Randomised controlled trialindependent cross-checkabstract only checked★ key study I-SOD-03 in-depth review

Sweeteners and blood sugar: a 120-person trial

Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance.

Overview

Suez J et al.. Cell 2022 · PMID 35987213 · DOI 10.1016/j.cell.2022.07.016

Saccharin and sucralose worsened glucose responses in some people; aspartame and stevia did not significantly.

Does the study support the specific claim? Partly · Methodological quality: high

Study explained simply

What did the researchers want to find out?: Do NNS causally affect human microbiome and glycaemic responses?
How was the study done?: Randomized controlled trial (2 weeks) plus gnotobiotic mouse transfer.
How many people, animals or samples were studied?: 120; Healthy adults
What was actually found?: Each NNS distinctly altered stool and oral microbiome and plasma metabolome; saccharin and sucralose significantly impaired glycaemic responses; responder-specific effects reproduced in mice.
How large was the observed effect?: Qualitative (numbers not in abstract)
What do the results mean in everyday life?: Some sweeteners affect some people.
What are the study's limitations?: Short (2 weeks); Clinical relevance unknown; Authors' commercial interests
What does it say about Elawady's specific claim?: Mixed for C-SOD-07.
Do the results apply to Germany and Europe?: High.
What can explicitly not be concluded from this study?: Long-term disease risk.

Do NNS causally affect human microbiome and glycaemic responses?

Study design: Randomised controlled trial – Randomized controlled trial (2 weeks) plus gnotobiotic mouse transfer.
Population: Healthy adults
Country: Israel
Period: not stated in abstract
Sample size: 120
Inclusion and exclusion criteria: not stated in abstract

Exposure / intervention: Saccharin, sucralose, aspartame, stevia sachets below ADI
Comparator: Glucose vehicle or no supplement
Endpoints: Microbiome, metabolome, glycaemic responses
Statistical methods: Group comparisons; mouse transfer

Results: Each NNS distinctly altered stool and oral microbiome and plasma metabolome; saccharin and sucralose significantly impaired glycaemic responses; responder-specific effects reproduced in mice.
Absolute risks: not applicable
Authors' conclusion: NNS may induce person-specific, microbiome-dependent glycaemic alterations.

Effects sweetener-specific.

Mixed for C-SOD-07.

Aspartame and stevia without significant glycaemic impairment.

High.

Best human evidence on NNS and microbiome.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	high
Risk of bias	some concerns
Precision of results	moderate
Directness	direct
Reproducibility	partly replicated
Consistency with the overall evidence	mixed
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable

Long-term effects.