Not-so-healthy sugar substitutes?

- Artificially-sweetened beverages are linked to increased risk for negative health outcomes in clinical cohorts.
- Little scientific evidence supports a role for diet soft drinks in reducing risk of overweight or obesity.
- Multiple biologically plausible mechanisms have been supported by experimental models in pre-clinical studies.
- Reduced intake of beverages sweetened with sugar or sugar-substitutes may improve public health outcomes.

Replacing sugar-sweetened beverages with diet soft drinks containing sugar substitutes that provide few or no calories has been suggested as one strategy for promoting improved public health outcomes. However, current scientific evidence indicates that routine consumption of beverages with non-nutritive sweeteners not only fails to prevent disease, but is associated with increases in risks for the same health outcomes associated with sugar-sweetened beverages, including type 2 diabetes, cardiovascular disease, hypertension and stroke. Results from pre-clinical studies have provided plausible biological mechanisms that could promote these counterintuitive negative health effects of artificial sweeteners. Taken together, scientific studies currently indicate that public health will be improved by reducing intake of all sweeteners, both caloric and non-caloric.