These data suggest that low-calorie sweetener consumption may deleteriously affect visceral fat deposition, a strong risk factor for cardiovascular disease and mortality.

Mechanisms for the association between low-calorie sweetener use and progressively rising prevalence of abdominal obesity remain unknown. One potential explanation derives from the physiology of the brain food reward system.

Therefore, individuals who consume low-calorie sweeteners may compensate by over-eating in order to experience the expected satiety. Another possible mechanism may involve the gut microbiome.