Diabetes Care: Diabetes Journal: July, 2023

Dietary sugars are associated with various health issues, including overweight, obesity, cardiovascular diseases (CVDs), and type 2 diabetes (T2D).

Manufacturers have proposed alternatives to reduce added sugars, notably by substituting artificial sweeteners (e.g., aspartame, acesulfame potassium [K], and sucralose) for them. Health-conscious consumers might also shift to artificial sweeteners.

Those food additives have high sweetening power and low/zero calorie content. They are used in ultraprocessed foods (UPFs), such as artificially sweetened beverages (ASBs) or table-top sweeteners directly added by consumers. 

The World Health Organization (WHO) recently published a systematic review and meta-analysis of artificial sweeteners-health relationships, based on randomized controlled trials (RCT), prospective, and case-control studies. They suggested associations with obesity, CVD, and mortality and identified positive associations with T2D

Given the obesity and diabetes epidemic, there is a growing use of artificial sweeteners in ultra-processed foods.

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In the present study, the authors evaluated the associations between artificial sweeteners, more specifically aspartame, acesulfame K, and sucralose, and type 2 diabetes risk.

With a robust sample of 105,588 participants, the results showed that, compared with nonconsumers, consumers of higher amounts of artificial sweeteners had a higher type 2 diabetes risk, more so with aspartame and acesulfame K than with sucralose.

The results of this study provide a new piece of evidence that complements recent mounting scientific literature regarding the potential adverse effects associated with artificial sweeteners on chronic disease and can add a layer of discussion with patients.

Altogether, this suggests that artificial sweeteners should not be recommended for a massive consumption as safe alternatives to sugar and that an overall reduction of sugary taste in occidental diets should rather be targeted.