Background: 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.
Methods: 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 and coronary heart disease have been observed in 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.
Funding: Coca-cola Australia