Are artificial sweeteners safe?

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1. 1

   Lack of Genotoxic and Carcinogenic Potential for Nonsugar Sweeteners: A Review of Animal and Mechanistic Evidence.

   Advances in nutrition (Bethesda, Md.) (Marchitti et al.)Published Nov 4, 2025Checked Oct 4, 2026

   “For this evaluation, we focused on genotoxicity, other potential cancer modes of action (MoAs), and carcinogenicity. Overall, high-quality studies have not shown evidence for carcinogenicity in animal models, except for saccharin, which causes bladder tumors in rats via a mechanism not relevant to humans. There is also no consistent or compelling evidence for any biologically plausible MoA by which any of these NSSs could cause cancer in humans. The results of this evaluation are consistent with the results of epidemiology studies, which have shown no consistent associations between NSS intake and cancer risk. Taken together, the body of available evidence supports previous conclusions by authoritative and regulatory bodies that Ace-K, advantame, aspartame, cyclamate, neotame, saccharin, steviol glycosides, and sucralose do not pose a genotoxic or carcinogenic risk to humans.”

2. 2

   The longitudinal association between artificial sweetener intake and the risk of type 2 diabetes among adults aged 18 years and older: a systematic review and meta-analysis.

   Frontiers in nutrition (Lu et al.)Published Aug 11, 2026Checked Oct 4, 2026

   “Publication bias was evaluated by inspection of funnel plots and Egger's regression test.ResultsA total of six cohort studies including 721,003 participants were analyzed in this meta-analysis. Compared with those with low or no consumption of artificial sweeteners, participants with higher artificial sweetener intake were more likely to develop T2D (pooled HR = 1.31, 95% CI = 1.16-1.49). Substantial heterogeneity was observed across studies (I 2 = 86.02%), while the overall estimate remained stable in sensitivity analysis. No significant publication bias was observed among the studies included in this meta-analysis.ConclusionA longitudinal association was observed between artificial sweetener intake and the risk of developing T2D among adults. This study has important public health implications. The findings of this study highlight that artificial sweeteners may not be a completely risk-free alternative to sugar in dietary interventions aimed at reducing high-energy sugar intake and suggest that their potential adverse metabolic effects should be considered in public health policy-making and clinical dietary recommendations regarding artificial sweetener intake.”

3. 3

   Artificial sweeteners and risk of cardiometabolic outcomes and mortality: a systematic review and meta-analysis.

   Nutrition research and practice (Kim et al.)Published May 19, 2026Checked Oct 4, 2026

   “The methodological quality of the included studies was evaluated using the Newcastle-Ottawa Scale.ResultsIn total, 3,625,613 participants from 37 studies were included. Higher artificial sweetener intake was associated with an increased risk of type 2 diabetes (HR, 1.26; 95% CI, 1.14-1.40), hypertension (HR, 1.13; 95% CI, 1.09-1.18), heart failure (HR, 1.26; 95% CI, 1.14-1.39), stroke (HR, 1.12; 95% CI, 1.05-1.19), coronary artery disease (HR, 1.11; 95% CI, 1.00-1.23), cardiovascular mortality (HR, 1.18; 95% CI, 1.03-1.35), and all-cause mortality (HR, 1.09; 95% CI, 1.01-1.17). The association with atrial fibrillation was not significant (HR, 1.13; 95% CI, 0.94-1.37). Significant heterogeneity was observed for all endpoints except for stroke and heart failure.ConclusionsThis meta-analysis demonstrates that a higher intake of artificial sweeteners is associated with an increased risk of several cardiometabolic outcomes and mortality. These findings underscore the need for cautious consumption and further research into their cardiometabolic effects.Trial registrationInternational Prospective Registration of Systematic Reviews (PROSPERO) Identifier: CRD420251020488.”

4. 4

   Sugar substitute (Wikipedia)

   WikipediaPublished Oct 4, 2026Checked Oct 4, 2026

   “A sugar substitute or artificial sweetener is a food additive that provides a sweetness like that of sugar while containing significantly less food energy than sugar-based sweeteners, making it a zero-calorie (non-nutritive) or low-calorie sweetener. Artificial sweeteners may be derived from plant extracts or processed by chemical synthesis. Sugar substitute products are commercially available in various forms, such as small pills, powders and packets. Common sugar substitutes include aspartame, monk fruit extract, saccharin, sucralose, stevia, acesulfame potassium (ace-K) and cyclamate. These sweeteners are a fundamental ingredient in diet drinks to sweeten them without adding calories. Additionally, sugar alcohols such as erythritol, xylitol and sorbitol are derived from sugars. No links have been found between approved artificial sweeteners and cancer in humans. Reviews and dietetic professionals have concluded that moderate use of non-nutritive sweeteners as a relatively safe replacement for sugars that can help limit energy intake and assist with managing blood glucose and body weight.”

5. 5

   The Safety Profile of Aspartame: A Review of Regulatory Standards and Emerging Health Concerns.

   Journal of nutrition and metabolism (Öncel & Sökmen)Published Apr 21, 2026Checked Oct 4, 2026

   “We evaluated the chemical structure, metabolic processes, and potential health effects of aspartame in light of scientific studies. Studies in various health areas, such as cancer risk assessment, effects on the nervous system and cardiovascular system, and its role in metabolic disorders, have led to various debates about the safety of aspartame for human health. While aspartame's low-calorie structure provides an advantage for metabolic diseases such as obesity and diabetes, its potential effects on insulin sensitivity and gut microbiota have led to different conclusions. In light of the adverse effects of the phenylalanine amino acid in the structure of aspartame on brain development, we have tried to emphasize that consumption levels should be more closely monitored in special risk groups such as phenylketonuria (PKU) patients, children, pregnant women, and the elderly. The widespread use of aspartame in the food industry has led to the view that this structure is safe when consumed as a sweetener at acceptable daily intake levels. This review seeks to answer, "Is it a safe additive for human health when individual sensitivities and long-term effects are considered?".”

6. 6

   Synthetic Sweeteners and Human Health: An Overview of Health Risks, Vulnerable Populations, and Effects on Key Biological Systems.

   Medicina (Kaunas, Lithuania) (Ivanova et al.)Published Jun 11, 2026Checked Oct 4, 2026

   “While considered safe, artificial sweeteners are linked to potential influence on hormonal responses, affecting glucose homeostasis and insulin secretion, as well as effects on gut microbiota composition and glucose metabolism. However, the results reveal inconsistencies of the impact of artificial sweeteners on vulnerable populations, as well as their effects on the human gut microbiota, neurological behavior and endocrine effects and evidence remain limited. Continuous human trials, post-market surveillance and regulatory evaluations are therefore essential to ensure the safety of sugar substitutes for consumers' health.”

7. 7

   Consumption of non-sugar sweeteners by Brazilian adolescents and adults in 2017-2018: Socioeconomic distribution and food sources.

   PloS one (Lage et al.)Published Nov 17, 2025Checked Oct 4, 2026

   “Prevalence estimates were stratified by sex, age group (adolescents ≥10 to <18 years, adults 18 to <60 years, and elderly ≥60 years), and income quintiles. Additionally, food sources, types of sweeteners, and patterns of concurrent sweetener consumption were evaluated. Overall, 20.6% of Brazilians consumed non-sugar sweeteners. Prevalence was higher prevalence among women (22.7%), older adultes (27.0%), adolescents (24.4%), and individual in the highest income quintile (30.7%). Tabletop sweeteners were the main source (38.2%), followed by artificially sweetened beverages, including juices (25.3%), and yogurts or dairy drinks (25.1%). Most individuals consumed a combination of sweeteners, primarily acesulfame K, sucralose, and aspartame. Non-sugar sweeteners are widely consumed in Brazil, particularly among specific demographic groups, with tabletop sweeteners and sweetened beverages as the main sources. These findings provide essential insights to guide public health policies and regulatory discussions.”