITCH, and Sweet Tooth) which collectively examined the effects of low/no calorie sweeteners (LNCS) and dietary sweet taste exposure on body weight, cardiometabolic health, sweet taste preference, and eating behaviour.
The findings show that neither LNCS consumption nor higher habitual exposure to sweet-tasting diets increased appetite, energy intake, sweet food preference, or body weight. Replacing sugars with LNCS supported weight-loss maintenance and had neutral or favourable effects on glycaemic outcomes, with no adverse effects on cardiometabolic biomarkers or gut microbiota-related health markers. These findings are consistent with systematic reviews and meta-analyses of RCTs and reinforce the current evidence base by providing additional evidence for the long-term efficacy of LNCS.
The authors conclude that the evidence does not support concerns that LNCS or dietary sweetness promote weight gain, increase appetite or sweet taste preferences, or adversely affect cardiometabolic health. Instead, replacing sugars with LNCS may help reduce sugar intake and support weight management without negative cardiometabolic effects