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The Artificial Sweetener Paradox: Weight Gain and Metabolic Dysfunction?

The Artificial Sweetener Paradox: Weight Gain and Metabolic Dysfunction?

  • The Artificial Sweetener Paradox: Weight Gain & Cardiometabolic Dysfunction

  • Meta-analysis: 37 Studies of Artificial Sweeteners

  • Randomized Controlled Trials: Evidence Limited, Benefits not Supported

  • Cohort Studies: Increased BMI, T2D, CV Events

  • Study Limitations

  • Comments from the Authors

  • Take-home Points

The Academy of Nutrition and Dietetics' current position on nonnutritive sweeteners is that they may help limit inatke of energy in an effort to manage weight or blood glucose. The consumption of artificial sweeteners, including aspartame, sucralose, and stevia, however, has been associated with both weight gain and incident obesity. 

Existing evidence, from both randomized controlled trials and observational studies, is conflicting.

The objective of the meta-analysis summarized in the short slide show above was to determine whether "routine consumption of nonnutritive sweeteners by adults and adolescents [is] associated with adverse long-term cardiometabolic effects in RCTs and prospective cohort studies."


1. Swithers SE. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends Endocrinol Metab. 2013;24:431–41.

2. Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016; 164(Pt B):488–93

3. Azad MB, Abou-Setta AM, Chauhan BF, et al. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies. CMAJ. 2017;189:E929-E939. doi: 10.1503/cmaj.161390.


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Jack @

Given the outcomes, then the statement that "the opposite effect" ensued is very incorrect.

Sandy @

If a purpose of this meta-analysis was partly to discover whether metabolic effects could be the result measured as a result of non-nutritive sugar substitute intake over time, it's discouraging to read that there were not outcome data? Why?

Sandy @

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