Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association

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Author(s): Gardner C, Wylie-Rosett J, Gidding SS, Steffen LM, Johnson RK, Reader D and Lichtenstein AH
Publication name: Diabetes care. 2012; 35(8): 1798-808
Publication year: 2012


Limiting added sugars is an important strategy for supporting optimal nutrition and healthy weights, as concluded in the 2009 American Heart Association scientific statement “Dietary Sugars Intake and Cardiovascular Health.” Monitoring carbohydrate intake, which includes limiting added sugars, is also a key strategy to achieve glycemic control as published in the American Diabetes Association clinical practice recommendations.

With regard to low calorie sweeteners and glycemic response, 4 randomized trials that varied from 1 to 16 weeks in duration found no significant difference between the effects of LCS and various comparisons (sucrose, starch, or placebo) on standard measures of glycemic response (ie, plasma glucose and insulin, HbA1c, C-peptide) and, in general, did not detect clinically relevant effects. Furthermore, there are some data to suggest that low calorie sweeteners may be used in a structured diet to replace sources of added sugars and that this substitution may result in modest energy intake reductions and weight loss. Successful reduction in energy intake requires that there is incomplete compensation of energy reduction from the use of LCS-containing beverages and/or foods.

The evidence reviewed suggests that when used judiciously, low calorie sweeteners could facilitate reductions in added sugars intake, thereby resulting in decreased total energy and weight loss/weight control, and promoting beneficial effects on related metabolic parameters. However, these potential benefits will not be fully realized if there is a compensatory increase in energy intake from other sources.

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