Sugar substitutes deliver modest metabolic benefits, but no perfect replacement yet

Randomised trials show that replacing sugar with approved sweeteners can lower post-meal glucose and insulin and aid weight maintenance in structured diets; there is no universal substitute that perfectly mimics sugar's bulk and mouthfeel, and policy debates continue to hinge on differences between observational studies and trials. Future advances may come from blends, sweet proteins, rare sugars, and AI-assisted discovery, but more data across children and high-risk groups are needed.