Brussels, 9th April 2025: In light of new observational research on food additive mixtures and risk of T2 diabetes, the International Sweeteners Association (ISA) highlights existing evidence indicating that consuming low/no calorie sweeteners does not affect glucose control or increase the risk of type 2 diabetes.
The present analysis of the NutriNet-Santé cohort data does not provide causal evidence that consumption of low/no calorie sweeteners, or a mixture of food additives containing them, increases the risk of type 2 diabetes. By their nature, observational studies cannot establish a cause-and-effect relationship. The authors themselves recognise that “causality cannot be established on the basis of this observational study alone”. Considering the weak associations observed in this research, it is highly likely that unmeasured and residual confounding (factors not considered or controlled in the research) are significant problems in this study. Also, these small associations may be due to reverse causation (meaning that people with diabetes turned to sweeteners to manage their disease, and not the other way round).
Notably, the collective research on low/no calorie sweeteners specifically, which are amongst the most studied food additives globally, indicates no evidence of a causal link between consuming low/no calorie sweeteners and developing diabetes and supports the assertion that low/no calorie sweeteners, by themselves, do not affect blood glucose or insulin levels (Diabetes UK, 2018; Greyling et al, 2020).
All approved food additives, including sweeteners, undergo a rigorous safety assessment before they can be used in foods and drinks. In accordance with EU legislative requirements, assessments are carried on single additives, unless EFSA recognises the need to evaluate the potential “combined effects” of chemical mixtures (EFSA, 2019).