ReviewNutrition research and practice2026
Low- and no-calorie sweeteners and beverages and their associated health outcomes: an umbrella review of systematic reviews and meta-analyses.
Review in Nutrition research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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12 authors.
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Abstract
backgroundLong-term health effects of low- and no-calorie sweeteners (LNCSs) have not been established.
objectiveThis review aimed to evaluate the associations between different types of LNCSs and a wide range of health outcomes from observational studies and randomized controlled trials (RCTs).
methodsWe systematically searched PubMed/MEDLINE, Embase, CINAHL, and Google Scholar from inception to December 2024 for meta-analyses. LNCSs were categorized into artificial sweeteners and other non-sugar sweeteners (NSSs), including non-nutritive sweeteners and sugar alcohols, along with their corresponding beverages. The A Measurement Tool Assessment Systematic Reviews 2 (AMSTAR 2) tool was used in this study. The credibility of observational evidence was evaluated using a classification system. The certainty of evidence from RCTs was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Eligible meta-analyses were reanalyzed using random-effects models and presented as estimated odds ratios (eOR) or standard mean differences (SMDs) with 95% confidence intervals (CIs).
resultsA total of 29 meta-analyses (AMSTAR 2: high, 22; moderate, 2; low, 3; and critically low, 2) with 24 observational studies and 6 RCTs, covering 50,034,327 participants, were included. Among the 135 associations, observational studies indicated that higher intake of NSSs was associated with increased risk of being overweight (eOR, 1.84; 95% CI, 1.30 to 2.61; credibility of evidence [CE], IV), having metabolic syndrome (eOR, 1.31; 95% CI, 1.21 to 1.42; CE, I), type 2 diabetes (eOR, 1.14; 95% CI, 1.02 to 1.29; CE, IV), and hypertension (eOR, 1.13; 95% CI, 1.07 to 1.19; CE, II). In contrast, RCTs showed that NSS consumption significantly decreased body weight in populations with overweight or obesity (SMD, -0.50; 95% CI, -0.70 to -0.30; GRADE, high).
conclusionsOur findings indicate that the use of LNCSs and their corresponding beverages is associated with potential health risks and modest benefits. Trial Registration: International Prospective Registration of Systematic Reviews (PROSPERO) Identifier: CRD420251006761.
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