No adverse effect of sucralose on glucose metabolism

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ISA statement in response to study by Dalenberg et al.

Brussels, 4th March 2020*: The International Sweeteners Association (ISA) responds to a new study by Dalenberg et al.1 Contrary to the claims by Dalenberg et al., the collective evidence including from systematic reviews confirms that sucralose does not affect acute or longer-term glycaemic control in both healthy individuals and in people with diabetes.2,3,4

Importantly also, any effect on glucose metabolism of the combination of low/no calorie sweeteners like sucralose with carbohydrates, as claimed by Dalenberg et al., has not been confirmed by several other studies, including clinical trials, which have looked at the impact of the consumption of a low/no calorie sweetener together with a carbohydrate load or meal.5,6,7,8 Other experts have rejected the study’s conclusions, upon re-analysing the results.9 Contrary to the findings by Dalenberg et al., Khan and Sievenpiper found that combining sucralose with a carbohydrate had the same impact on glucose metabolism when compared to the carbohydrate alone.9 This confirms that sucralose, consumed either alone or with a carbohydrate, does not affect by itself glucose metabolism or tolerance.    

Furthermore, none of the mechanisms proposed by Dalenberg et al. to explain a potential metabolic dysfunction due to the combination of low/no calorie sweeteners and carbohydrates has been confirmed in humans.2 Interestingly, the study findings actually refute the ‘sweet uncoupling’ hypothesis that was originally tested by Dalenberg et al.: in contrast, the study results suggest that the sucralose-sweetened beverage did not significantly influence glucose metabolism and produced no effect on brain or perceptual response to sweet taste.

At a time when obesity and non-communicable diseases including diabetes remain major global health challenges, and in light of current public health recommendations to reduce overall sugar intake, low/no calorie sweeteners including sucralose can be helpful in creating healthier food environments. They provide people with a wide choice of sweet-tasting options with low or no calories, and thus can be a useful tool, when used in place of sugar and as part of a balanced diet, in helping reduce overall sugar and calorie intake, as well as in managing blood glucose levels. Low/no calorie sweeteners are also not fermentable by oral bacteria, which means that they do not contribute to tooth decay.

* updated 1st April 2021

  1. Dalenberg JR, Patel BP, Denis R, et al. Short-Term Consumption of Sucralose with, but Not without, Carbohydrate Impairs Neural and Metabolic Sensitivity to Sugar in Humans. Cell Metabolism 2020;31:493–502
  2. Grotz, VL, Pi-Sunyer X, Porte DJ, Roberts A, Trout JR. A 12-week randomized clinical trial investigating the potential for sucralose to affect glucose homeostasis. Regul Toxicol Pharmacol 2017; 88: 22-33
  3. Nichol AD, Holle MJ, An R. Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials. Eur J Clin Nutr 2018; 72: 796-804
  4. Tucker RM, Tan SY. Do non-nutritive sweeteners influence acute glucose homeostasis in humans? A systematic review. Physiol Behav 2017; 182: 17-26
  5. Brown AW, Brown MMB, Onken KL, Beitz DC. Short-term consumption of sucralose, a nonnutritive sweetener, is similar to water with regard to select markers of hunger signaling and short-term glucose homeostasis in women. Nutr. Res. 2011; 31: 882–888.
  6. Ford HE, Peters V, Martin NM, et al. Effects of oral ingestion of sucralose on gut hormone response and appetite in healthy normal-weight subjects. Eur. J. Clin. Nutr. 2011; 65: 508–513.
  7. Ma J, Chang JJ, Checklin HL, et al. Effect of the artificial sweetener, sucralose, on small intestinal glucose absorption in healthy human subjects. Br. J. Nutr. 2010; 104: 803–806
  8. Wu T, Zhao BR, Bound MJ, et al., Effects of different sweet preloads on incretin hormone secretion, gastric emptying, and postprandial glycemia in healthy humans. Am. J. Clin. Nutr. 2012; 95: 78–83.
  9. Khan TA, Sievenpiper JL. Low-calorie sweeteners with carbohydrate do not impair insulin sensitivity in humans: Re-analysis highlighting the importance of the comparator. Cell Metabolism 2021;33(2):P225-226