Intestinal Nutrient Sensing Group & Centre of Research Excellence in Translating Nutritional Science to Good Health, Adelaide Medical School, The University of Adelaide, South Australia
Nutrition, Diabetes & Gut Health Program, Lifelong Health, South Australian Health & Medical Research Institute
Habitual high intake of added sugars is known to increase the risk of developing type 2 diabetes (T2D) and obesity and a driver of global health policy to limit sugar consumption (i.e., sugar taxes). The corresponding increase in pervasiveness and intake of non-nutritive sweeteners (NNS) in beverages and foods has been rapid. The promise of sweetness without calories offered by acesulfame-potassium (E-number 950), aspartame (E951), saccharin (E954), sucralose (E955) and steviol glycosides (E960) was expected to be beneficial, particularly for people with T2D and/or obesity. The evidence base for health benefits of NNS is, however, equivocal, and large epidemiological studies have shown that habitual high intake (in beverages) increases the risk of developing T2D to a similar, or greater, degree to that for the equivalent intake of sugar. Moreover, this risk is independent of total energy consumed or body mass index, and occurs in normal-weight subjects, making reverse causality an inadequate explanation.
This overview will discuss the forms of NNS, their discovery, differences in metabolic fate and quality of evidence for their impact on health.