Sweeteners revisited: Scientific evidence, regulatory shifts, and industry implications

Sweeteners are consumed daily by hundreds of millions of people and are embedded across a vast range of food, beverage, and pharmaceutical products. Historically approved based on animal toxicology and human intake modelling, the assumption that these substances have minimal interaction with the body is now being questioned. Between 2023 and 2025, pivotal new studies have examined potential links between low- and no-calorie sweeteners (LNCS) and metabolic outcomes, cardiovascular and cognitive health, microbiome composition, endocrine development, and possible cancer risk signals. Concurrently, juxtaposed health policy and regulatory shifts occurred, with the World Health Organization (WHO) advising against the use of intense sweeteners for weight control while the European Food Safety Authority (EFSA) raised the acceptable daily intakes (ADIs) for acesulfameK and saccharin. The US Food and Drug Administration (FDA) reasserted its confidence in aspartame. This review integrates emerging health evidence, evaluates the fragmented regulatory and health policy landscape, and analyses the resulting market dynamics and strategic implications for the global sweetener industry. It is concluded that, based on the mixed and methodologically heterogeneous findings from research into sweeteners and health, including study limitations such as difficulty separating cause and effect and the influence of other daily habits, LNCS warrant a precautionary, transparencyfirst public health approach, continued highquality longitudinal research, and industry innovation towards naturally derived sweetening solutions. For the sugar industry, consumer demand for ‘clean label’ products presents both risks and opportunities. As LNCS face rising scrutiny, sugar producers can reposition sugar as a traceable, naturally derived ingredient and also diversify into other plant-based or fermentation-derived sweeteners. This evolving landscape may change the competitive balance between traditional and alternative sweeteners, driving reformulation, innovation, and sustainability commitments across the value chain.