Key TakeawaysArtificial sweeteners may affect metabolismArtificial and low-calorie sweeteners have been linked to higher fasting insulin, higher HbA1c and reduced insulin sensitivityAlterations to the gut microbiome may help explain the observed metabolic changes.MONDAY, July 6, 2026 (HealthDay News) — For decades, artificial sweeteners have been promoted as a healthier alternative to sugar. But new research suggests they may have unexpected effects on your metabolism."What makes our analysis notable is that by focusing on non-caloric comparators, we better isolated the direct physiological effects of the sweeteners themselves, not the calories they replace," said first author Meng Wang, a research assistant professor at Tufts University’s Friedman School of Nutrition Science and Policy in Boston. "When pooling findings from individual trials, we see signals that these compounds may have metabolic harms," she added in a news release.The researchers analyzed 21 randomized clinical trials comparing artificial and low-calorie sweeteners with non-caloric options like water or a placebo.The result: Artificial sweeteners were linked to higher fasting insulin levels and a higher HbA1c — a measure of long-term blood sugar control. The analysis also showed a trend toward reduced insulin sensitivity.Researchers said one possible explanation involves the gut microbiome. Previous evidence suggests certain non-nutritive sweeteners can alter the makeup and function of your gut bacteria.The review also found that people who consume more artificial sweeteners may have a higher risk of cardiometabolic conditions, including type 2 diabetes and heart disease.Researchers said their overall findings suggest these compounds may have metabolic harms, but more studies are needed to establish cause and effect.In the meantime, "if you're replacing large amounts of added sugar in your diet, such as in multiple servings of soda, these low-calorie sweeteners may be a better alternative." said study senior author Dr. Dariush Mozaffarian, a cardiologist and director of Tufts’ Food is Medicine Institute. "We can't simply assume they are safe and innocuous, and avoiding them whenever possible appears a prudent choice."The review was recently published in the journal Current Atherosclerosis Reports.More informationThe Mayo Clinic has more on artificial sweeteners.SOURCE: HealthDay TV, July 6, 2026 .What This Means For YouArtificial sweeteners may not be as metabolically harmless as once thought. While they can still be a better choice than lots of added sugar, they may affect blood sugar regulation and insulin levels, so it's probably best not to rely on them heavily..Sign up for our weekly HealthDay newsletter