Research

Mixed

Routine consumption of nonnutritive sweeteners (NNS) is associated with modest long-term increases in BMI, weight, and waist circumference, as well as higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes, and cardiovascular events in observational studies.

If you consume nonnutritive sweeteners regularly, be aware that observational studies link this habit to modest increases in BMI, waist circumference, and risk of metabolic conditions like type 2 diabetes and hypertension. While short-term trials don't show weight gain, long-term data suggests a correlation. Focus on overall diet quality rather than just swapping sugar for sweeteners.

ModerateSupportsMEDIUM confidence
In the cohort studies, consumption of nonnutritive sweeteners was associated with increases in weight and waist circumference, and higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events.
Meghan B. Azad et al. · Canadian Medical Association Journal · 2017

Why this rating

RCTs showed no consistent effect, but large cohort studies showed significant associations; however, publication bias was noted for diabetes outcomes.

Source

Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies

Meghan B. Azad et al. · Canadian Medical Association Journal · 2017

DOI 10.1503/cmaj.161390

Meta-analysis · 37 studiesCited 381×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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