The Effects of Aspartame on Glucose, Insulin, and Appetite-Regulating Hormone Responses in Humans: Systematic Review and Meta-Analyses.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of controlled intervention trials
PubMed 40381807 · doi:10.1016/j.advnut.2025.100449
What was done
Authors searched five databases and four trial registries through June 2024 for controlled intervention studies evaluating aspartame versus comparators on glucose, insulin, and appetite-regulating hormone responses. Meta-analyses were conducted when ≥10 studies used similar methodology. Risk of bias was evaluated via RoB-2, and evidence certainty was assessed using GRADE. The review included 101 articles detailing 100 experiments: 79 acute (≤1 day), 8 medium-term (2–30 days), and 13 long-term (>30 days) across healthy adults, individuals with aspartame sensitivity, and populations with compromised glucose metabolism.
What was found
The abstract reports no numerical point estimates or confidence intervals. In acute crossover meta-analyses, aspartame showed few effects on blood glucose or insulin compared with vehicle or other low-calorie sweeteners, and yielded lower glucose and insulin concentrations than sugars, other carbohydrates, or nutritive elements. Medium- and long-term trials similarly showed few effects on glucose metabolism alongside high heterogeneity. Most studies raised "some concerns" for risk of bias, and certainty of evidence was judged "very low" across all outcomes and populations.
Why it matters
This review aggregates human trial evidence to show that aspartame behaves similarly to non-caloric vehicles rather than sugars with respect to acute and chronic glycemic control, though underlying evidence quality remains low.
Limits
The abstract provides no numerical effect estimates or confidence intervals. The overall body of evidence was graded very low certainty due to risk of bias and high heterogeneity in medium- and long-term experiments. Few studies evaluated non-insulin appetite-regulating hormones or compared aspartame directly against other low-calorie sweeteners.
Cited by
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