Toews I, Lohner S, de Gaudry D, Sommer H, Meerpohl J. BMJ 2019; 364: 10.1136/bmj.k4718.

Foods containing non-sugar sweeteners (NSS) are gaining popularity. However, the evidence for the health benefits of NSS is conflicting with some studies showing reduced risk of type 2 diabetes and obesity but others showing an increased risk of weight gain and cancer. NSS are usually synthetic, sweeter, and contain fewer (or no) calories than sucrose. Each NSS is metabolised differently in the body. Current evidence suggests that many (but not all) sweeteners are safe to use in food preparation at or below recommended levels of daily intake.

For health outcomes including body weight management, diabetes, eating behaviour, cancer and blood pressure, this comprehensive systematic review found there to be no difference between NSS intake versus no intake or between different doses of NSS. There was no evidence of health benefits. However, potential harms could not be excluded. In all cases, the quality of evidence ranged from very low to moderate.