Effects of Non-Nutritive Sweeteners and Sweet Taste Exposure on Weight Management, Biomarkers of Health and Sweet Taste Preference—A Review of the Evidence from Recent European Consortia Studies
Autores: Čad, E. M.; Appleton, K. M.; Blaak, E. E.; Dakin, C.; de Graaf, K.; Finlayson, G.; Forde, C. G.; Halford, J. C. G. et al.
Revista: Nutrients (2026)
DOI: https://doi.org/10.3390/nu18111647
Eje / subcolección Zotero: Seguridad y salud de ingredientes
Acceso al texto completo: abierto (gold) · enlace
Abstract
Non-nutritive sweeteners (NNSs) are consumed to reduce intake by providing a sweet taste with little to no energy. Despite regulatory approval and extensive use, uncertainty remains about their long-term role in weight management and health, and about whether exposure to sweet taste itself, independent of energy, influences these outcomes. This narrative review synthesizes evidence from three recent European consortia: SWEET, SWITCH and Sweet Tooth, which together provide complementary data from acute, short- and long-term randomized controlled trials. The studies examined the effects of NNSs and dietary sweet taste exposure on body weight, health-related biomarkers, sweet taste preference, and eating behavior. Across studies, replacing sugars with NNSs appeared to support weight loss maintenance, while NNS consumption and dietary sweet taste exposure showed no adverse changes in body weight, glucoregulatory and endocrine biomarkers, cardiometabolic risk factors, gut microbiota, or liver enzymes. Likewise, neither NNS use nor different dietary sweet taste exposure altered sweet taste liking, appetite sensation, energy intake, or food choice. However, interpretation should consider the characteristics of the included studies, including selected populations, intervention context, outcome heterogeneity, and the fact that several behavioral and biomarker outcomes were secondary or exploratory. Overall, the reviewed evidence suggests that replacing sugar intake with NNSs may support weight management strategies, while differences in habitual dietary sweet taste exposure per se appear largely neutral with respect to health-related biomarkers and sweet taste preferences.
Lectura guiada
Problema de investigación
¿Qué efectos tienen los edulcorantes no nutritivos y la exposición al sabor dulce sobre el peso, los biomarcadores de salud y la preferencia por el dulce, según los consorcios europeos SWEET, SWITCH y Sweet Tooth? (verificado en el PDF, pp. 1-3)
Metodología
- Diseño: revisión narrativa de cinco ensayos aleatorizados de tres consorcios europeos (paralelos de 6-12 meses y cruzados agudos o de 2 semanas).
- Población / muestra: SWEET 341, 53 y 59 adultos con sobrepeso u obesidad; SWITCH 493 adultos con sobrepeso u obesidad; Sweet Tooth 180 adultos (tabla 1, p. 4).
“This narrative review synthesizes evidence from three recent European consortia: SWEET, SWITCH and Sweet Tooth, which together provide complementary data from acute, short- and long-term randomized controlled trials.” (p. 1)
- Mi nota: Revisión narrativa de ensayos europeos recientes; evidencia actual y europea útil para un TFE orientado a España.
“The sweetness of the overall diet was modified using both non-nutritive sweeteners and sugars, thereby altering total sensory sweet taste exposure rather than isolating a specific sweetener type.” (p. 4)
- Mi nota: Sweet Tooth no aísla un edulcorante concreto: sus resultados no prueban nada específico sobre el eritritol.
🟡 Ideas principales (hallazgos clave)
✅ Evidencia:
“Across studies, replacing sugars with NNSs appeared to support weight loss maintenance, while NNS consumption and dietary sweet taste exposure showed no adverse changes in body weight, glucoregulatory and endocrine biomarkers, cardiometabolic risk factors, gut microbiota, or liver enzymes.” (p. 1)
- Mi nota: Respaldo de ensayos: sin cambios adversos en biomarcadores cardiometabólicos. Contrapeso a la evidencia observacional.
“Much of this controversy stems from divergent findings between randomized controlled trials (RCTs) and observational studies (OS) [4–7]. High-quality RCTs, which have appropriate controls and are designed to establish causal relationships, generally report beneficial or neutral effects of NNSs on body weight, energy intake, and glycemic outcomes, whereas observational studies, which are designed to understand correlation, frequently report adverse associations with adiposity, cardiometabolic disease, and mortality [8].” (p. 2)
- Mi nota: Idea principal: la controversia depende del tipo de estudio. Marco para ordenar el eje de seguridad en 04 Marco teórico.
✅ Evidencia:
“At 12 months, both groups maintained substantial weight loss (−5.6 ± 5.7 kg vs. −7.2 ± 7.0 kg), and the group including NNS maintained significantly greater weight loss than the NNS avoidance group (between-group difference: −1.6 ± 0.7 kg).” (p. 5)
- Mi nota: Dato cuantitativo del ensayo SWEET (12 meses): pequeña ventaja en peso con edulcorantes.
✅ Evidencia:
“Overall, these findings show that replacing sucrose in solid foods with neotame or StRebM attenuates postprandial glucose and insulin responses sustainably, suggesting potential benefit for glycemic control in individuals at risk of type 2 diabetes [14].” (p. 7)
- Mi nota: Evidencia en matriz sólida (galletas) con glucósido de esteviol Reb M: lo más cercano a un dulce con estevia.
✅ Evidencia:
“The results showed that inclusion of NNSs did not increase explicit liking nor implicit wanting for sweet foods, while avoidance of NNSs led to an increase in explicit liking toward sweet (sugar-containing) foods.” (p. 9)
- Mi nota: Responde a la objeción de que los edulcorantes ‘enganchan’ al dulce.
🔵 Conceptos clave
“Non-nutritive sweeteners (NNSs) provide the sweet taste of sugar but have little to no energy; they have been widely adopted as tools to reduce sugar intake while maintaining the palatability of foods and beverages.” (p. 2)
- Mi nota: Definición de edulcorante no nutritivo (aplica a la Reb A de la fórmula).
“In contrast, observational studies incorporate larger and more diverse populations and typically span longer timeframes, but they are susceptible to measurement error, residual confounding, and reverse causality. For instance, NNS consumption is frequently higher among individuals already exhibiting elevated metabolic risk, reducing the generalizability of associations observed in these cohorts [9].” (p. 2)
- Mi nota: Concepto de causalidad inversa aplicado a edulcorantes; sirve para leer Witkowski 2023 con criterio.
🔴 Citas textuales relevantes
“The WHO has stated that “people should reduce the sweetness of the diet altogether,” irrespective of whether this sweetness derives from sugars, NNSs, or naturally sweet foods [12].” (p. 2)
- Mi nota: Cita de la OMS sobre reducir el dulzor en general; reto para el posicionamiento de un masmelo ‘sin azúcar’.
“Taken together, these findings are consistent with the existing body of evidence that replacing sugars with NNSs can support weight management strategies and reduction in sugar intake, whereas variation in habitual dietary sweet taste exposure per se (independent of whether sweetness is derived from sugars or NNSs), within the studied intervention periods, appears largely neutral with respect to weight regulation, health-related biomarkers, and eating behavior.” (p. 13)
- Mi nota: Conclusión citable para la justificación del producto sin azúcar.
🟢 Conexiones con el TFE de Mary
- Evidencia de ensayos europeos recientes sin efectos adversos cardiometabólicos de los edulcorantes no nutritivos: contrapeso a la evidencia observacional en el eje de seguridad.
- Ninguno de los ensayos estudia el eritritol en concreto (neotame, Reb M, mezclas): no sirve para cerrar el debate eritritol-cardiovascular.
- En el ensayo de bebidas las mezclas con estevia gustaron menos que la sacarosa: refuerza la necesidad de la prueba hedónica de 9 puntos para la Reb A del masmelo.
- Muestra la falta de consenso entre guías (OMS y EE. UU. vs Reino Unido), útil para matizar la justificación del producto.
- Financiada por IAFNS y con autores vinculados a la industria (Cargill): declarar al citar.
🟠 Limitaciones y vacíos
“The contrast in how the evidence is evaluated is highlighted by diverse guidelines, which typically rely more on the findings from OS: the WHO advises against the use of NNSs for weight control [8], and the recent US Dietary Guidelines for Americans (2025–2030) [10] emphasize a ‘real food’ approach and generally discourage intake of highly processed foods, including NNSs, whereas UK professional bodies (the British Dietetic Association (BDA), the British Nutrition Foundation (BNF) and Diabetes UK) recognize NNSs as suitable tools for sugar reduction [11].” (p. 2)
- Mi nota: Tensión entre guías (OMS y EE. UU. vs Reino Unido): el TFE debe reconocer que no hay consenso.
“Sucrose and a sucralose–acesulfame-K blend were rated as more liked and more desired than both stevia-containing blends [19]. Thus, the trial demonstrated formulation-dependent differences in acute hedonic acceptance, without assessing longer-term changes in sweet taste liking or preference.” (p. 10)
- Mi nota: Las mezclas con estevia gustaron menos: riesgo sensorial para la Reb A de Mary; justificar la prueba hedónica de 9 puntos.
“Although RCTs provide the strongest basis for causal inference, the studies reviewed here were conducted in selected European populations, mainly adults, with overweight or obesity, often within structured dietary or behavioral intervention contexts. Accordingly, the findings may not fully generalize to other population groups or habitual real-world dietary patterns.” (p. 12)
- Mi nota: Limitación: poblaciones seleccionadas; no extrapolar sin matices al consumidor general.
“However, long-term effects and developmental effects, particularly in children and adolescents, remain uncertain.” (p. 13)
- Mi nota: Vacío: efectos a largo plazo y en niños inciertos; importante si el masmelo se consume por niños.
“C.S. is an employee of Cargill B.V., a company that manufactures low- and no-calorie sweeteners and is Vice Chair of the IAFNS LNCS Committee.” (p. 14)
- Mi nota: Conflicto de interés (autor empleado de fabricante de edulcorantes; revisión financiada por IAFNS). Declararlo al citar.
Preguntas orientadoras
- Čad et al. reúnen cinco ensayos europeos (SWEET, SWITCH y Sweet Tooth) sin cambios cardiometabólicos adversos, pero ninguno estudia el eritritol. ¿Puedes citarlos en el debate del eritritol o solo para defender la Reb A? ¿Cómo lo dejarías claro en un párrafo?
- En uno de los ensayos, la sacarosa y la mezcla sucralosa–acesulfamo K gustaron más que las dos mezclas con estevia. ¿Qué te dice esto sobre el resultado que podría salir al comparar tu masmelo con el tradicional en la prueba de 9 puntos, y cómo te prepararías para interpretarlo?
- La OMS pide reducir el dulzor de la dieta en general, venga de azúcares o de edulcorantes, mientras que la BDA, la BNF y Diabetes UK aceptan los edulcorantes para reducir azúcar. ¿Cómo justificarías un masmelo “sin azúcar” en tu Justificación sin contradecir a la OMS?
- 🎓 Pregunta de sustentación: “Esta revisión la financió IAFNS y uno de sus autores trabaja en Cargill. ¿No se apoya su discusión de seguridad en fuentes vinculadas a la industria de edulcorantes?”
Mi reflexión
Graba tu respuesta a estas preguntas con tus palabras. No hace falta responderlas todas ni en orden.
Notas derivadas
¿Dónde lo uso en el TFE?
- 04 Marco teórico — edulcorantes no nutritivos y salud
- 08 Resultados y discusión — seguridad y aceptación sensorial de la estevia