Are non-nutritive sweeteners vascular-safe substitutes for added sugars?

In an effort to reduce the incidence of obesity, type 2 diabetes and cardiovascular disease, leading health agencies around the world are currently promoting the consumption of food and beverages containing non-nutritive sweeteners (NNS), advocating them as healthy alternatives to products sweetened with added sugars.

As the harmful health effects of excess sugar consumption are often attributed to the high-energy content of added sugar, it has been assumed that NNS are physiologically inactive simply because they have little to no energy content.

Recent evidence, however, demonstrates an increased risk in total and cardiovascular disease mortality in people consuming at least two NNS-sweetened beverages per day.

While these findings are interesting, they are difficult to interpret as NNS are typically consumed more often by those whose cardiometabolic health is already compromised.

Despite this, evidence from animal studies, including that delivered by our own consortium, indicate that NNS have the potential to disrupt normal metabolic and vascular function, events that are primary in the development of obesity, insulin resistance and cardiovascular disease.

Indeed, rather than benefiting us, the impact of consuming NNS may be as bad on human health as the effects of excess sugar consumption.

To bridge the findings from epidemiological and experimental research, this Standard EF will, for the first time in vivo, in humans, assess the metabolic and vascular effects of consuming NNS habitually; via a prospective, placebo-controlled, randomized, three-period crossover study.

This research will also provide information about the role of type 1 sweet taste receptors (T1Rs), as well as oral sweet taste perception, in any potential NNS-mediated vascular/metabolic dysfunction.

Ultimately, the findings from this research will inform policy makers about the safety of NNS, with the potential to lobby health authorities to revisit the regulatory status of these substances.