No plausible link between low/no calorie sweeteners and depression

ISA statement in response to new observational study by Samuthpongtorn et al.

Brussels, 20th September 2023: Following the publication of a new study by Samuthpongtorn et al.1 the International Sweeteners Association (ISA) is concerned that this observational study will confuse consumers, as there is no plausible mechanism to support the link between low/no calorie sweeteners and clinical depression in humans. In fact, human studies conducted to-date show that low/no calorie sweeteners have no impact on mood and overall mental health.2

This study did not examine most factors that contribute to experiencing depression including stressful or traumatic events in life including during childhood, or other mental health conditions such as anxiety, poor physical health, family history of depression, and side effects of several medicines, among others. It is also important to understand that this is an observational study which, by design, cannot establish a cause-and-effect relationship.

We also know that people living with obesity or diabetes, conditions that can be associated with increased risk of depression, may use low/no calorie sweeteners as a risk reduction strategy in their effort to limit their sugars intake.3 This is a common case of reverse causation which does not confirm an association.

Low/no calorie sweeteners are safe ingredients that play an important role in providing consumers choice with sweet-tasting options with low or no calories. As part of a balanced diet, low/no calorie sweeteners can be a useful tool to reduce sugar and calorie intake, as well as to manage blood glucose levels4 and reduce the risk of dental caries5.

  2. Rios-Leyvraz M, Montez J. Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.
  3. Drewnowski A, Rehm CD. The use of low-calorie sweeteners is associated with self-reported prior intent to lose weight in a representative sample of US adults. Nutr Diabetes. 2016 Mar 7;6(3):e202.
  4. Diabetes UK. The use of low or no calorie sweeteners. Position Statement (Updated December 2018). Available at:
  5. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9(6): 2229, and 9(4): 2076