Synthetic Sweeteners and Human Health: An Overview of Health Risks, Vulnerable Populations, and Effects on Key Biological Systems.

Background and Objectives: Nowadays synthetic sweeteners are widely used as sugar substitutes in beverages, processed foods, and pharmaceutical products, largely due to their low caloric content and perceived benefits for weight management and glycemic control. Their consumption has increased markedly over recent decades, paralleling global efforts to reduce added sugar intake and combat obesity and diabetes. This review examines the regulation of artificial sweeteners, their impact on vulnerable populations, and the increased concern about their health effects, including metabolic effects, effects on gut microbiota and neurological and behavioral issues. Materials and Methods: A comprehensive search was performed across multiple electronic databases, including PubMed, Scopus, Web of Science, and Google Scholar, to identify studies relevant to synthetic sweeteners and human health. Results: While considered safe, artificial sweeteners are linked to potential influence on hormonal responses, affecting glucose homeostasis and insulin secretion, as well as effects on gut microbiota composition and glucose metabolism. However, the results reveal inconsistencies of the impact of artificial sweeteners on vulnerable populations, as well as their effects on the human gut microbiota, neurological behavior and endocrine effects and evidence remain limited. Conclusions: Continuous human trials, post-market surveillance and regulatory evaluations are therefore essential to ensure the safety of sugar substitutes for consumers' health.