Can artificially sweetened drinks be helpful weight loss tools, or are they secretly sabotaging health and fitness goals? Dr. Layne Norton dissected recent research favoring “diet” products and explained association versus causation.
Most Recent Science on Artificial Sweeteners
A large cohort study from 2024 concluded that “[Artificial sweetener] consumers generally have lower quality diets.” (1) Cohorts might show correlations between risk factors, though they don’t prove a cause.
In human randomized controlled trials, which are usually more accurate, replacing sugar-sweetened drinks with diet options leads to weight loss. (2) This could be because artificial sweeteners satisfy sweet cravings, reducing the desire for other sugary fixes.
It’s very clear, very consistent, and even produces a little bit more weight loss than substituting with water.
—Dr. Layne Norton
Epidemiological studies — those that assess large populations over time — have shown the opposite. “In those studies, we see that diet drink or artificial sweetener intake tends to be associated with increased body fat levels and obesity.” This conflict brings up the next critical concept: reverse causation.
Correlation to Cause & Effect
Associations don’t guarantee a stimulus and response. An example is overweight individuals consuming more artificially sweetened products to lose weight.
People who consume more artificial sweeteners are more likely to be overweight or obese. It’s diet quality, not artificial sweeteners.
—Dr. Layne Norton
[Related: New Study Shows No Association Between Artificial Sweeteners and Cancer Mortality]
A Parallel with Intermittent Fasting
To illustrate further, Dr. Norton mentioned a study linking intermittent fasting (IF) with eating disorders and higher body mass index (BMI) since the same logic applies. (3) Randomized controlled studies show that IF is unlikely to be the cause. Dr. Norton argues that those with a negative body image are just more likely to try IF as a weight-loss method.
“We must be careful about our conclusions based on the study type being examined.”
[Related: New Meta-Analysis Suggests Artificial and Stevia-Based Sweeteners Help Reduce Fat Mass]
Establishing Causation & Key Takeaway
Dr. Norton explained, “Usually, we’re looking for human randomized controlled trials. Those control variables that could influence the outcome…inherent characteristics.” They ensure constancy by ruling out certain factors. “Artificial sweeteners can be a useful tool for weight loss, but make sure you’re focusing on your overall diet quality.”
Effects on Gut & General Heath
While human meta-analyses show artificial sweeteners are beneficial for weight loss, there are still general health concerns. Recent literature describes negative impacts on blood glucose, gut bacteria, and metabolic health, though data is conflicting. (4) Similar concerns are also shared with natural, non-sugar sweeteners.
Thus, more studies are needed on long-term consumption. While you probably don’t need to give up your diet sodas, it is likely best to drink them in moderation.
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References
- Sylvetsky, A. C., Mitchell, E. L., Grilo, M. F., Um, C. Y., Wang, Y., Hodge, R. A., Patel, A. V., & McCullough, M. L. (2024). Cross-sectional associations between consumption of non-nutritive sweeteners and diet quality among United States adults in the Cancer Prevention Study-3. The American journal of clinical nutrition, S0002-9165(24)01418-7. Advance online publication. https://doi.org/10.1016/j.ajcnut.2024.11.023
- Laviada-Molina, H., Molina-Segui, F., Pérez-Gaxiola, G., Cuello-García, C., Arjona-Villicaña, R., Espinosa-Marrón, A., & Martinez-Portilla, R. J. (2020). Effects of nonnutritive sweeteners on body weight and BMI in diverse clinical contexts: Systematic review and meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity, 21(7), e13020. https://doi.org/10.1111/obr.13020
- Ganson, K. T., Cuccolo, K., Hallward, L., & Nagata, J. M. (2022). Intermittent fasting: Describing engagement and associations with eating disorder behaviors and psychopathology among Canadian adolescents and young adults. Eating behaviors, 47, 101681. https://doi.org/10.1016/j.eatbeh.2022.101681
- Angelin M, Kumar J, Vajravelu LK, Satheesan A, Chaithanya V, Murugesan R. Artificial sweeteners and their implications in diabetes: a review. Front Nutr. 2024 Jun 25;11:1411560. doi: 10.3389/fnut.2024.1411560. PMID: 38988858; PMCID: PMC11233937.
Featured image via Shutterstock/Mirror-Images
