Conclusions from the 1st Latin American Scientific Forum on Low/No Calorie Sweeteners
Highlights:
- Latin American and international experts concluded that approved low/no calorie sweeteners are safe within established intake limits and can support efforts to reduce excess free sugars consumption.
- Clinical trials and bias-adjusted prospective cohorts agree that replacing sugar with low/no calorie sweeteners has neutral or modestly beneficial effects on body weight and cardiometabolic health.
- Experts called for evidence-based policies and further Latin American research to better inform future dietary recommendations and public health strategies.
Excess free sugars consumption remains a significant public health challenge across Latin America, contributing to the growing burden of obesity, type 2 diabetes and other non-communicable diseases (NCDs). With the objective to review the latest evidence on the safety, efficacy, and use of low/no calorie sweeteners (LNCS) as a sugar reduction strategy, the 1st Latin American Scientific Forum on Low/ No Calorie Sweeteners was held in November 2025 in Mexico, bringing together 25 scientific experts from across Latin America and internationally.1
Addressing a major public health challenge
A major focus of the discussions was the role of LNCS in supporting sugar reduction strategies. Experts noted that reducing excess free sugars intake remains a public health priority throughout the region and that LNCS can serve as a useful tool when replacing sugars within healthy dietary patterns. While they are not considered a standalone solution to obesity or NCD prevention, LNCS may help facilitate reductions in sugar and energy intake, particularly through product reformulation and consumer substitution of sugar-sweetened foods and beverages.
The Forum concluded that approved LNCS are safe when consumed within established Acceptable Daily Intake (ADI) levels, consistent with evaluations conducted by international, regional, and national food safety authorities. Current evidence also indicates that consumption levels in Latin American countries remain well below these safety thresholds.
Evidence review: Understanding the differences between study designs
The Forum reviewed evidence from randomised controlled trials (RCTs), which are widely regarded as the strongest study design for establishing cause-and-effect relationships. These studies consistently show that replacing sugar with LNCS has neutral to modestly beneficial effects on body weight, glycaemic control and cardiometabolic risk factors. Longer-term RCTs, including recent European studies, further suggest that LNCS may support weight-loss maintenance when incorporated into comprehensive lifestyle interventions, without adverse cardiometabolic impact.
Experts also discussed the apparent discrepancies between findings from RCTs and some observational studies that have reported associations between LNCS consumption and adverse health outcomes. According to the Forum, these differences may be partly explained by methodological limitations including residual confounding and reverse causality. For example, individuals already at increased risk of obesity, diabetes or cardiovascular disease may be more likely to choose products containing LNCS, leading to statistical associations that do not necessarily reflect a causal effect. When observational studies employ appropriate substitution models and account for key confounding factors, the evidence generally shows neutral or favourable health outcomes when LNCS replace sugar-sweetened products.
Policy implications for the region
The policy implications of these findings were another key area of discussion at the Forum. Experts discussed the possibility that, in the absence of robust impact assessments, policies discouraging the use of LNCS, such as warning front-of-pack labels, could have unintended consequences. Potential unintended consequences may include discouraging product reformulation, reducing consumer confidence in lower-sugar alternatives, and potentially increasing consumption of products containing higher amounts of sugar.
The Forum emphasized the importance of evidence-based policymaking that considers the totality of available scientific evidence, including both clinical trials and high-quality observational research using substitution models. Participants also highlighted the need for stronger regional data to support future policy decisions.
Strengthening the evidence base in Latin America
Several research priorities were identified by the experts, including improved monitoring of sugar and sweetener consumption in the region, development of prospective cohort studies in Latin American populations, and additional RCTs evaluating individual sweeteners and sweetener blends. Greater attention is also needed to vulnerable populations, including children, pregnant and lactating women, and people living with metabolic disorders.
Looking ahead
As Latin American countries continue to implement strategies to reduce sugar consumption and address the growing burden of NCDs, the Forum concluded that approved LNCS can play a supportive role when used as substitutes for sugar within broader public health and nutrition strategies. Continued investment in research, surveillance and evidence-based communication will be essential to inform future policies and ensure that recommendations reflect the evolving scientific evidence.