Sweeteners: majority of studies confirm no adverse health effects – however, the study situation is insufficient

Note: the original source of this report is the BfR website – see BfR Opinion No 004/2023 issued 07 February 2023

The German Federal Institute for Risk Assessment (BfR) has assessed whether the in-creased use of sweeteners poses a health risk to the population. For this purpose, the insti-tute evaluated data on the five most commonly used non-nutritive sweeteners – sucralose, acesulfame K, saccharin, aspartame and cyclamate.

Studies on the influence of these substances on body weight show that their intake instead of sugar, as part of a weight-loss programme with a sub-caloric diet and behavioural interven-tion measures, can lead to or support weight loss. However, the available data do not allow a statement as to whether the intake of non-nutritive sweeteners or the consumption of diet drinks has an effect on body weight if no accompanying weight-loss programme is followed.

From the BfR’s point of view, and based on the evaluation of the available studies, no clear statement can be made as to whether the consumption of beverages containing sweeteners increases the risk of certain neurodegenerative diseases or influences the gut flora to a clini-cally significant extent. In the majority of studies, no negative metabolic effect of the non-nu-tritive sweeteners under consideration (on blood glucose, insulin secretion or insulin sensitiv-ity) was observed. Also, according to the current state of knowledge, it is not clear whether risk groups such as children, pregnant women or people with certain pre-existing conditions or diseases would be affected to a higher degree by any potential negative effects of sweeteners.

The BfR is of the opinion that the current data situation on the health effects of non-nutritive sweeteners is not sufficient to carry out a conclusive health risk assessment. The available epidemiological studies only consider the exposure to non-nutritive sweeteners from diet drinks. However, the actual exposure could be much higher as individual non-nutritive sweet-eners as well as combinations of different non-nutritive sweeteners are also used in pro-cessed foods and cosmetics (e.g. toothpastes). Since studies to date have primarily focused on single individual non-nutritive sweeteners, there is also a need for research on the health effects of combinations of non-nutritive sweeteners.

In addition, there are some special features for individual sweeteners that have to be taken into account in the health assessment. For example, current data indicate that heating of su-cralose may lead to the formation of potentially harmful and partly carcinogenic compounds. The BfR recommends to give special consideration to this aspect in the re-evaluation of su-cralose as a food additive.