Problems with most gummies on the market

Lower Quality Ingredients

Gummy vitamins do not always contain the highest quality and most bioavailable ingredients. When an ingredient is bioavailable, it means the body can absorb it and use it effectively right away. One reason for lower-quality ingredients in gummies is that the manufacturer isn’t invested in high-quality and bioavailable forms of nutrients, which are the standard in integrative and functional medicine. Another reason is the harsh manufacturing conditions for gummies. Highly bioavailable ingredients have trouble surviving extremes of heat, moisture, light, and pH during gummy vitamin manufacturing. Therefore, it is important to select a trustworthy and knowledgeable manufacturer when shopping for gummies.

DaVinci® Laboratories designs gummy formulas with ingredients that are as bioavailable as possible, without compromising the quality and stability of the ingredients. They use ingredients that are tested and maintained with approved suppliers through vendor qualification programs. When well-matched for a gummy formula, they include ingredients that are trademarked and backed by research

For example, they use bioactive ingredients such as vitamin K2 in the form of menaquinone (MK-7) and vitamin D3 instead of vitamin D2. They may use the more bioavailable Quatrefolic® instead of folic acid and methylcobalamin instead of cyanocobalamin. This level of research and development balances the demand for quality ingredients with the limitations of gummy manufacturing for the best possible outcome.

patients who may benefit from premium-quality gummies

When designing a comprehensive nutritional protocol, gummies hold promise, especially for certain groups of patients.

Patients with Dysphagia

An estimated 38% of Americans have difficulty swallowing pills, and gummy vitamins could be a valuable route for delivering nutrients to them.¹⁵ Also known as dysphagia, difficulty swallowing is estimated to affect 22% of adults over 50 years of age.¹⁶ According to the American Speech-Language-Hearing Association, approximately one in 25 adults will experience a swallowing problem in the United States each year.¹⁶

Dysphagia is common in people who have dementia and can lead to aspiration pneumonia when particles of food, drinks, saliva, or pills enter the lungs. Dysphagia can also lead to malnutrition, making gummies an important source of nutrients in this patient population. Any issue affecting muscle control and nerves can interfere with proper swallowing. In addition, an enlarged thyroid or heart can lead to dysphagia by putting pressure on the esophagus. Other conditions linked to dysphagia include certain autoimmune diseases such as systemic lupus erythematosus and Sjogren’s syndrome. High-quality gummy vitamins could provide an important source of supplemental nutrition to this group.

The Elderly

In a study of healthy older adults, 45% of the people had inadequate intake of nutrients and micronutrient deficiencies. Being undernourished occurred in:

• 5%-10% of community-dwelling older adults
• 50% of older adults in rehabilitation facilities
• 20% of adults in residential care
• 40% of older adults in hospitals¹⁷

Children

Kids find gummies a fun way to obtain their vitamins and nutrients. An estimated 70% of children’s vitamins are sold as gummies. Because children like the taste of gummies, it’s best to store the gummies out of reach of children, to avoid having a child consume more than the recommended dose.

Busy People

People who are on the go find gummies a convenient way to take dietary supplements. It’s much easier to grab a gummy and rush out of the house than to take the time to find a beverage and swallow vitamins. Taking gummy vitamins regularly requires less discipline because they always provide a hit of sweetness, like a baked-in sweet reward.

pros and cons of sweeteners used in gummies

Integrative and functional health practitioners usually promote a whole-foods diet that has little to no sugar or processed carbohydrates for optimum metabolic, brain, and gut health. Yet, for patients who have difficulty taking pills or who are non-compliant, a sugar-free gummy supplement supports health goals.

There are many sweeteners out there on the gummy market, which may make it difficult for practitioners and consumers to determine which ones are best. The goal is to have a sweet and pleasant flavor without a detrimental impact on blood sugar, metabolism, body weight, brain function, or heart health. This article presents the science behind common sweeteners such as sucrose and sucralose, as well as naturally occurring sweeteners that are popular in the integrative and functional health industry for their minimal impact on blood sugar (e.g. stevia, xylitol, monk fruit).

Lastly, we will introduce allulose, a low-calorie sweetener that promotes metabolic health and can even help support healthy GLP-1.*

The Dangers of Sucrose and High Fructose Corn Syrup

When most patients hear the term “sugar,” they’re going to think of table sugar. Sucrose is the scientific name for table sugar. It is a type of carbohydrate known as a disaccharide, meaning it contains two simple sugar molecules linked together: glucose and fructose. The body breaks down sucrose into glucose and fructose for energy.

Fructose is a free-form monosaccharide carbohydrate, or a simple sugar, found in fruits, honey, and vegetables. Fructose has a glycemic index of 15, while glucose has a glycemic index of 100. The glycemic index is a scale (0 to 100) that measures how quickly a carbohydrate-containing food raises blood sugar compared to pure glucose (100).¹⁸

High-fructose corn syrup (HFCS) is a sweetener made from corn starch that has been processed to convert some of its glucose into fructose, making it sweeter than regular corn syrup. Like sucrose, it contains nearly equal amounts of glucose and fructose.¹⁹ Diets high in fructose are known to encourage cardiometabolic disease.¹⁹ HFCS intake by way of processed foods in the United States increased dramatically from the 1970s to 2000s and has been suggested as a factor in the increased incidence of obesity and overweight during that same time period.²⁰

While glucose is easily used by every cell in the body, fructose—whether it’s from table sugar or high fructose corn syrup—needs to be converted to glucose, glycogen, or fat in the liver before the body can use it as fuel. Sucrose has a glycemic index of 65 while high-fructose corn syrup’s glycemic index is 56.

Excessive consumption of sucrose and high fructose corn syrup can pose problems for metabolism, heart health, blood lipids, body weight, and liver function. It can also lead to an imbalanced inflammatory response.²¹ This is concerning, given that Americans eat an average of 69.8 pounds of refined sugar (sucrose) and 39.5 pounds of high fructose corn syrup per capita annually, according to the United States Department of Agriculture (USDA).²² Limiting the intake of sucrose and HFCS is therefore recommended to reduce the risk of developing these chronic conditions. Naturally occurring sweeteners can serve as promising alternatives to sucrose and HFCS.

Sucrose and high-fructose corn syrup can increase liver fat storage and spike fasting insulin levels.^23,24 Fructose and glucose do not always have the same effects on the body. In overweight/obese adults, fasting plasma glucose and insulin levels increased and insulin sensitivity declined in subjects who consumed large amounts of fructose, but not in those consuming an equal amount of glucose.²⁵ Markers of alterations in lipid metabolism, such as low-density lipoprotein (LDL) cholesterol, oxidized LDL, and small density LDL, increased during fructose—but not glucose—consumption.

Aside from the detrimental effects on metabolism, cognition, heart health, and body weight, sugars wreak havoc on dental health. Sugars in the diet are the most important dietary factor in the etiology of dental caries.²⁶ Sugars are metabolized by numerous oral bacteria into acidic byproducts, which lead to tooth structure breakdown (demineralization) and dental caries.²⁶

Avoiding sucrose or high-fructose corn syrup is not easy, since they are added to countless ultra-processed foods, such as tomato sauce, ketchup, mustard, beverages, baked goods, canned soups, energy bars, and salad dressings, to name just a few. When taking a health-promoting nutritional supplement, why include more unhealthy sweeteners to the mix?

Sucralose: Gateway to Inflammation, Dysbiosis, and Insulin Problems

Sucralose is a sugar alternative used as a sweetener in many gummies that are marketed as low sugar or zero sugar. Originally sold under the brand name Splenda, sucralose was approved in 1998 for use in 15 categories of foods. A year later, it was approved for use as a general sweetener with an ability to impart sweetness to foods without contributing a substantial caloric load.²⁷ Approximately 600% sweeter than table sugar, sucralose has a glycemic index of 0 and is produced from sucrose through a multiple-step process that involves adding three chlorine atoms to the sucrose molecule, which reduces intestinal absorption.²⁸ Present in over 4,500 food and beverage items, sucralose now comprises 30% of the U.S. sweetener market.²⁹

Sucralose was initially marketed to overweight and obese people as well as people with diabetes due to its ability to suppress blood sugar spikes and reduce the intake of calories while still satisfying this group’s sweet tooth. However, now sucralose is widely used even among non-diabetics. Many people prefer sucralose because it has less of a bitter aftertaste than some other artificial sweeteners. In addition to its ability to act as a non-caloric, low-glycemic sweetener, sucralose is bacteriostatic and therefore can help support dental health.³⁰

Despite these beneficial actions, sucralose intake is associated with adverse effects. The World Health Organization (WHO) issued an alert that sucralose consumption may be associated with systemic inflammation and metabolic diseases.³¹ The WHO’s alert was in response to evidence about sucralose’s negative effects. For example, in a study of overweight women, eight weeks of consuming sucralose-sweetened beverages led to changes in NF-κB inflammatory pathways in subcutaneous adipose tissue biopsies.³² Another study observed similar changes in young and healthy people who experienced worsened insulin sensitivity after consuming sucralose-sweetened diet drinks together with a carbohydrate-rich diet.³³

Other research found elevated cellular markers of systemic inflammation, blood glucose, and insulin levels in healthy young adults drinking an amount of sucralose equal to that found in a 500 mL diet drink per day.³² Another study demonstrated problems with insulin sensitivity and insulin response in healthy subjects who consumed a 200 mg sucralose pill for four weeks. The reduced insulin sensitivity occurred despite a corresponding increase in GLP-1 release.³⁴ Some studies indicate that sucralose has different effects in healthy subjects compared with people who have type 2 diabetes, with sucralose enhancing GLP-1 release and lowering blood glucose in healthy subjects, effects not seen in people with diabetes.³⁵

Sucralose may promote other adverse effects. Human research has shown maternal consumption of sweeteners like sucralose during pregnancy correlates with alterations in the colostrum microbiota.³⁶ Animal research has found that giving sucralose to pregnant mice alters the gut microbiota of offspring and worsens liver fat accumulation in adulthood.³⁷ Cell culture research indicates sucralose is associated with an increased mutation rate of Escherichia coli (E. coli), leading to resistance to antibiotics like rifampicin.³⁸ Furthermore, when heated to 250°C/482°F in the presence of glycerol or lipids, the metabolites of sucralose may contribute to the formation of toxic chloropropanols³⁹ as well as promote the formation of dioxin-like polychlorinated biphenyls (dl-PCBs) during cooking at 160°C/320°F.⁴⁰

xylitol and erythritol: promoting strong teeth, supporting glp-1

These low-calorie natural sugar alcohols are used in some gummies as well as a host of other foods and drinks. Erythritol is a naturally occurring monosaccharide sugar alcohol (polyol) found in a variety of fruits such as melons, pears, and grapes. Commercial large-scale erythritol production uses fermentation by yeast and yeast-like fungi as a cost-effective measure using substrates such as glucose, fructose, xylose, sucrose, cellulose, and glycerol. Since erythritol is found in fruits, the FDA also considers microbial-produced erythritol to be a natural sweetener. About 60% to 80% as sweet as sucrose, erythritol has a mild cooling effect in the mouth. It also is nearly completely noncaloric.

Erythritol increases the secretion of GLP-1, an intestinal hormone associated with glucose control and reduced appetite.⁴¹ Erythritol may also promote the release of (cholecystokinin) CCK and peptide tyrosine (PYY), both of which are involved in signaling a feeling of fullness to the brain after eating.⁴¹ Furthermore, it suppresses ghrelin, the hormone primarily responsible for appetite stimulation. Lower ghrelin levels can support feelings of fullness and reduce food intake

Xylitol is known as wood sugar, birch sugar, and meso-xylitol. It is a five-carbon polyol, produced in small amounts by the human body. Although it is found in fruits, vegetables, algae, and mushrooms, the levels are too low for commercial extraction, and it is commonly commercially produced from birch bark and corn cobs. Xylitol is used in many foods and pharmaceutical products in addition to sugar-free candies and chewing gums. It can be used as an emulsifier, humectant, stabilizer, sweetener, and thickener. Xylitol is as sweet as sucrose. It has a glycemic index of 13 and insulinemic index of 11 and provides 2.4 kcal/gram.

The biggest disadvantage of sugar alcohols such as xylitol and erythritol is that they can cause bloating, gas, and diarrhea. This usually occurs at high doses (>20 grams of xylitol) but some individuals are especially sensitive, and laxative effects can occur at lower doses. Patients may be consuming many different types of gummies and/or food and beverage products sweetened with sugar alcohols and even gummies with low doses of xylitol or erythritol could exceed the threshold, triggering symptoms. In some cases, when patients are constipated, the laxative effect of sugar alcohols is an advantage.

Some 2024 studies indicated xylitol and erythritol were linked to cardiovascular risks.^42,43 However, these studies were criticized for small sample size, the short-term duration of the studies, the fact the studies showed correlation not causation, and the studies used higher dosages that are not typical of everyday use.

Xylitol’s most significant advantage is its antiplaque, antigingivitic, and remineralizing properties, as demonstrated in a number of dental health studies. Xylitol is well known to reduce the incidence of dental caries and related opportunistic microbes, such as Streptococcus mutans.⁴⁴ Pregnant mothers who chewed xylitol gum reduced the incidence of cavities in their offspring.^45,46 In a study of people given either a placebo or xylitol, at the end of three weeks, gingival and plaque index scores were significantly decreased in the xylitol group with respect to baseline values.⁴⁷ In addition, the salivary concentration of inflammatory markers TNF-α, IL-6, and IL-8 were statistically reduced at three weeks in the xylitol group. S. mutans expression significantly declined about fivefold at three weeks of using xylitol compared to baseline.

stevia

Stevia is extracted from the leaves of Stevia rebaudiana Bertoni, a shrub native to South America. Indigenous people have used stevia leaves for centuries in health-supporting products and sweet drinks. The sweetness of steviol glycosides from stevia is derived from two major chemical compounds: stevioside and rebaudioside A. Steviol glycosides preparations are 200 - 450% sweeter than sucrose, are noncaloric, and have a glycemic index of 0.

Steviol glycosides produce significant improvement in glucose metabolism in adult participants when compared with the control.⁴⁸ When tested against other sweeteners, stevia produced an anti-inflammatory response while other sweeteners increased inflammation markers.⁴⁹ Other research found that stevia reduces energy intake and maintains weight in healthy adults.⁵⁰

The primary disadvantage of stevia is that it has an aftertaste that is unpleasing to certain people, which is why it’s usually combined with other sweeteners.

Monk fruit: limited applications

Monk fruit is also known as Swingle fruit or luo han guo. Monk fruit is made using a water extraction of the fruit, creating a solution of water-soluble solids, mainly cucurbitane glycoside and mogroside V. Monk fruit is 100 - 250% sweeter than table sugar and has a glycemic index of 0.

Monk fruit is less sweet than some other sweeteners and can have bitter and metallic aftertaste at higher concentrations, which is why it’s often combined with other sweeteners. Substituting monk fruit for sugar can lead to drier baked goods. Monk fruit also browns more quickly than sugar in heat applications like baking. 

allulose: the superstar sweetener

Allulose has been used as a sweetening agent and a replacement for sugar for nearly ten years. It occurs in small doses in wheat, fruits such as raisins and figs, and other sweet foods such as molasses and maple syrup. Allulose is only 70% as sweet as sugar but has only 5% of its caloric value and a glycemic index of 0. 

Allulose is a c-3 epimer of fructose, meaning that it has the same chemical formula and atomic connectivity, but a different three-dimensional arrangement. Therefore, it follows the same absorption, distribution, and excretion routes as fructose, but unlike fructose, the human body does not break down or metabolize allulose. This leads to an almost complete renal excretion in the urine of the absorbed dose resulting in a very low caloric response. This last property of allulose makes it an attractive choice as a sweetening agent for gummies as it does not directly raise blood sugar and supports healthy levels, thus providing a low-calorie alternative to sucrose and high-fructose corn syrup in addition to other low or zero calorie sweeteners.* Allulose tastes like sugar without providing the calories. It’s keto-friendly, vegetarian, and may act as a prebiotic.⁵¹*

Allulose supports health in a number of ways:*

• Supports healthy blood sugar*
• Promotes a healthy weight*
• Helps maintain metabolic health*
  
  

Allulose can help counteract blood sugar spikes, even after ingesting table sugar.* For example, allulose inhibits postprandial plasma glucose and insulin levels when adding it to a sucrose-sweetened beverage in a dose-dependent manner.⁵²* The more allulose added, the less the glucose and insulin response.* In a large study investigating the effects of allulose in people without preexisting metabolic conditions, allulose led to a dose-dependent postprandial reduction in plasma glucose and insulin levels.⁵³*

Allulose has impressive supportive effects on body weight.* In a 12-week trial, compared to sucralose, allulose reduced body mass index (BMI) including abdominal and subcutaneous fat in participants who were overweight, with no adverse effect on blood lipids.²¹*

Allulose leads to a release of GLP-1, CCK, and PYY, indicating it can improve satiety and support weight management.⁴¹* Allulose can stimulate taste receptors in the intestine, leading to a signaling cascade that enhances GLP-1 release.* This mechanism is crucial for the body’s ability to help control glucose levels after a meal. Allulose may also activate neural pathways to trigger GLP-1.⁴¹*

By virtue of its ability to support metabolic health, allulose is an ideal alternative to sucrose and other sweeteners.* Allulose has been used extensively in cooking, baked goods and as a general sweetening agent in the human diet without reports of adverse effects.²¹ Research has established that it has no effect on insulin, blood lipids, uric acid, and high-sensitivity C-reactive protein (hs-CRP), showing it supports a healthy inflammatory response.²¹*

The FDA considers this product to be GRAS (generally recognized as safe) in soft candies up to 25 grams. The FDA concluded that D-allulose intake of less than 0.5 to 0.6 g/kg body weight/day is safe. A study of dosages up to 15 grams per day showed no adverse effects and most importantly, the participants had improved fatty liver scores.* The tolerable dose of allulose is estimated to be 30 to 35 grams for a 132-pound person taken as a single dose. Amounts above that dosage can result in gastrointestinal distress including gas, bloating, stomach upset, or diarrhea. These issues may improve when reducing the sdf dosage below 30 grams per day.

dos and don'ts shopping list for gummies

tapping into the health benefits of allulose

DaVinci® Laboratories formulated a new line of premium gummies with allulose, an innovative naturally occurring sweetener that shows impressive effects maintaining blood sugar, insulin, and liver health; balancing appetite; and promoting a trim and lean body.* The first gummy in this allulose-sweetened line is ADK Gummies, which meets all the expectations of a premium gummy and contains three critical nutrients: vitamins A, D, and K for the health of bones, teeth, and the heart as well as supporting immunity.* It is formulated with superior forms of these nutrients best suited to a gummy matrix: vitamin K2 in the form of menaquinone (MK-7) and vitamin D3 instead of D2.

ADK Gummies haves all of the high-quality ingredients you want, without the ingredients you don’t want. ADK Gummies are non-GMO, and has no preservatives or dyes. It is sugar-free, gluten-free, and soy-free. Stored in an opaque bottle to ensure a long shelf-life, ADK Gummies have a pleasant pineapple flavor. It is third-party tested for microbes, soy, and gluten as well as its ingredients meeting the label claim. This ensures proper potency, so you can trust that your patients are nourished with the amount of ingredients stated on the label. ADK Gummies are also tested for heavy metals and genetically modified ingredients initially when it is released to market, and then periodically at strategic timepoints during production.

choosing the best gummies for your patients

Finding the right gummy can be a daunting task with an overwhelming number of choices available to patients. First and foremost, choosing a premium gummy involves looking for one that includes a healthy sweetener such as allulose while avoiding those sweetened with sugar, high-fructose corn syrup, or sucralose. Look for gummy vitamins that are formulated for maximum ingredient quality and stability.

Premium gummies also are:

• Formulated with the best forms of nutrients suited to a gummy matrix
• Gluten-free
• Third-party tested for label claims
• Non-GMO
• Soy-free
• Stored in an opaque bottle to ensure a long shelf life for light-sensitive ingredients

DaVinci® Laboratories has ushered in a new era of gummies that meets all these expectations. You can be assured your patients’ health is supported by healthy sweeteners and high-quality ingredients at clinically relevant doses that match the label claims.*

References:

1. Gummy Vitamins Global Market Report 2025. Accessed August 4, 2025. https://www.thebusinessresearchcompany.com/report/gummy-vitamins-global-market-report

2. Cooperman T. Multivitamin and Multimineral Supplements Review. Accessed August 4, 2025. https://www.consumerlab.com/reviews/multivitamin-review-comparisons/multivitamins/?search=80%20of%20gummy %20vitamins%20failed%20quality%20tests

3. uclahealth. Should You Take Gummy Vitamins? UCLA Health. https://www.uclahealth.org/news/article/should-you-take-gummy-vitamins. Published 2022. Accessed August 21, 2025.

4. Baratto PS, Sangalli CN, Leffa PDS, Valmorbida JL, Vitolo MR. Associations between children's dietary patterns, excessive weight gain, and … risk: cohort study nested to a randomized field trial. Rev Paul Pediatr. 2025;43:e2024117. doi:10.1590/1984-0462/2025/43/2024117

5. Yang Q, Zhang Z, Gregg EW, Flanders WD, Merritt R, Hu FB. Added sugar intake and … mortality among US adults. JAMA Intern Med. Apr 2014;174(4):516-24. doi:10.1001/jamainternmed.2013.13563

6. Yao S, Zhu J, Zhang H, et al. Prevalence and risk factors for … among 3-year-old children in Shanghai, China: a cross-sectional study. BMC Oral Health. Jul 9 2025;25(1):1132. doi:10.1186/s12903-025-06454-9

7. Gillespie KM, White MJ, Kemps E, Moore H, Dymond A, Bartlett SE. The Impact of Free and Added Sugars on Cognitive Function: A Systematic Review and Meta-Analysis. Nutrients. Dec 25 2023;16(1)doi:10.3390/nu16010075

8. Jacques A, Chaaya N, Beecher K, Ali SA, Belmer A, Bartlett S. The impact of sugar consumption on stress driven, emotional and addictive behaviors. Neurosci Biobehav Rev. Aug 2019;103:178-199. doi:10.1016/j.neubiorev.2019.05.021
9. Farsad-Naeimi A, Asjodi F, Omidian M, et al. Sugar consumption, sugar sweetened beverages and …: A systematic review and meta-analysis. Complement Ther Med. Sep 2020;53:102512. doi:10.1016/j.ctim.2020.102512
10. Pappe CL, Peters B, Pivovarova-Ramich O, et al. Effects of a 4-week free-sugar avoidance during …: An explorative randomized controlled clinical trial. J Periodontol. Jun 2025;96(6):675-690. doi:10.1002/jper.24-0208
11. National … Statistics Report. Accessed March 13, 2025. https://www.cdc.gov/diabetes/php/data-research/index.html
12. Overweight and … Statistics. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed August 4, 2025. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity
13. New Research Uncovers Concerning Increases in Youth Living with…in the U.S. [press release]. Centers for Disease Control and Prevention2021.
14. Zhang S, Wang C, Zhong W, Kemp AH, Guo M, Killpartrick A. Polymerized Whey Protein Concentrate-Based Glutathione Delivery System: Physicochemical Characterization, Bioavailability and Sub-Chronic Toxicity Evaluation. Molecules. Mar 24 2021;26(7)doi:10.3390/molecules26071824
15. Global Gummy Vitamins Market Grows Steadily at a CAGR of 6.3%. Straits Research. Accessed August 4, 2025. https://straitsresearch.com/press-release/global-gummy-vitamins-market-size
16. Adult …. American Speech-Language-Hearing Association Accessed August 4, 2025. https://www.asha.org/practice-portal/clinical-topics/adult-dysphagia/?srsltid=AfmBOoobOLdrI8oq6N9FC2ryp96I1IF734 VyDVcJgRZBx6BRrWCzKBoX#collapse_1
17. Gana W, De Luca A, Debacq C, et al. Analysis of the Impact of Selected Vitamins Deficiencies on the Risk of Disability in Older People. Nutrients. Sep 10 2021;13(9)doi:10.3390/nu13093163
18. Atkinson FS, Brand-Miller JC, Foster-Powell K, Buyken AE, Goletzke J. International tables of glycemic index and glycemic load values 2021: a systematic review. Am J Clin Nutr. 2021;114(5):1625-1632.
19. Herman MA, Birnbaum MJ. Molecular aspects of fructose metabolism and metabolic disease. Cell Metab. 2021;33(12):2329-2354.
20. Jung S, Bae H, Song WS, Jang C. Dietary Fructose and Fructose-Induced Pathologies. Annu Rev Nutr. 2022;42:45-66.
21. Teysseire F, Bordier V, Budzinska A, et al. Metabolic Effects and Safety Aspects of Acute D-allulose and Erythritol Administration in Healthy Subjects. Nutrients. Jan 15 2023;15(2)doi:10.3390/nu15020458
22. Abadam V. How sweet it is: Deliveries of caloric sweeteners for food and beverage use are on the rise. U.S. Department of Agriculture. Accessed August 9, 2025. https://www.ers.usda.gov/data-products/charts-of-note/chart-detail?chartId=105825
23. Maersk M, Belza A, Stødkilde-Jørgensen H, et al. Sucrose-sweetened beverages increase fat storage in the liver, muscle, and visceral fat depot: a 6-mo randomized intervention study. Am J Clin Nutr. Feb 2012;95(2):283-9. doi:10.3945/ajcn.111.022533
24. Lin WT, Chan TF, Huang HL, et al. Fructose-Rich Beverage Intake and Central Adiposity, Uric Acid, and Pediatric Insulin Resistance. J Pediatr. Apr 2016;171:90-6.e1. doi:10.1016/j.jpeds.2015.12.061
25. Stanhope KL, Schwarz JM, Keim NL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. J Clin Invest. May 2009;119(5):1322-34. doi:10.1172/jci37385
26. Gupta P, Gupta N, Pawar AP, Birajdar SS, Natt AS, Singh HP. Role of sugar and sugar substitutes in …: a review. ISRN Dent. 2013;2013:519421. doi:10.1155/2013/519421
27. Durán Agüero S, Angarita Dávila L, Escobar Contreras MC, Rojas Gómez D, de Assis Costa J. Noncaloric Sweeteners in Children: A Controversial Theme. Biomed Res Int. 2018;2018:4806534. doi:10.1155/2018/4806534
28. Magnuson BA, Roberts A, Nestmann ER. Critical review of the current literature on the safety of sucralose. Food Chem Toxicol. Aug 2017;106(Pt A):324-355. doi:10.1016/j.fct.2017.05.047
29. Risdon S, Battault S, Romo-Romo A, et al. Sucralose and Cardiometabolic Health: Current Understanding from Receptors to Clinical Investigations. Adv Nutr. Jul 30 2021;12(4):1500-1513. doi:10.1093/advances/nmaa185
30. Young DA, Bowen WH. The influence of sucralose on … metabolism. J Dent Res. Aug 1990;69(8):1480-4. doi:10.1177/00220345900690080601
31. WHO Guidelines Approved by the Guidelines Review Committee. Use of non-sugar sweeteners: WHO guideline. World Health Organization © World Health Organization 2023.; 2023.
32. Gómez-Arauz AY, Bueno-Hernández N, Palomera LF, et al. A Single 48 mg Sucralose Sip Unbalances Monocyte Subpopulations and Stimulates Insulin Secretion in Healthy Young Adults. J Immunol Res. 2019;2019:6105059. doi:10.1155/2019/6105059
33. Dalenberg JR, Patel BP, Denis R, et al. Short-Term Consumption of Sucralose with, but Not without, Carbohydrate Impairs Neural and Metabolic Sensitivity to Sugar in Humans. Cell Metab. Mar 3 2020;31(3):493-502.e7. doi:10.1016/j.cmet.2020.01.014
34. Lertrit A, Srimachai S, Saetung S, et al. Effects of sucralose on insulin and glucagon-like peptide-1 secretion in healthy subjects: a randomized, double-blind, placebo-controlled trial. Nutrition. Nov 2018;55-56:125-130. doi:10.1016/j.nut.2018.04.001
35. Temizkan S, Deyneli O, Yasar M, et al. Sucralose enhances GLP-1 release and lowers blood glucose in the presence of carbohydrate in healthy subjects but not in patients with…. Eur J Clin Nutr. Feb 2015;69(2):162-6. doi:10.1038/ejcn.2014.208
36. Tapia-González A, Vélez-Ixta JM, Bueno-Hernández N, et al. Maternal Consumption of Non-Nutritive Sweeteners during Pregnancy Is Associated with Alterations in the Colostrum Microbiota. Nutrients. Nov 26 2023;15(23)doi:10.3390/nu15234928
37. Dai X, Guo Z, Chen D, et al. Maternal sucralose intake alters gut microbiota of offspring and exacerbates …. in adulthood. Gut Microbes. Jul 3 2020;11(4):1043-1063. doi:10.1080/19490976.2020.1738187
38. Qu Y, Li R, Jiang M, Wang X. Sucralose Increases Antimicrobial Resistance and Stimulates… Mutants. Curr Microbiol. Jul 2017;74(7):885-888. doi:10.1007/s00284-017-1255-5
39. Anja Rahn VAY. Thermal degradation of sucralose and its potential in generating chloropropanols in the presence of glycerol. Food Chem. 2010;118(1):56-61.
40. Shujun Dong JW, Guorui Liu. Unintentionally produced dioxin-like polychlorinated biphenyls during cooking. Food Control 2011;22(11):1797-1802.
41. Teysseire F, Bordier V, Budzinska A, et al. The Role of D-allulose and Erythritol on the Activity of the Gut Sweet Taste Receptor and Gastrointestinal Satiation Hormone Release in Humans: A Randomized, Controlled Trial. J Nutr. May 5 2022;152(5):1228-1238. doi:10.1093/jn/nxac026
42. Xylitol may affect cardiovascular health. National Institute of Health Accessed August 4, 2025. https://www.nih.gov/news-events/nih-research-matters/xylitol-may-affect-cardiovascular-health
43. Cleveland Clinic Study Adds to Increasing Evidence that Sugar Substitute Erythritol Raises Cardiovascular Risk. Cleveland Clinic. Accessed August 4, 2025. https://newsroom.clevelandclinic.org/2024/08/08/cleveland-clinic-study-adds-to-increasing-evidence-that-sugar-substitute-ery thritol-raises-cardiovascular-risk
44. Krupa NC, Thippeswamy HM, Chandrashekar BR. … efficacy of Xylitol, Probiotic and Chlorhexidine mouth rinses among children and elderly population at high risk for … - A Randomized Controlled Trial. J Prev Med Hyg. Jun 2022;63(2):E282-e287. doi:10.15167/2421-4248/jpmh2022.63.2.1772
45. Nayak PA, Nayak UA, Khandelwal V. The effect of xylitol on…and oral flora. Clin Cosmet Investig Dent. 2014;6:89-94.
46. Xylitol chewing gum in mothers greatly reduces decay in offspring. J Evid Base Dent Pract. 2001;1(1):16-17.
47. Akgül Ö, Topaloğlu Ak A, Zorlu S, Öner Özdaş D, Uslu M, Çayirgan D. Effects of short-term xylitol chewing gum on pro-inflammatory cytokines and …: A randomised, placebo-controlled trial. Int J Clin Pract. Sep 2020;74(9):e13623. doi:10.1111/ijcp.13623
48. Bai X, Qu H, Zhang J, et al. Effect of steviol glycosides as natural sweeteners on glucose metabolism in adult participants. Food Funct. Apr 22 2024;15(8):3908-3919. doi:10.1039/d3fo04695h
49. Zafrilla P, Masoodi H, Cerdá B, García-Viguera C, Villaño D. Biological effects of stevia, sucralose and sucrose in citrus-maqui juices on overweight subjects. Food Funct. Sep 20 2021;12(18):8535-8543. doi:10.1039/d1fo01160j
50. Stamataki NS, Crooks B, Ahmed A, McLaughlin JT. Effects of the Daily Consumption of Stevia on Glucose Homeostasis, Body Weight, and Energy Intake: A Randomised Open-Label 12-Week Trial in Healthy Adults. Nutrients. Oct 6 2020;12(10)doi:10.3390/nu12103049
51. Adolphus K, Van den Abbeele P, Poppe J, et al. d-Allulose and erythritol increase butyrate production and impact the gut microbiota in healthy adults and adults with …ex vivo. Benef Microbes. Apr 10 2025:1-19. doi:10.1163/18762891-bja00071
52. Buranapin S, Kosachunhanan N, Waisayanand N, Yokoi H, Tokuda M. Effects of D-Allulose with Sucrose Beverage on Glucose Tolerance and Insulin Levels among Thai Healthy Volunteers. J Nutr Sci Vitaminol (Tokyo). 2024;70(3):203-209. doi:10.3177/jnsv.70.203
53. Franchi F, Yaranov DM, Rollini F, et al. Effects of D-allulose on glucose tolerance and insulin response to a standard oral sucrose load: results of a prospective, randomized, crossover study. BMJ Open Diabetes Res Care. Feb 2021;9(1)doi:10.1136/bmjdrc-2020-001939