Table of ContentsView AllTable of ContentsBenefitsRisksWho Shouldn’t UseTypes and Brands

Table of ContentsView All

View All

Table of Contents

Benefits

Risks

Who Shouldn’t Use

Types and Brands

Artificial sweeteners are a type of processed food additive made from chemicals in a lab.Also called nonnutritive sweeteners and sugar substitutes, artificial sweeteners offer a solution for people who have a sweet tooth and don’t want the excess calories ofrefined sugar. But are artificial sweeteners bad for you?

This article covers the types of artificial sweeteners, what research shows about these risks, and the benefits of using sugar substitutes in place of sugar.

Sharon Pruitt / EyeEm / Getty Images

Close-Up Of Sugar And Sweetener Packets In Container At Cafe

Good News About Artificial Sweeteners

Artificial sweeteners are marketed as the perfect “sugar-free” solution for people who like sweetened foods and beverages, but want to avoid the risks that come with consuming too much sugar.

There are six FDA-approved artificial sweeteners, ordered here from most to least sweet:

In order for these artificial sweeteners to receive FDA approval, the FDA reviewed numerous safety studies to identify possible health harms. The FDA’s reviews concluded that all six artificial sweeteners are safe for human consumption.

Uses

Artificial sweeteners can be found in myriad food and beverage products, including:

Artificial sweeteners can also be found in:

Generally speaking, if you see a food or beverage product that is labeled “sugar-free,” “diet,” or “low-calorie,” the product likely contains some kind of sugar substitute.

Health Benefits

Artificial sweeteners are marketed as having several benefits, including:

Artificial sweeteners have their pros and cons. But, some researchers assert that the benefits of artificial sweeteners are short-term, and may not outweigh the long-term risks.

How Are Artificial Sweeteners Made?

Bad News About Artificial Sweeteners

Artificial sweeteners are made from chemicals in a lab. Although the FDA considers them safe, a large body of independent research shows that long-term, regular use of artificial sweeteners poses serious health hazards.

Cancer Risk

The risk of cancer associated with artificial sweeteners has been evaluated in a variety of studies—some in animals, and some in humans. The results of these studies are inconsistent.

According to a study published in 2022, the consumption of artificially sweetened beverages is linked to an increased risk ofkidney cancerin postmenopausal women.However, a similar study conducted on a more diverse group of healthy adults found no link between artificial sweeteners and kidney cancer at all.

Another study conducted in France found that people who consume the highest amounts of artificial sweeteners, especially aspartame and acesulfame potassium, have the highest risk of developing cancer.

Obesity is linked to at least 13 types of cancer, including kidney, ovarian, liver, and colorectal cancers.According to the French study, the risk ofobesity-related cancersis slightly higher in people who consume artificial sweeteners compared to those who don’t.

But, a similar study out of Australia found no link between artificial sweeteners and obesity-related cancers.As such, more research is needed to clarify what link, if any, exists between cancers and artificial sweeteners.

The International Agency for Research on Cancer (IARC) classifies aspartame as a Group 2B carcinogen (cancer-causing agent). The agency cites “limited evidence” that aspartame is possibly carcinogenic in humans. However, the World Health Organization reaffirms that aspartame is safe to consume in quantities of up to 40 mg/kg of body weight per day.

Does Splenda Cause Cancer?

Digestive Issues

Thegut microbiomeconsists of healthy and potentially unhealthy microbes that flourish throughout the digestive tract. It is critical for human health, as it plays a key role in:

Ahealthy, balanced gut microbiomeis also essential for digestion. An imbalanced gut microbiome (dysbiosis) can lead to a number of digestive problems, such asinflammatory bowel disease.

Since the 1980s, studies have reported clear associations between artificial sweetener consumption and changes in the gut microbiome.Only a few small studies have examined these changes in humans.

For one of them, seven people between the ages of 28 to 36 were given 5 milligrams (mg) of saccharin for one week. Compared to people who did not consume saccharin, those who did had altered intestinal microbiota and poorer glucose (blood sugar) tolerance.

One possible theory is that artificial sweeteners weaken healthy gut microbiota, making it easier for unhealthy microbiota to flourish. But, again, more research is needed.

Best and Worst Foods for Gut Health

Weight Gain

In 2023, the World Health Organization (WHO) warned against using artificial sweeteners to control body weight. The warning was issued after a review of studies showed that artificial sweeteners do not help with weight control in the long term.

Another study released in 2023 found clear evidence that habitual, long-term consumption of aspartame, saccharin, and diet beverages increases body fat, regardless of how much a person eats or the quality of their diet.

Healthy Weight and BMI Range for Older Adults

Overconsumption of artificial sweeteners has been linked to excessive weight gain and health complications liketype 2 diabetes.

Furthermore, regular use of artificial sweeteners heightens your chances of developingmetabolic syndrome, a cluster of conditions that increase the risk of type 2 diabetes.

Metabolic syndrome is diagnosed when someone has three or more of the following risk factors:

While artificial sweeteners were designed to not cause blood sugar spikes, there is mounting evidence that they directly increase insulin resistance, which makes it harder for the body to control blood sugar levels.

Headache Trigger

Does Sugar Consumption Cause Headaches?

Mood and Emotional Disorders

Aspartame has been linked to numerous behavioral cognitive problems, including anxiety, irritable moods, depression, andinsomnia. It’s thought that aspartame elevatescortisol(a stress hormone) levels, which make the brain vulnerable to inflammation.

Researchers warn that people should limit their intake of artificial sweeteners, especially if they have preexisting depression or other mental health conditions.

Reproductive Problems

Consumption of artificial sweeteners during pregnancy is associated with an increased risk ofpreterm birthand increased weight at birth and later in life.

Artificial sweeteners are also associated with a risk ofearly menstruation(before age 11). The increased risk has been seen in girls who consume one or more artificially-sweetened soft drinks per day.

Does Consuming Artificial Sweeteners During Pregnancy Cause Autism?According to a 2023 published in the journalNutrients, the incidence ofautismis three times higher in boys, but not in girls, whose mothers consumed aspartame daily during pregnancy or breastfeeding.More research is needed to determine if other sweeteners carry this same risk.

Does Consuming Artificial Sweeteners During Pregnancy Cause Autism?

According to a 2023 published in the journalNutrients, the incidence ofautismis three times higher in boys, but not in girls, whose mothers consumed aspartame daily during pregnancy or breastfeeding.More research is needed to determine if other sweeteners carry this same risk.

Who Should Avoid Artificial Sweeteners

Aspartame contains an amino acid called phenylalanine. High levels of phenylalanine in body fluids can cause brain damage. Most people’s bodies break down phenylalanine without problems, but some people can’t.

Therefore, certain people should avoid aspartame completely, including people with the genetic diseasephenylketonuria(PKU), advanced liver disease, and pregnant people withhyperphenylalanine(high levels of phenylalanine in blood).

People who are pregnant should not use saccharin, as it contains a weakcarcinogenthat crosses the placenta.

If you have gestational diabetes, diabetes mellitus, or insulin resistance, talk to your healthcare provider about how much artificial sweetener is safe for you to use. If you have depression, insomnia, or a family history of cancer, ask your provider if you should avoid aspartame.

Ultimately, it is the responsibility of individuals to weigh the benefits and risks of artificial sweeteners carefully, and contact their healthcare providers with any questions that arise.

Types of Artificial Sweeteners

There are six FDA-approved artificial sweeteners:

Other categories of sugar substitutes that can be used instead of the artificial sweeteners above include:

Does Splenda Contain Chlorine?

Sucralose vs. Aspartame: Differences and Health Impacts

Summary

Despite being hundreds to thousands of times sweeter than table sugar, artificial sweeteners have few to no calories and do not cause blood sugar spikes. For this reason, they are pitched as the perfect solution for people with diabetes mellitus, as well as people who want to lose weight.

5 Best Sweeteners for People With Diabetes

38 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Facts about sugar and sugar substitutes.Harvard T.H. Chan School of Public Health.Low-calorie sweeteners.National Cancer Institute.Artificial sweeteners and cancer.U.S. Food and Drug Administration.Aspartame and other sweeteners in food.World Health Organization.WHO advises not to use non-sugar sweeteners for weight control in newly released guideline.Bruyère O, Ahmed S, Atlan C, et al.Review of the nutritional benefits and risks related to intense sweeteners.Arch Pub Health. 2015;73(41):1-10. doi:10.1186/s13690-015-0092-xGupta M.Sugar substitutes: mechanism, availability, current use and safety concerns-an update.Open Access Maced J Med Sci. 2018;6(10):1888-1894. doi:10.3889/oamjms.2018.336Sharma A, Amarnath S, Thulasimani M, Ramaswamy S.Artificial sweeteners as a sugar substitute: Are they really safe?.Indian J Pharmacol.2016;48(3):237-240. doi:10.4103/0253-7613.182888Harris E.WHO warns against artificial sugars for weight loss.JAMA. 2023 May;329(23):2011. doi:10.1001/jama.2023.9600Czarnecka K, Pilarz A, Rogut A, et al.Aspartame-true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021 Jun;13(6):1957. doi:10.3390/nu13061957Chakraborty R, Das A.Artificial sweeteners. In:Encyclopedia of Food Chemistry. 2019;1(1):30-34. doi:10.1016/B978-0-08-100596-5.21619-3Ringel N, Hovey K, Andrews C, et al.Association of artificially sweetened beverage consumption and urinary tract cancers in the Women’s Health Initiative Observational Study.Eur Urol Open Sci.2022 Dec;47(1):80-86. doi:10.1016/j.euros.2022.11.016Heath A, Clasen J, Jayanth N, et al.Soft drink and juice consumption and renal cell carcinoma incidence and mortality in the European Prospective Investigation into Cancer and Nutrition.Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1270-1274. doi:10.1158/1055-9965.EPI-20-1726Debras C, Chazelas E, Srour B, et al.Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study.PLoS Med. 2022 Mar;19(3):e1003950. doi:10.1371/journal.pmed.1003950National Cancer Institute.Obesity and cancer.Hodge A, Bassett J, Milne R, English D, Giles G.Consumption of sugar-sweetened and artificially sweetened soft drinks and risk of obesity-related cancers.Public Health Nutr. 2018 Jun;21(9):1618-1626. doi:10.1017/S1368980017002555World Health Organization.Aspartame hazard and risk assessment results released.Hou K, Wu ZX, Chen XY, et al.Microbiota in health and diseases.Sig Transduct Target Ther. 2022 Apr;7(1):135. doi:10.1038/s41392-022-00974-4Shan Y, Lee M, Chang E.The gut microbiome and inflammatory bowel disease.Annu Rev Med. 2022 Jan;73(1):455-468. doi:10.1146/annurev-med-042320-021020Harpaz D, Yeo LP, Cecchini F, et al.Measuring artificial sweeteners toxicity using a bioluminescent bacterial panel.Molecules. 2018 Sep;23(10):2454. doi:10.3390/molecules23102454Spencer M, Gupta A, Dam L, Shannon C, Menees S, Chey W.Artificial sweeteners: A systematic review and primer for gastroenterologists.J Neurogastroenterol Motil.2016 Apr;22(2):168-180. doi:10.5056/jnm15206Steffen B, Jacobs D, Yi SY, et al.Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study.Int J Obes. 2023 Jul;47(1):939–947. doi:10.1038/s41366-023-01336-ySanyaolu A, Marinkovic A, Gosse J, et al.Artificial sweeteners and their association with diabetes: a review.J Pub Health Catalog.2018;1(4):86-88.Liauchonak I, Qorri B, Dawoud F, Riat Y, Szewczuk M.Non-nutritive sweeteners and their implications on the development of metabolic syndrome.Nutrients. 2019 Mar;11(3):644. doi:10.3390/nu11030644American Heart Association.What is metabolic syndrome?.Mathur K, Agrawal R, Nagpure S, Deshpande D.Effect of artificial sweeteners on insulin resistance among type-2 diabetes mellitus patients.J Family Med Prim Care. 2020 Jan;9(1):69-71. doi:10.4103/jfmpc.jfmpc_329_19Samuthpongtorn C, Nguyen L, Okereke O, et al.Consumption of ultraprocessed food and risk of depression.JAMA. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770Choudhary A, Lee Y.Neurophysiological symptoms and aspartame: What is the connection?.Nutr Neurosci. 2018 Jun;21(5):306-316. doi:10.1080/1028415X.2017.1288340Chen YC, Yeh YC, Lin YF, et al.Aspartame consumption, mitochondrial disorder-induced impaired ovarian function, and infertility risk.Int J Mol Sci. 2022 Nov;23(21):12740. doi:10.3390/ijms232112740Concha F, Sambra V, Cáceres P, López-Arana S, Carvajal B, Gotteland M.Maternal consumption and perinatal exposure to non-nutritive sweeteners: Should we be concerned?.Front Pediatr. 2023 Jun;11(1):1-7. doi:10.3389/fped.2023.1200990Mueller N, Jacobs D, MacLehose R, et al.Consumptions of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche.Am J Clin Nutr. 2015 Sep;102(3):648-654. doi:10.3945/ajcn.114.100958Fowler S, Ruiz de Porras D, Swartz M, Granados P, Heilbrun L, Palmer R.Daily early-life exposures to diet soda and aspartame are associated with autism in males: A case-control study.Nutrients. 2024;16(5):675. doi:10.3390/nu15173772American Cancer Society.Aspartame and cancer risk.U.S. Department of Health and Human Services.Is aspartame safe?.Brigham and Women’s Hospital.Substances of concern during pregnancy.Food and Drug Administration.How sweet it is: all about sweeteners.Harvard Health Publishing.How healthy is sugar alcohol?McGill Office for Science and Society.Sweetener battles.

38 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Facts about sugar and sugar substitutes.Harvard T.H. Chan School of Public Health.Low-calorie sweeteners.National Cancer Institute.Artificial sweeteners and cancer.U.S. Food and Drug Administration.Aspartame and other sweeteners in food.World Health Organization.WHO advises not to use non-sugar sweeteners for weight control in newly released guideline.Bruyère O, Ahmed S, Atlan C, et al.Review of the nutritional benefits and risks related to intense sweeteners.Arch Pub Health. 2015;73(41):1-10. doi:10.1186/s13690-015-0092-xGupta M.Sugar substitutes: mechanism, availability, current use and safety concerns-an update.Open Access Maced J Med Sci. 2018;6(10):1888-1894. doi:10.3889/oamjms.2018.336Sharma A, Amarnath S, Thulasimani M, Ramaswamy S.Artificial sweeteners as a sugar substitute: Are they really safe?.Indian J Pharmacol.2016;48(3):237-240. doi:10.4103/0253-7613.182888Harris E.WHO warns against artificial sugars for weight loss.JAMA. 2023 May;329(23):2011. doi:10.1001/jama.2023.9600Czarnecka K, Pilarz A, Rogut A, et al.Aspartame-true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021 Jun;13(6):1957. doi:10.3390/nu13061957Chakraborty R, Das A.Artificial sweeteners. In:Encyclopedia of Food Chemistry. 2019;1(1):30-34. doi:10.1016/B978-0-08-100596-5.21619-3Ringel N, Hovey K, Andrews C, et al.Association of artificially sweetened beverage consumption and urinary tract cancers in the Women’s Health Initiative Observational Study.Eur Urol Open Sci.2022 Dec;47(1):80-86. doi:10.1016/j.euros.2022.11.016Heath A, Clasen J, Jayanth N, et al.Soft drink and juice consumption and renal cell carcinoma incidence and mortality in the European Prospective Investigation into Cancer and Nutrition.Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1270-1274. doi:10.1158/1055-9965.EPI-20-1726Debras C, Chazelas E, Srour B, et al.Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study.PLoS Med. 2022 Mar;19(3):e1003950. doi:10.1371/journal.pmed.1003950National Cancer Institute.Obesity and cancer.Hodge A, Bassett J, Milne R, English D, Giles G.Consumption of sugar-sweetened and artificially sweetened soft drinks and risk of obesity-related cancers.Public Health Nutr. 2018 Jun;21(9):1618-1626. doi:10.1017/S1368980017002555World Health Organization.Aspartame hazard and risk assessment results released.Hou K, Wu ZX, Chen XY, et al.Microbiota in health and diseases.Sig Transduct Target Ther. 2022 Apr;7(1):135. doi:10.1038/s41392-022-00974-4Shan Y, Lee M, Chang E.The gut microbiome and inflammatory bowel disease.Annu Rev Med. 2022 Jan;73(1):455-468. doi:10.1146/annurev-med-042320-021020Harpaz D, Yeo LP, Cecchini F, et al.Measuring artificial sweeteners toxicity using a bioluminescent bacterial panel.Molecules. 2018 Sep;23(10):2454. doi:10.3390/molecules23102454Spencer M, Gupta A, Dam L, Shannon C, Menees S, Chey W.Artificial sweeteners: A systematic review and primer for gastroenterologists.J Neurogastroenterol Motil.2016 Apr;22(2):168-180. doi:10.5056/jnm15206Steffen B, Jacobs D, Yi SY, et al.Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study.Int J Obes. 2023 Jul;47(1):939–947. doi:10.1038/s41366-023-01336-ySanyaolu A, Marinkovic A, Gosse J, et al.Artificial sweeteners and their association with diabetes: a review.J Pub Health Catalog.2018;1(4):86-88.Liauchonak I, Qorri B, Dawoud F, Riat Y, Szewczuk M.Non-nutritive sweeteners and their implications on the development of metabolic syndrome.Nutrients. 2019 Mar;11(3):644. doi:10.3390/nu11030644American Heart Association.What is metabolic syndrome?.Mathur K, Agrawal R, Nagpure S, Deshpande D.Effect of artificial sweeteners on insulin resistance among type-2 diabetes mellitus patients.J Family Med Prim Care. 2020 Jan;9(1):69-71. doi:10.4103/jfmpc.jfmpc_329_19Samuthpongtorn C, Nguyen L, Okereke O, et al.Consumption of ultraprocessed food and risk of depression.JAMA. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770Choudhary A, Lee Y.Neurophysiological symptoms and aspartame: What is the connection?.Nutr Neurosci. 2018 Jun;21(5):306-316. doi:10.1080/1028415X.2017.1288340Chen YC, Yeh YC, Lin YF, et al.Aspartame consumption, mitochondrial disorder-induced impaired ovarian function, and infertility risk.Int J Mol Sci. 2022 Nov;23(21):12740. doi:10.3390/ijms232112740Concha F, Sambra V, Cáceres P, López-Arana S, Carvajal B, Gotteland M.Maternal consumption and perinatal exposure to non-nutritive sweeteners: Should we be concerned?.Front Pediatr. 2023 Jun;11(1):1-7. doi:10.3389/fped.2023.1200990Mueller N, Jacobs D, MacLehose R, et al.Consumptions of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche.Am J Clin Nutr. 2015 Sep;102(3):648-654. doi:10.3945/ajcn.114.100958Fowler S, Ruiz de Porras D, Swartz M, Granados P, Heilbrun L, Palmer R.Daily early-life exposures to diet soda and aspartame are associated with autism in males: A case-control study.Nutrients. 2024;16(5):675. doi:10.3390/nu15173772American Cancer Society.Aspartame and cancer risk.U.S. Department of Health and Human Services.Is aspartame safe?.Brigham and Women’s Hospital.Substances of concern during pregnancy.Food and Drug Administration.How sweet it is: all about sweeteners.Harvard Health Publishing.How healthy is sugar alcohol?McGill Office for Science and Society.Sweetener battles.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Johns Hopkins Medicine.Facts about sugar and sugar substitutes.Harvard T.H. Chan School of Public Health.Low-calorie sweeteners.National Cancer Institute.Artificial sweeteners and cancer.U.S. Food and Drug Administration.Aspartame and other sweeteners in food.World Health Organization.WHO advises not to use non-sugar sweeteners for weight control in newly released guideline.Bruyère O, Ahmed S, Atlan C, et al.Review of the nutritional benefits and risks related to intense sweeteners.Arch Pub Health. 2015;73(41):1-10. doi:10.1186/s13690-015-0092-xGupta M.Sugar substitutes: mechanism, availability, current use and safety concerns-an update.Open Access Maced J Med Sci. 2018;6(10):1888-1894. doi:10.3889/oamjms.2018.336Sharma A, Amarnath S, Thulasimani M, Ramaswamy S.Artificial sweeteners as a sugar substitute: Are they really safe?.Indian J Pharmacol.2016;48(3):237-240. doi:10.4103/0253-7613.182888Harris E.WHO warns against artificial sugars for weight loss.JAMA. 2023 May;329(23):2011. doi:10.1001/jama.2023.9600Czarnecka K, Pilarz A, Rogut A, et al.Aspartame-true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021 Jun;13(6):1957. doi:10.3390/nu13061957Chakraborty R, Das A.Artificial sweeteners. In:Encyclopedia of Food Chemistry. 2019;1(1):30-34. doi:10.1016/B978-0-08-100596-5.21619-3Ringel N, Hovey K, Andrews C, et al.Association of artificially sweetened beverage consumption and urinary tract cancers in the Women’s Health Initiative Observational Study.Eur Urol Open Sci.2022 Dec;47(1):80-86. doi:10.1016/j.euros.2022.11.016Heath A, Clasen J, Jayanth N, et al.Soft drink and juice consumption and renal cell carcinoma incidence and mortality in the European Prospective Investigation into Cancer and Nutrition.Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1270-1274. doi:10.1158/1055-9965.EPI-20-1726Debras C, Chazelas E, Srour B, et al.Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study.PLoS Med. 2022 Mar;19(3):e1003950. doi:10.1371/journal.pmed.1003950National Cancer Institute.Obesity and cancer.Hodge A, Bassett J, Milne R, English D, Giles G.Consumption of sugar-sweetened and artificially sweetened soft drinks and risk of obesity-related cancers.Public Health Nutr. 2018 Jun;21(9):1618-1626. doi:10.1017/S1368980017002555World Health Organization.Aspartame hazard and risk assessment results released.Hou K, Wu ZX, Chen XY, et al.Microbiota in health and diseases.Sig Transduct Target Ther. 2022 Apr;7(1):135. doi:10.1038/s41392-022-00974-4Shan Y, Lee M, Chang E.The gut microbiome and inflammatory bowel disease.Annu Rev Med. 2022 Jan;73(1):455-468. doi:10.1146/annurev-med-042320-021020Harpaz D, Yeo LP, Cecchini F, et al.Measuring artificial sweeteners toxicity using a bioluminescent bacterial panel.Molecules. 2018 Sep;23(10):2454. doi:10.3390/molecules23102454Spencer M, Gupta A, Dam L, Shannon C, Menees S, Chey W.Artificial sweeteners: A systematic review and primer for gastroenterologists.J Neurogastroenterol Motil.2016 Apr;22(2):168-180. doi:10.5056/jnm15206Steffen B, Jacobs D, Yi SY, et al.Long-term aspartame and saccharin intakes are related to greater volumes of visceral, intermuscular, and subcutaneous adipose tissue: the CARDIA study.Int J Obes. 2023 Jul;47(1):939–947. doi:10.1038/s41366-023-01336-ySanyaolu A, Marinkovic A, Gosse J, et al.Artificial sweeteners and their association with diabetes: a review.J Pub Health Catalog.2018;1(4):86-88.Liauchonak I, Qorri B, Dawoud F, Riat Y, Szewczuk M.Non-nutritive sweeteners and their implications on the development of metabolic syndrome.Nutrients. 2019 Mar;11(3):644. doi:10.3390/nu11030644American Heart Association.What is metabolic syndrome?.Mathur K, Agrawal R, Nagpure S, Deshpande D.Effect of artificial sweeteners on insulin resistance among type-2 diabetes mellitus patients.J Family Med Prim Care. 2020 Jan;9(1):69-71. doi:10.4103/jfmpc.jfmpc_329_19Samuthpongtorn C, Nguyen L, Okereke O, et al.Consumption of ultraprocessed food and risk of depression.JAMA. 2023;6(9):e2334770. doi:10.1001/jamanetworkopen.2023.34770Choudhary A, Lee Y.Neurophysiological symptoms and aspartame: What is the connection?.Nutr Neurosci. 2018 Jun;21(5):306-316. doi:10.1080/1028415X.2017.1288340Chen YC, Yeh YC, Lin YF, et al.Aspartame consumption, mitochondrial disorder-induced impaired ovarian function, and infertility risk.Int J Mol Sci. 2022 Nov;23(21):12740. doi:10.3390/ijms232112740Concha F, Sambra V, Cáceres P, López-Arana S, Carvajal B, Gotteland M.Maternal consumption and perinatal exposure to non-nutritive sweeteners: Should we be concerned?.Front Pediatr. 2023 Jun;11(1):1-7. doi:10.3389/fped.2023.1200990Mueller N, Jacobs D, MacLehose R, et al.Consumptions of caffeinated and artificially sweetened soft drinks is associated with risk of early menarche.Am J Clin Nutr. 2015 Sep;102(3):648-654. doi:10.3945/ajcn.114.100958Fowler S, Ruiz de Porras D, Swartz M, Granados P, Heilbrun L, Palmer R.Daily early-life exposures to diet soda and aspartame are associated with autism in males: A case-control study.Nutrients. 2024;16(5):675. doi:10.3390/nu15173772American Cancer Society.Aspartame and cancer risk.U.S. Department of Health and Human Services.Is aspartame safe?.Brigham and Women’s Hospital.Substances of concern during pregnancy.Food and Drug Administration.How sweet it is: all about sweeteners.Harvard Health Publishing.How healthy is sugar alcohol?McGill Office for Science and Society.Sweetener battles.

Johns Hopkins Medicine.Facts about sugar and sugar substitutes.

Harvard T.H. Chan School of Public Health.Low-calorie sweeteners.

National Cancer Institute.Artificial sweeteners and cancer.

U.S. Food and Drug Administration.Aspartame and other sweeteners in food.

World Health Organization.WHO advises not to use non-sugar sweeteners for weight control in newly released guideline.

Bruyère O, Ahmed S, Atlan C, et al.Review of the nutritional benefits and risks related to intense sweeteners.Arch Pub Health. 2015;73(41):1-10. doi:10.1186/s13690-015-0092-x

Gupta M.Sugar substitutes: mechanism, availability, current use and safety concerns-an update.Open Access Maced J Med Sci. 2018;6(10):1888-1894. doi:10.3889/oamjms.2018.336

Sharma A, Amarnath S, Thulasimani M, Ramaswamy S.Artificial sweeteners as a sugar substitute: Are they really safe?.Indian J Pharmacol.2016;48(3):237-240. doi:10.4103/0253-7613.182888

Harris E.WHO warns against artificial sugars for weight loss.JAMA. 2023 May;329(23):2011. doi:10.1001/jama.2023.9600

Czarnecka K, Pilarz A, Rogut A, et al.Aspartame-true or false? Narrative review of safety analysis of general use in products.Nutrients. 2021 Jun;13(6):1957. doi:10.3390/nu13061957

Chakraborty R, Das A.Artificial sweeteners. In:Encyclopedia of Food Chemistry. 2019;1(1):30-34. doi:10.1016/B978-0-08-100596-5.21619-3

Ringel N, Hovey K, Andrews C, et al.Association of artificially sweetened beverage consumption and urinary tract cancers in the Women’s Health Initiative Observational Study.Eur Urol Open Sci.2022 Dec;47(1):80-86. doi:10.1016/j.euros.2022.11.016

Heath A, Clasen J, Jayanth N, et al.Soft drink and juice consumption and renal cell carcinoma incidence and mortality in the European Prospective Investigation into Cancer and Nutrition.Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1270-1274. doi:10.1158/1055-9965.EPI-20-1726

Debras C, Chazelas E, Srour B, et al.Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study.PLoS Med. 2022 Mar;19(3):e1003950. doi:10.1371/journal.pmed.1003950

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