Sugar sweetened beverages have been associated with obesity, type 2 diabetes and CVD. In Australia nearly 40% of soft drinks contain non nutritive sweeteners (NNS) but in the USA there have been concerns over the safety of non nutritive sweeteners.
Aims: to review the recent literature on NNS from June 2010 to November 2013. The following key words were used in Pubmed : Non-nutritive sweeteners, Artificial sweeteners, Aspartame, AcesulphameK, Acesulphame Potassium, Stevia, Stevia rebaudiana, Stevioside, Rebaudioside A plus health and safety terms.
Results. 86 publications on health and safety were found. A 2013 EFSA review found aspartame was safe. The consumption of beverages containing NNS has been associated with weight gain in some prospective cohort studies but reverse causality is a possible explanation. The evidence on whether NNS can affect appetite or preference for sweet foods is very limited and no firm conclusions can be drawn. The replacement of sugar-sweetened beverages with drinks containing NNS is a useful adjunctive strategy for weight management but long term studies are limited. Aspartame, acesulphame K and stevia have no effect on blood glucose or insulin levels. The effects of NNS on cardiometabolic risk are unclear. Although associations between the consumption of non-nutritive sweeteners and the risk for type 2 diabetes, the metabolic syndrome, hypertension, stroke and coronary heart disease have been observed in several prospective cohort studies, potential mechanisms are lacking and reverse causality is possible. Limited evidence suggests that the replacement of sugar-sweetened beverages with drinks sweetened with NNS may lower risk for dental caries.
Dr Flavia Fayet-Moore was funded by Coca Cola Australia to perform the review