Research into the impact of artificial or non-nutritive sweeteners (AS/NSS) often focuses on groups like those with diabetes or who are pregnant, but University of Adelaide researchers have released their findings from an under-studied group.
The systematic review of 15 papers by the School of Public Health and Robinson Research Institute's Associate Professor Zohra Lassi and Saima Shaukat Ali focused on how the sweeteners affected non-pregnant, non-lactating women aged 15 to 49.
Artificial sweeteners like aspartame, sucralose and steviol are often used as low-calorie substitutes for sugar in soft drinks and food.
"As the World Health Organisation recommends limiting sugar consumption to 10 per cent of the total daily energy intake, we're seeing an increase in artificial or non-nutritive sweeteners purchasing and consumption globally," says Associate Professor Lassi.
"Literature on the health implications of AS/NNS use is conflicting, with some studies showing links to increased risk of metabolic syndrome, diabetes mellitus, cardiovascular problems, depression, dementia, osteoporosis and some types of cancer, whilst others show the positive impacts of AS/NNS substitution on weight loss/maintenance.
"Consumption of AS/NNS during pregnancy has also been linked with neonatal outcomes, including preterm delivery and increased birth weight; however, non-pregnant and non-lactating women of reproductive age have unique dietary patterns and health considerations that are frequently overlooked in this research.
"Women within these age ranges experience unique physiological and metabolic conditions influenced by hormonal fluctuations, reproductive health, and lifestyle factors."
The review, which was published in Current Developments in Nutrition, found white participants had the highest rate of AS/NSS use.
"In four studies which reported on participant income, those with higher socioeconomic position and/or income had the highest prevalence of AS/NSS compared to those with lower socioeconomic position," says Ms Ali, the paper's first author.
"One study reported that women of reproductive age (non-pregnant and non-breastfeeding) who participated in the weight loss program, who had high BMIs, and who were using low-calorie sweeteners (LCS) for weight loss reasons were more likely to be moderate or heavy LCS users than light users."
Ms Ali said the findings suggest that interventions, policies, and health recommendations need to account for these specific determinants rather than applying a one-size-fits-all approach.
"These insights provide an evidence base for tailoring public health messaging and clinical guidelines for women of reproductive age," she said.
"They can inform nutrition policies, weight management programs, and future research that better reflects real-world consumption patterns, particularly among women with varying socioeconomic backgrounds.
"Further research on long-term health impacts and cultural and behavioural factors driving consumption is required, to help develop more targeted and effective interventions for improving health equity and dietary quality."
