Artificially sweetened beverages (ASB) are drinks, such as soda, carbonated water and juices, that have been sweetened with nonnutritive sweeteners (NNS) instead of (or in addition to) sugar. These NNS include aspartame, sucralose, and acesulfame potassium (or acesulfame K). They produce a sweet taste using the same taste receptors as sugar, but are not similar enough to sugar for the body to process as energy.^[3] ASB consumption is on the rise globally, with many people choosing to replace sugar-sweetened beverages with ASBs. While controversy exists around the safety of ASB, they are often recommended to people who are trying to lose weight and to diabetics.^[4]

ASBs are often used by people who are trying to lose weight. Since they taste sweet, they can be substituted in place of higher-calorie sugar-sweetened beverages, helping to lower calorie intake while still providing a similar taste. This is also beneficial since fluids are generally less satiating than solid foods, so drinking ASBs helps limit the calories in drinks, leaving more room in a weight loss plan for food.^[5][6][7] In some studies, a high intake of ASBs is associated with higher BMI, but this is not necessarily because they cause weight gain: it’s commonly thought that people who have a higher BMI are more likely to drink ASBs, possibly in support of attempts to lose weight. In fact, some research shows that replacing sugar-sweetened beverages with ASBs may help not only with losing weight, but also with maintaining weight loss.^[8][9][10] In people with diabetes, replacing sugar-sweetened beverages with ASBs may not only help improve disease control, but may even lower medication requirements in some cases. Of course, ASBs should be used in conjunction with other appropriate lifestyle modifications.^[5][11]

Maintaining a healthy weight with the help of ASBs in place of sugar-sweetened beverages may lower the risk of cardiovascular disease and of certain cancers associated with overweight or obesity. Obesity-related cancers include gastric cancer, esophageal cancer, pancreatic cancer, and breast cancer. However, the study also noted a possible association between ASB and CVD in some subgroups; this needs to be investigated further, but in the meantime, the study authors note that it is worth considering replacing SSBs with water rather than ASB where possible.^[12]

While the majority of the evidence seems to support the safety of ASBs at moderate intake levels, there may be some negative aspects to their consumption. Infants born to mothers who consumed ASBs throughout pregnancy had an increased risk of being overweight according to BMI at 1 year of age. With childhood obesity on the rise, this is a concerning association, although this link is not necessarily causative.^[13]

It is theorized that ASBs may impact the gut microbiome, causing changes in appetite regulation and weight, but this is not yet supported by research. In fact, some studies found that sugar-sweetened beverages can have more impact on the gut than ASBs. More research is needed to understand the effect of ASB intake on the gut microbiome.^[14]

While some research has found an association between the intake of artificial sweeteners and cardiovascular disease, this could be related to lifestyle choices and confounding factors; there is no clear evidence that ASBs cause cardiovascular disease.^[15][8][16]