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REVIEW PAPER
 
KEYWORDS
TOPICS
ABSTRACT
Introduction and objective:
Artificial sweeteners are noncaloric substances which are added to multiple products. There used by many people as substitutes for sugar in the belief this will be beneficial to their health. However, there is much controversy about artificial sweeteners and the safety of their consumption. The purpose of this review was to assess the newest articles on this topic, and define impact of artificial sweeteners on different aspects of health.

Review methods:
1) The research question was defined on the basis of recent literature; 2) inclusion criteria: indexed in Pubmed database, published in last 20 years, at least 75% of included articles published after 2015; 3) exclusion criteria: Case Reports, studies in languages other than Polish or English; 4) studies that seemed to be significantly biased.

Brief description of the state of knowledge:
Each sweetener may have a unique impact on the human body and can be taken from a variety of sources. Only a few authors have taken these two facts into account in their studies, the results of which may be inconclusive or misinterpreted. Artificial sweeteners may increase the risk of cancer, cardiovascular diseases, diabetesmellitus and obesity; however, these thesis are uncertain due to lack of data and possible reverse causation in observational cohort studies. There is also the presumption that artificial sweeteners can alter gut microbiota and cause a change in the glycaemic response of the organism. In opposition to this, artificial sweeteners could be useful tool in reducing weight

Summary:
According to the current literature, it is difficult to state unequivocally that artificial sweeteners have a positive, neutral, or negative impact on human health. In future studies, researchers should differentiate the types of sweeteners and focus on including all possible sources.

 
REFERENCES (41)
1.
Wilk K, Korytek W, Pelczynska M, et al. The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review. Nutrients. 2022;14(6). https://dx.doi.org/10.3390/nu1....
 
2.
COMMISSION REGULATION (EU) No 1129/2011 of 11 November 2011 amending Annex II to Regulation (EC) No 1333/2008 of the European Parliament and of the Council by establishing a Union list of food additives.
 
3.
Lewis K, Tzilivakis J. Review and synthesis of data on the potential environmental impact of artificial sweeteners. EFSA Supporting Publications. 2021;18(10):6918E. https://dx.doi.org/https://doi. org/10.2903/sp.efsa.2021.EN-6918.
 
4.
Regulation (EC) No 1333/2008 of the European Parliament and of the Council of 16 December 2008 on food additives (Text with EEA relevance)Text with EEA relevance.
 
5.
Riboli E, Beland FA, Lachenmeier DW, et al. Carcinogenicity of aspartame, methyleugenol, and isoeugenol. Lancet Oncol. 2023;24(8):848–850. https://dx.doi.org/10.1016/S14....
 
6.
Debras C, Chazelas E, Srour B, et al. Artificial sweeteners and cancer risk: Results from the NutriNet-Sante population-based cohort study. PLoS Med. 2022;19(3):e1003950. https://dx.doi.org/10.1371/jou.... pmed.1003950.
 
7.
McCullough ML, Teras LR, Shah R, et al. Artificially and sugarsweetened carbonated beverage consumption is not associated with risk of lymphoid neoplasms in older men and women. J Nutr. 2014;144(12):2041–2049. https://dx.doi.org/10.3945/jn.....
 
8.
Schernhammer ES, Bertrand KA, Birmann BM, et al. Consumption of artificial sweetener- and sugar-containing soda and risk of lymphoma and leukemia in men and women. Am J Clin Nutr. 2012;96(6):1419–1428. https://dx.doi.org/10.3945/ajc....
 
9.
Hodge AM, Bassett JK, Milne RL, et al. Consumption of sugar-sweetened and artificially sweetened soft drinks and risk of obesity-related cancers. Public Health Nutr. 2018;21(9):1618–1626. https://dx.doi.org/10.1017/ S1368980017002555.
 
10.
Soffritti M, Belpoggi F, Degli Esposti D, et al. First experimental demonstration of the multipotential carcinogenic effects of aspartame administered in the feed to Sprague-Dawley rats. Environ Health Perspect. 2006;114(3):379–385. https://dx.doi.org/10.1289/ehp....
 
11.
Soffritti M, Belpoggi F, Tibaldi E, et al. Life-span exposure to low doses of aspartame beginning during prenatal life increases cancer effects in rats. Environ Health Perspect. 2007;115(9):1293–1297. https://dx.doi. org/10.1289/ehp.10271.
 
12.
McCullough ML, Hodge RA, Campbell PT, et al. Sugar- and Artificially- Sweetened Beverages and Cancer Mortality in a Large U.S. Prospective Cohort. Cancer Epidemiol Biomarkers Prev. 2022;31(10):1907–1918. https://dx.doi.org/10.1158/105....
 
13.
Pavanello S, Moretto A, La Vecchia C, et al. Non-sugar sweeteners and cancer: Toxicological and epidemiological evidence. Regul Toxicol Pharmacol. 2023;139:105369. https://dx.doi.org/10.1016/j. yrtph.2023.105369.
 
14.
Malik VS, Li Y, Pan A, et al. Long-Term Consumption of Sugar-Sweetened and Artificially Sweetened Beverages and Risk of Mortality in US Adults. Circulation. 2019;139(18):2113–2125. https://dx.doi. org/10.1161/CIRCULATIONAHA.118.037401.
 
15.
Debras C, Chazelas E, Sellem L, et al. Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Sante cohort. BMJ. 2022;378:e071204. https://dx.doi.org/10.1136/bmj...- 071204.
 
16.
Mossavar-Rahmani Y, Kamensky V, Manson JE, et al. Artificially Sweetened Beverages and Stroke, Coronary Heart Disease, and All-Cause Mortality in the Women's Health Initiative. Stroke. 2019;50(3):555–562. https://dx.doi.org/10.1161/STR....
 
17.
Conz A, Salmona M, Diomede L Effect of Non-Nutritive Sweeteners on the Gut Microbiota. Nutrients. 2023;15(8). https://dx.doi.org/10.3390/ nu15081869.
 
18.
Gałęcka M, Bartnicka A, Basińska A Znaczenie mikrobioty jelitowej w kształtowaniu zdrowia człowieka — implikacje w praktyce lekarza rodzinnego. The importance of intestinal microbiota in shaping human health — implications in the practice of the family physician. Forum Medycyny Rodzinnej. 2018;12:50–59.
 
19.
Plaza-Diaz J, Pastor-Villaescusa B, Rueda-Robles A, et al. Plausible Biological Interactions of Low- and Non-Calorie Sweeteners with the Intestinal Microbiota: An Update of Recent Studies. Nutrients. 2020;12(4). https://dx.doi.org/10.3390/nu1....
 
20.
Olivier-Van Stichelen S, Rother KI, Hanover JA Maternal Exposure to Non-nutritive Sweeteners Impacts Progeny›s Metabolism and Microbiome. Front Microbiol. 2019;10:1360. https://dx.doi.org/10.3389/ fmicb.2019.01360.
 
21.
Uebanso T, Ohnishi A, Kitayama R, et al. Effects of Low-Dose Non- Caloric Sweetener Consumption on Gut Microbiota in Mice. Nutrients. 2017;9(6). https://dx.doi.org/10.3390/nu9....
 
22.
Nettleton JE, Cho NA, Klancic T, et al. Maternal low-dose aspartame and stevia consumption with an obesogenic diet alters metabolism, gut microbiota and mesolimbic reward system in rat dams and their offspring. Gut. 2020;69(10):1807–1817. https://dx.doi.org/10.1136/ gutjnl-2018-317505.
 
23.
Ahmad SY, Friel J, Mackay D The Effects of Non-Nutritive Artificial Sweeteners, Aspartame and Sucralose, on the Gut Microbiome in Healthy Adults: Secondary Outcomes of a Randomized Double- Blinded Crossover Clinical Trial. Nutrients. 2020;12(11). https://dx.doi. org/10.3390/nu12113408.
 
24.
Serrano J, Smith KR, Crouch AL, et al. High-dose saccharin supplementation does not induce gut microbiota changes or glucose intolerance in healthy humans and mice. Microbiome. 2021;9(1):11. https://dx.doi.org/10.1186/s40....
 
25.
Frankenfeld CL, Sikaroodi M, Lamb E, et al. High-intensity sweetener consumption and gut microbiome content and predicted gene function in a cross-sectional study of adults in the United States. Ann Epidemiol. 2015;25(10):736–742 e734. https://dx.doi.org/10.1016/j. annepidem.2015.06.083.
 
26.
Shil A, Chichger H. Artificial Sweeteners Negatively Regulate Pathogenic Characteristics of Two Model Gut Bacteria, E. coli and E. faecalis. Int J Mol Sci. 2021;22(10). https://dx.doi.org/10.3390/ijm....
 
27.
Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014;514(7521):181– 186. https://dx.doi.org/10.1038/nat....
 
28.
Higgins KA, Mattes RD A randomized controlled trial contrasting the effects of 4 low-calorie sweeteners and sucrose on body weight in adults with overweight or obesity. Am J Clin Nutr. 2019;109(5):1288–1301. https://dx.doi.org/10.1093/ajc....
 
29.
Bian X, Chi L, Gao B, et al. The artificial sweetener acesulfame potassium affects the gut microbiome and body weight gain in CD-1 mice. PLoS One. 2017;12(6):e0178426. https://dx.doi.org/10.1371/jou.... pone.0178426.
 
30.
Rogers PJ, Hogenkamp PS, de Graaf C, et al. 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. Int J Obes (Lond). 2016;40(3):381–394. https://dx.doi. org/10.1038/ijo.2015.177.
 
31.
Pearlman M, Obert J, Casey L The Association Between Artificial Sweeteners and Obesity. Curr Gastroenterol Rep. 2017;19(12):64. https:// dx.doi.org/10.1007/s11894-017-0602-9.
 
32.
In: Use of non-sugar sweeteners: WHO guideline. Geneva; 2023.
 
33.
Pepino MY, Tiemann CD, Patterson BW, et al. Sucralose affects glycemic and hormonal responses to an oral glucose load. Diabetes Care. 2013; 36(9):2530–2535. https://dx.doi.org/10.2337/dc1....
 
34.
Ritu M, Nandini J Nutritional composition of Stevia rebaudiana, a sweet herb, and its hypoglycaemic and hypolipidaemic effect on patients with non-insulin dependent diabetes mellitus. J Sci Food Agric. 2016; 96(12):4231–4234. https://dx.doi.org/10.1002/jsf....
 
35.
Fagherazzi G, Gusto G, Affret A, et al. Chronic Consumption of Artificial Sweetener in Packets or Tablets and Type 2 Diabetes Risk: Evidence from the E3N-European Prospective Investigation into Cancer and Nutrition Study. Ann Nutr Metab. 2017; 70(1):51–58. https://dx.doi.org/10.1159/000....
 
36.
Drouin-Chartier JP, Zheng Y, Li Y, et al. Changes in Consumption of Sugary Beverages and Artificially Sweetened Beverages and Subsequent Risk of Type 2 Diabetes: Results From Three Large Prospective U.S. Cohorts of Women and Men. Diabetes Care. 2019;42(12):2181–2189. https://dx.doi.org/10.2337/dc1....
 
37.
Imamura F, O'Connor L, Ye Z, et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ. 2015;351:h3576. https://dx.doi.org/10.1136/bmj....
 
38.
World Health O, Rios-Leyvraz M, Montez J: Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis. Geneva: World Health Organization; 2022.
 
39.
de Ruyter JC, Olthof MR, Seidell JC, et al. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397–1406. https://dx.doi.org/10.1056/NEJ....
 
40.
Englund-Ogge L, Brantsaeter AL, Haugen M, et al. Association between intake of artificially sweetened and sugar-sweetened beverages and preterm delivery: a large prospective cohort study. Am J Clin Nutr. 2012;96(3):552–559. https://dx.doi.org/10.3945/ajc....
 
41.
Halldorsson TI, Strom M, Petersen SB, et al. Intake of artificially sweetened soft drinks and risk of preterm delivery: a prospective cohort study in 59,334 Danish pregnant women. Am J Clin Nutr. 2010;92(3):626–633. https://dx.doi.org/10.3945/ajc....
 
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