Chen Huang-Pin, Kao Yuan, Lin Meng-Wei, Lee Chun-Te, Wu Hung-Tsung, Kuo Hsin-Yu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
Department of Emergency Medicine, Chi Mei Medical Center, Tainan 710, Taiwan.
Nutrients. 2025 Aug 22;17(17):2726. doi: 10.3390/nu17172726.
Low-calorie sweeteners (LCS) are widely utilized as sugar substitutes due to their intense sweetness, thermal stability, and applicability in weight management and diabetic-friendly products. However, increasing evidence has raised concerns about their potential long-term effects on metabolic health, glucose regulation, cardiovascular function, carcinogenicity, and gut microbiota composition. This review systematically evaluates the pharmacokinetics, metabolic effects, and associated health outcomes of major LCS. Mechanistically, LCS exert effects via sweet taste receptor-mediated pathways, altering glucose absorption, insulin secretion, and intracellular signaling cascades. Additionally, LCS influence gut microbiota composition, with certain agents promoting dysbiosis and glucose intolerance. While some findings support the metabolic benefits of selected LCS, others underscore potential risks, necessitating cautious interpretation. In conclusion, while LCS offer viable alternatives to sugar, their health effects are context-dependent and may vary across different sweeteners and populations. Long-term, high-quality clinical trials are essential to elucidate their safety and efficacy.
低热量甜味剂（LCS）因其甜度高、热稳定性好且适用于体重管理和糖尿病友好型产品而被广泛用作糖替代品。然而，越来越多的证据引发了人们对其对代谢健康、血糖调节、心血管功能、致癌性和肠道微生物群组成的潜在长期影响的担忧。本综述系统地评估了主要低热量甜味剂的药代动力学、代谢效应和相关健康结果。从机制上讲，低热量甜味剂通过甜味受体介导的途径发挥作用，改变葡萄糖吸收、胰岛素分泌和细胞内信号级联反应。此外，低热量甜味剂会影响肠道微生物群组成，某些制剂会促进生态失调和葡萄糖不耐受。虽然一些研究结果支持特定低热量甜味剂的代谢益处，但其他研究结果强调了潜在风险，需要谨慎解读。总之，虽然低热量甜味剂为糖提供了可行的替代品，但其健康影响取决于具体情况，可能因不同的甜味剂和人群而异。长期、高质量的临床试验对于阐明其安全性和有效性至关重要。
