No evidence that low calorie sweeteners would adversely affect obesity or diabetes in humans

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ISA statement in response to study by Hoffmann et al. presented at the congress of Experimental Biology 2018

The study by Hoffmann et al.1, examining biochemical effects of glucose and low calorie sweeteners in cell (in-vitro) and animal experiments, presented at the congress of Experimental Biology 2018 and in a Press Release on 22nd April 2018, does not provide evidence that low calorie sweeteners could adversely affect obesity or diabetes in humans.

None of the reported outcomes of this experimental study has ever been observed nor confirmed in human studies. Moreover, these experiments exposed cells to a very high concentration of low calorie sweeteners, which would not be seen in real-life exposure conditions and therefore do not provide evidence of any clinically meaningful effect of low calorie sweeteners’ consumption on weight management or glucose control. Overall, as information about the methodology and the results of this study is limited, and importantly, the study has not been published in a peer-reviewed scientific journal and has therefore not been reviewed by other experts yet, it is scientifically critical to review and interpret the effects suggested in the available abstract with caution.

In contrast, a wealth of clinical trials in humans have consistently shown that low calorie sweeteners can help reduce calorie intake and thus body weight, when used in place of sugar and as part of a calorie-controlled diet, and that they do not affect blood glucose homeostasis.2,3,4,5,6,7,8 

Contrary to the claims made in the study by Hoffmann et al., low calorie sweeteners can also be a significant aid to people with diabetes, as they do not affect blood glucose control7,8. The beneficial effect of low calorie sweeteners in post-prandial glucose is recognised also in a health claim authorised in Europe, further to the scientific opinion by the European Food Safety Authority (EFSA)6: “Consumption of foods with low calorie sweeteners instead of sugar induces a lower blood glucose rise after their consumption compared to sugar-containing foods”.

As also widely recognised by the scientific community, it is critical to look at the entire body of evidence when considering new studies and the results of this type of studies must not supersede the findings of well-designed, controlled human intervention studies. Based on the wealth of well-designed research, all approved low calorie sweeteners, including aspartame and acesulfame potassium, can help lower calorie and sugar intake and have no impact on blood glucose levels. Low calorie sweeteners are also non-fermentable by oral bacteria and thus non-cariogenic and tooth-friendly ingredients.6

  1. Brian Hoffmann, George Ronan, Dhanush Haspula, ‘The Influence of Sugar and Artificial Sweeteners on Vascular Health during the Onset and Progression of Diabetes’ (abstract),
  2. Peters, J. C., & Beck, J. Low Calorie Sweetener (LCS) use and energy balance. Physiology & behavior, 2016; 164: 524-528
  3. Rogers PJ. et al. Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies. Int J Obes, 2016; 40(3): 381-94.
  4. Miller, P. E., & Perez, V. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. Am J Clin Nutr 2014; 100(3): 765-777
  5. Tucker, R. M., & Tan, S. Y.. Do non-nutritive sweeteners influence acute glucose homeostasis in humans? A systematic review. Physiol Behav 2017; 182: 17-26
  6. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9: 2229
  7. American Diabetes Association (ADA). 4. Lifestyle management: Standards of Medical Care in Diabetes – 2018. Diabetes Care 2018; 41(Suppl 1): S38-S50
  8. Dyson, P. A., Twenefour, D., Breen, C., Duncan, A., Elvin, E., Goff, L., . . . Watson, K.. Diabetes UK evidence-based nutrition guidelines for the prevention and management of diabetes (2018). Diabet Med. 2018 May;35(5):541-547.