Review Article | Published:

Carbohydrates, glycemic index and diabetes mellitus

Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials

European Journal of Clinical Nutritionvolume 72pages796804 (2018) | Download Citation

Abstract

Background/objectives

Nonnutritive sweeteners (NNSs) are zero- or low-calorie alternatives to nutritive sweeteners, such as table sugars. A systematic review and meta-analysis of randomized controlled trials was conducted to quantitatively synthesize existing scientific evidence on the glycemic impact of NNSs.

Subjects/methods

PubMed and Web of Science databases were searched. Two authors screened the titles and abstracts of candidate publications. The third author was consulted to resolve discrepancies. Twenty-nine randomized controlled trials, with a total of 741 participants, were included and their quality assessed. NNSs under examination included aspartame, saccharin, steviosides, and sucralose. The review followed the PRISMA guidelines.

Results

Meta-analysis was performed to estimate and track the trajectory of blood glucose concentrations over time after NNS consumption, and to test differential effects by type of NNS and participants’ age, weight, and disease status. In comparison with the baseline, NNS consumption was not found to increase blood glucose level, and its concentration gradually declined over the course of observation following NNS consumption. The glycemic impact of NNS consumption did not differ by type of NNS but to some extent varied by participants’ age, body weight, and diabetic status.

Conclusions

NNS consumption was not found to elevate blood glucose level. Future studies are warranted to assess the health implications of frequent and chronic NNS consumption and elucidate the underlying biological mechanisms.

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Author notes

  1. These authors contributed equally: Alexander D. Nichol, Maxwell J. Holle.

Affiliations

  1. Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA

    • Alexander D. Nichol
    •  & Maxwell J. Holle
  2. Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA

    • Ruopeng An

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Alexander D. Nichol.

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DOI

https://doi.org/10.1038/s41430-018-0170-6