A new meta-analysis found non-nutritive artificial sweeteners were associated with short-term worsening in blood sugar control and a higher long-term risk of cardiometabolic disease in adults.
The review examined 21 randomized controlled trials and 27 trial comparisons, and also pointed to gut microbiome changes as a possible pathway behind the adverse effects.
Doctors and nutrition experts said the findings add to existing concerns but do not prove causation, because much of the evidence is observational and people already at higher risk may be more likely to use sweeteners.
Experts said the results do not justify avoiding artificial sweeteners entirely; they advised moderation, gradual reduction in overall sweetness, and a broader focus on diet, exercise, sleep and genetics while more research is done.