Effect of Sucralose Consumption on Gut Microbiota: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Journal
- International journal of molecular sciences (Q1)
- Published
- 20 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Dwi Tari Wulandari, Nuri Andarwulan, Saraswati, Eny Palupi, Dominika Średnicka-Tober
- PMID
- 42794802
- DOI
- 10.3390/ijms27188377
Why clinicians should know about it
- Picked for Microbiology (medical) (top studies of the week, 27 September 2026).
Abstract
Sucralose is a widely consumed non-nutritive sweetener, with approximately 85% reaching the colon unmetabolized and directly interacting with the gut microbiota. Despite regulatory approval, its impact on microbial ecology and metabolic outcomes remains inconclusive. Previous meta-analyses included only two human studies and did not integrate microbiota, short-chain fatty acids, and metabolic parameters. This systematic review and meta-analysis evaluated the effects of sucralose on gut microbiota composition, alpha diversity, short-chain fatty acid production, and metabolic parameters in healthy adults based on randomized controlled trial evidence. A systematic search of PubMed, Scopus, and Google Scholar was conducted in May 2026 following PRISMA guidelines. Risk of bias was assessed using Cochrane RoB 2.0, and meta-analysis employed a REML random-effects model. Ten randomized controlled trials involving 8-61 participants per study (total across intervention and control groups) met the inclusion criteria; seven provided data for meta-analysis. Sucralose did not significantly alter alpha diversity (Shannon index: SMD = -0.00; 95% CI -1.16 to 1.15; p = 0.99; I2 = 25.67%), fasting blood glucose (SMD = -0.04; 95% CI = -0.63 to 0.56; p = 0.88; I2 = 69.61%), and HOMA-IR (SMD = -0.13; 95% CI = -0.36 to 0.10; p = 0.212; I2 = 0.00%). Butyrate showed a numerical decrease, although the pooled effect was not statistically significant and substantial heterogeneity was observed. Overall, the available evidence from short-term randomized controlled trials did not demonstrate statistically significant effects of sucralose consumption on the evaluated microbiota and metabolic outcomes. Standardized, longer-duration randomized controlled trials with inert comparators are needed.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.