Sweeteners and sweetness enhancers (S&SEs) are frequently used as sugar substitutes, particularly by those attempting to control their weight. Their actual effect on body weight and metabolic health has come under increased scrutiny, despite the fact that they offer sweetness with little or no calories. These substances may affect the gut flora, which is a crucial regulator of metabolism, inflammation, and hunger, in addition to energy balance.
The effects of various sweeteners on calorie intake, weight trajectories, microbial diversity, and the synthesis of important metabolites have all been studied recently. The goal of this expanding body of research is to determine if sweeteners and sweetness enhancers are neutral, advantageous, or detrimental tools for long-term metabolic health and weight management.
This research included 341 adults and 38 children who were overweight or obese. Adults had a 10-month healthy ad libitum diet with less than 10% energy from sweets after a 2-month low-energy diet for at least 5% weight loss. One group (S&SEs group) substituted S&SE items for sugar-rich products, but the other group (sugar group) did not. Changes in body weight and the makeup of the gut flora at one year were the main results. Changes in cardiometabolic markers were among the secondary outcomes.
At one year, the S&SEs group lost more weight than the sugar group (1.6 ± 0.7 kg, P = 0.029) and showed clear changes in the gut microbiota, including more short-chain fatty acid and methane-producing taxa (q ≤ 0.05). Neither children nor cardiometabolic indicators showed any discernible changes.
Overall, the current RCT demonstrated that adults who included S&SEs in a healthy, ad libitum, sugar-reduced diet showed improved 1-year weight loss maintenance and gut microbiota composition without affecting cardiometabolic health markers when compared to those who consumed drinks and foods without S&SEs.
Source:
Pang, M. D., Kjølbæk, L., Bastings, J. J. A. J., Andersen, S. S. H., Umanets, A., Sost, M. M., Navas-Carretero, S., Reppas, K., Finlayson, G., Hodgkins, C. E., Del Álamo, M., Lam, T., Moshoyiannis, H., Feskens, E. J. M., Adam, T. C. M., Goossens, G. H., Halford, J. C. G., Harrold, J. A., Manios, Y., … Raben, A. (2025). Effect of sweeteners and sweetness enhancers on weight management and gut microbiota composition in individuals with overweight or obesity: the SWEET study. Nature Metabolism, 7(10), 2083–2098. https://doi.org/10.1038/s42255-025-01381-z
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