Editing Sugar substitute (section)

==Research==

===Body weight===

Reviews and dietetic professionals have concluded that moderate use of non-nutritive sweeteners as a safe replacement for sugars may help limit energy intake and assist with managing [[blood glucose]] and [[Human body weight|weight]].<ref name="Rogers2016"/><ref name="Miller2014"/><ref name="Fitch2012">{{cite journal | vauthors = Fitch C, Keim KS | title = Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners | journal = Journal of the Academy of Nutrition and Dietetics | volume = 112 | issue = 5 | pages = 739–758 | date = May 2012 | pmid = 22709780 | doi = 10.1016/j.jand.2012.03.009 }}</ref> Other reviews found that the association between body weight and non-nutritive sweetener usage is inconclusive.<ref name="Lohner-2017"/><ref name="Brown RJ"/><ref name="Azad2017"/> [[Observational studies]] tend to show a relation with increased body weight, while [[randomized controlled trial]]s instead show a little [[causality|causal]] weight loss.<ref name="Lohner-2017"/><ref name="Brown RJ">{{cite journal | vauthors = Brown RJ, de Banate MA, Rother KI | title = Artificial sweeteners: a systematic review of metabolic effects in youth | journal = International Journal of Pediatric Obesity | volume = 5 | issue = 4 | pages = 305–312 | date = August 2010 | pmid = 20078374 | pmc = 2951976 | doi = 10.3109/17477160903497027 }}</ref><ref name="Azad2017">{{cite journal | vauthors = Azad MB, Abou-Setta AM, Chauhan BF, Rabbani R, Lys J, Copstein L, Mann A, Jeyaraman MM, Reid AE, Fiander M, MacKay DS, McGavock J, Wicklow B, Zarychanski R | display-authors = 6 | title = Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies | journal = CMAJ | volume = 189 | issue = 28 | pages = E929–E939 | date = July 2017 | pmid = 28716847 | pmc = 5515645 | doi = 10.1503/cmaj.161390 }}</ref> Other reviews concluded that use of non-nutritive sweeteners instead of sugar reduces body weight.<ref name="Rogers2016">{{cite journal | vauthors = Rogers PJ, Hogenkamp PS, de Graaf C, Higgs S, Lluch A, Ness AR, Penfold C, Perry R, Putz P, Yeomans MR, Mela DJ | display-authors = 6 | title = Does low-energy sweetener consumption affect energy intake and body weight? A systematic review, including meta-analyses, of the evidence from human and animal studies | journal = International Journal of Obesity | volume = 40 | issue = 3 | pages = 381–394 | date = March 2016 | pmid = 26365102 | pmc = 4786736 | doi = 10.1038/ijo.2015.177 }}</ref><ref name="Miller2014">{{cite journal | vauthors = Miller PE, Perez V | title = Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies | journal = The American Journal of Clinical Nutrition | volume = 100 | issue = 3 | pages = 765–777 | date = September 2014 | pmid = 24944060 | pmc = 4135487 | doi = 10.3945/ajcn.113.082826 }}</ref>

===Obesity===
There is little evidence that artificial sweeteners directly affect the onset and mechanisms of [[obesity]], although consuming sweetened products is associated with weight gain in children.<ref name="brown">{{cite journal | last1=Brown | first1=Rebecca J. | last2=de Banate | first2=Mary Ann | last3=Rother | first3=Kristina I. | title=Artificial Sweeteners: A systematic review of metabolic effects in youth | journal=International Journal of Pediatric Obesity | volume=5 | issue=4 | year=2010 | issn=1747-7166 | pmid=20078374 | pmc=2951976 | doi=10.3109/17477160903497027 | pages=305–312}}</ref><ref name="young">{{cite journal | last1=Young | first1=Jordan | last2=Conway | first2=Ellen M. | last3=Rother | first3=Kristina I. | last4=Sylvetsky | first4=Allison C. | title=Low-calorie sweetener use, weight, and metabolic health among children: A mini-review | journal=Pediatric Obesity | volume=14 | issue=8 | date=2019-04-14 | pages=e12521 | issn=2047-6302 | pmid=30983091 | doi=10.1111/ijpo.12521 | s2cid=115206999 }}</ref> Some preliminary studies indicate that consumption of products manufactured with artificial sweeteners is associated with obesity and [[metabolic syndrome]], decreased [[satiety]], disturbed glucose [[metabolism]], and weight gain, mainly due to increased overall calorie intake, although the numerous factors influencing obesity remain poorly studied, as of 2021.<ref name=brown/><ref name=young/><ref>{{Cite journal |last1=Pearlman |first1=Michelle |last2=Obert |first2=Jon |last3=Casey |first3=Lisa |name-list-style=amp |date=December 2017 |title=The association between artificial sweeteners and obesity |url=http://link.springer.com/10.1007/s11894-017-0602-9 |url-status=live |journal=Current Gastroenterology Reports |language=en |volume=19 |issue=12 |pages=64 |doi=10.1007/s11894-017-0602-9 |issn=1522-8037 |pmid=29159583 |s2cid=46270291 |archive-url=https://web.archive.org/web/20230423112917/https://link.springer.com/article/10.1007/s11894-017-0602-9 |archive-date=23 April 2023 |access-date=22 September 2022}}</ref><ref>{{Cite journal |last=Christofides |first=Elena A. |date=October 2021 |title=Artificial sweeteners and obesity—Not the solution and potentially a problem |url=https://linkinghub.elsevier.com/retrieve/pii/S1530891X21011575 |journal=Endocrine Practice |language=en |volume=27 |issue=10 |pages=1052–1055 |doi=10.1016/j.eprac.2021.08.001 |pmid=34389515 |s2cid=237009397 |access-date=22 September 2022 |archive-date=27 November 2022 |archive-url=https://web.archive.org/web/20221127161625/https://linkinghub.elsevier.com/retrieve/pii/S1530891X21011575 |url-status=live }}</ref>

===Cancer===

Multiple reviews have found no link between artificial sweeteners and the risk of [[cancer]].<ref name="Lohner-2017"/><ref name="cancer">{{cite web |date=3 February 2014 |title=Common Cancer Myths and Misconceptions |url=https://www.cancer.gov/about-cancer/causes-prevention/risk/myths |url-status=live |archive-url=https://web.archive.org/web/20220101101433/https://www.cancer.gov/about-cancer/causes-prevention/risk/myths |archive-date=1 January 2022 |access-date=17 August 2021 |work=[[National Cancer Institute]]}}</ref><ref>{{cite journal | vauthors = Bosetti C, Gallus S, Talamini R, Montella M, Franceschi S, Negri E, La Vecchia C | title = Artificial sweeteners and the risk of gastric, pancreatic, and endometrial cancers in Italy | journal = Cancer Epidemiology, Biomarkers & Prevention | volume = 18 | issue = 8 | pages = 2235–2238 | date = August 2009 | pmid = 19661082 | doi = 10.1158/1055-9965.epi-09-0365 | doi-access =  }}</ref><ref>{{cite journal | vauthors = Mishra A, Ahmed K, Froghi S, Dasgupta P | title = Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants | journal = International Journal of Clinical Practice | volume = 69 | issue = 12 | pages = 1418–1426 | date = December 2015 | pmid = 26202345 | doi = 10.1111/ijcp.12703 | doi-access = free }}</ref> FDA scientists have reviewed scientific data regarding the safety of aspartame and different sweeteners in food, concluding that they are safe for the general population under common intake conditions.<ref>{{Cite journal |author=Center for Food Safety and Applied Nutrition |date=2020-02-20 |title=Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States |url=https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states |journal=FDA |language=en |access-date=26 March 2022 |archive-date=10 December 2021 |archive-url=https://web.archive.org/web/20211210013904/https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states |url-status=live }}</ref>

===Mortality===
High consumption of artificially sweetened beverages was associated with a 12% higher risk of all-cause mortality and a 23% higher risk of [[cardiovascular disease]] (CVD) mortality in a 2021 [[meta-analysis]].<ref>{{cite journal | vauthors = Li H, Liang H, Yang H, Zhang X, Ding X, Zhang R, Mao Y, Liu Z, Kan Q, Sun T | display-authors = 6 | title = Association between intake of sweetened beverages with all-cause and cause-specific mortality: a systematic review and meta-analysis | journal = Journal of Public Health | volume =  44| issue =  3| date = April 2021 | pages = 516–526 | pmid = 33837431 | doi = 10.1093/pubmed/fdab069 | doi-access = free }}</ref> A 2020 meta-analysis found a similar result, with the highest consuming group having a 13% higher risk of all-cause mortality and a 25% higher risk of CVD mortality.<ref>{{cite journal | vauthors = Zhang YB, Jiang YW, Chen JX, Xia PF, Pan A | title = Association of Consumption of Sugar-Sweetened Beverages or Artificially Sweetened Beverages with Mortality: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies | journal = Advances in Nutrition | volume = 12 | issue = 2 | pages = 374–383 | date = March 2021 | pmid = 33786594 | pmc = 8009739 | doi = 10.1093/advances/nmaa110 }}</ref> However, both studies also found similar or greater increases in all-cause mortality when consuming the same amount of sugar-sweetened beverages.