Non-caloric artificial sweeteners (NAS) have gained widespread use in food, beverages, and pharmaceuticals due to their intense sweetness and minimal caloric contribution. Initially introduced as sugar substitutes for weight management and glycemic control, their safety profiles have come under renewed scrutiny. This mini-review summarizes current evidence on the health benefits and potential risks associated with NAS. Clinical trials support their short-term benefits, including modest reductions in body weight, improved glycemic indices, and dental health advantages due to their non-cariogenic properties. Additionally, certain NAS exhibit antimicrobial and antioxidant activities, although these may also disrupt beneficial gut microbiota. Notably, some epidemiological studies have paradoxically linked NAS consumption with weight gain, metabolic disturbances, and cardiovascular risk. Alterations in gut microbiota, neuroendocrine signaling, and taste perception are proposed mechanisms for these effects. Emerging data also raise concerns about carcinogenic and genotoxic potential, particularly for aspartame and acesulfame-K, although findings remain inconsistent across studies. Regulatory agencies maintain acceptable daily intake limits based on toxicological assessments; however, individual susceptibility, cumulative exposure, and long-term outcomes warrant further investigation. Overall, NAS offer useful alternatives to sugar but should be consumed with awareness of potential systemic and microbiome-mediated risks. Ongoing research, particularly well-designed longitudinal human studies, is essential to inform future dietary recommendations and regulatory policies.
Khalilipanah et al. (Mon,) studied this question.