Studies have shown that the body’s response to sugary food starts even before it enters the body, with the brain firing on all cylinders to excite the reward circuit and produce dopamine, a neurotransmitter that regulates pleasure and reward. Recently, non-nutritive sweeteners (NNSs) have become more ubiquitous, as more food products have replaced sugar with this calorie-free option. 

These days, nearly everyone knows why sugar – in particular, added sugars – is bad for the health. It increases the risk of dying because of heart disease, is associated with higher rates of periodontal disease, and may put an infant at a higher risk of allergy and asthma.

Researchers from the University of Pécs in Hungary, the University of Freiburg in Germany, and Paris Descartes University collected all relevant data on the health effects of NNS consumption. For a study to be included in the review, specific factors had to be met: It had to be a study on humans, it had to be either an intervention or exposure to artificial sweeteners or NNSs, it reported health outcomes, and it had no restrictions in study design or language.

To get data, the team scoured multiple electronic databases for pertinent data over a period of three years. Sites included Ovid MEDLINE, Embase, and Cochrane Library’s CENTRAL database. After collecting the studies, these were then sifted and grouped depending on the nature of the research.

The scoping review yielded 372 studies, of which 15 were systematic reviews, 155 randomized controlled trials (RCTs), 23 non-randomized controlled trials, 57 cohort studies, 52 case-control studies, 28 cross-sectional studies, and 42 case series (including case reports).

The results of the analysis were divided between short-term and long-term outcomes, with the research team recording both positive and negative effects of artificial sweeteners and NNSs. Based on the studies reviewed, NNSs have no significant impact on a person’s appetite and short-term intake.

Long-term outcomes, however, had differing results. In particular, studies that evaluated the link between artificial sweeteners and bladder cancer and urinary tract cancer show 11 case-control studies that positively link the two factors and 20 that report no association. The authors proffered that a systematic review may potentially bring conclusive results

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