Sucralose does not increase appetite

ISA statement in response to study by Yunker et al.

Brussels, 28th September 2021: The International Sweeteners Association (ISA) responds to a study by Yunker et al. on sucralose and appetite,1 pointing to the wealth of robust scientific evidence which confirms that low/no calorie sweeteners, including sucralose, does not affect appetite nor increases food cravings.

Actually, the results of the study by Yunker et al. regarding energy (calorie) intake do not support the conclusions outlined by the authors, including in a related press release, suggesting a link between the consumption by female individuals with obesity of drinks sweetened with low/no calorie sweeteners and enhanced feeling of hunger possibly leading to increased calorie intake. In fact, participants with obesity did not eat more at the ad libitum meal after the sucralose vs the sugar drink consumption. This was indicated by a lack of statistically significant difference by BMI status in total calorie intake between the two groups. Overall, neither male nor female participants fully compensated for the 300kcal sucrose preload after the sucralose drink ingestion compared with the sucrose drink condition.

Interestingly, an earlier study of the same research group (as Yunker et al.) reached the opposite conclusion, suggesting that: “Although the relationship between these observed acute effects and the effects of regular sucralose consumption are not clear, it is possible that acute effects could result in decreased energy intake over time”.2

The results of this acute, short-term study by Yunker et al. are also in total contrast with the findings of a longer-term clinical trial in 123 people with overweight and obesity which showed that sucralose consumption led to decreased food intake frequency, lower energy intake and weight loss after a 3-month period.3

Importantly, the collective evidence from acute and long-term clinical studies does not support the claims from the study by Yunker et al. On the contrary, the results from randomised controlled trials (RCTs), the gold standard in nutrition research, consistently show that the consumption of low/no calorie sweeteners, including sucralose, actually leads to lower short-term calorie intake when consumed in place of sugar.4,5,6,7 These calorie savings are important, as shown in a recent systematic review and meta-analysis of 35 RCTs, which found that the total energy intake was significantly lower by approximately 130 calories with low/no calorie sweeteners compared to sugar.6

Furthermore, thorough systematic reviews and meta-analyses of RCTs examining the effect of low/no calorie sweeteners on body weight show that replacing sugar with low/no calorie sweeteners leads to moderate yet significant weight reduction.7,8 In fact, this beneficial effect of low/no calorie sweeteners was found to be more evident in people with overweight/obesity,5,8 contrary to the claims from Yunker et al.

At a time when obesity and non-communicable diseases including diabetes and dental diseases remain major global health challenges, and in light of current public health recommendations to reduce overall sugar intake, low/no calorie sweeteners can be helpful in creating healthier food environments. They provide 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.9 Low/no calorie sweeteners are also not fermentable by oral bacteria, which means that they do not contribute to tooth demineralisation, which is one of the reasons for tooth decay.9

  1. Yunker AG, Alves JM, Luo S, et al. Obesity and sex-related associations with differential effects of sucralose vs sucrose on appetite and reward processing: a randomized crossover trial. JAMA Netw Open. 2021;4(9):e2126313. doi:10.1001/jamanetworkopen.2021.26313
  2. Zhang X, Luo S, Jones S, Hsu E, Page KA, Monterosso JR. Impacts of Acute Sucralose and Glucose on Brain Activity during Food Decisions in Humans. Nutrients. 2020; 12(11):3283.
  3. Higgins KA and Mattes RD. A randomized controlled trial contrasting the effects of 4 low-calorie sweeteners and sucrose on body weight in adults with overweight or obesity. Am J Clin Nutr 2019;109(5):1288-1301
  4. Rogers PJ, Hogenkamp PS, de Graaf C, 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 (Lond) 2016; 40: 381-94
  5. Toews I, Lohner S, de Gaudry DK, Sommer J, Meerpohl JJ. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. BMJ 2019;363: k4718
  6. Lee HY, Jack M, Poon T, Noori D, Venditti C, Hamamji S, Musa-Veloso K. Effects of Unsweetened Preloads and Preloads Sweetened with Caloric or Low-/No-Calorie Sweeteners on Subsequent Energy Intakes: A Systematic Review and Meta-Analysis of Controlled Human Intervention Studies. Adv Nutr 2021;12(4):1481-1499
  7. Rogers PJ and Appleton KM. The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies. Int J Obes 2021;45(3):464-478
  8. Laviada-Molina H, Molina-Segui F, Pérez-Gaxiola G, et al. Effects of nonnutritive sweeteners on body weight and BMI in diverse clinical contexts: Systematic review and meta-analysis. Obes Rev 2020; 21(7):e13020.
  9. EFSA Scientific opinion on the substantiation of health claims related to intense sweeteners. EFSA 2011 Journal 9(6): 2229, and 9(4): 2076 and Commission Regulation 432/2012/EU (OJ L 136 25.5.2012, p. 1):