Do Nonnutritive Sweeteners Alter Appetite and Food Preferences in Children? Current Evidence and Future Directions

Background/Objectives: Nonnutritive sweeteners (NNS) are increasingly consumed by children, but their effects on appetite regulation and food preference remain uncertain. This review evaluated whether NNS influence appetite, satiety, subsequent energy intake, sweet taste liking, preferred sweetness, or food choice in children, and how key study and developmental factors affect interpretation. Methods: This narrative review was informed by a structured PubMed search from database inception through August 2026, limited to English-language articles. Pediatric randomized and controlled studies were prioritized for direct behavioral outcomes; observational studies characterized habitual exposure and longer-term associations. Results: Direct pediatric evidence is limited and heterogeneous. Available studies do not show a consistent effect of NNS on subjective appetite or satiety. Differences in subsequent energy intake are most consistent with caloric substitution and incomplete compensation when NNS replace sugars, rather than an intrinsic appetite-suppressing effect. Pediatric studies show that NNS-sweetened products can be accepted and liked and that flavor-energy associations may influence learned liking, but they do not establish that sustained NNS exposure alters generalized preferred sweetness or habitual food choice. Anthropometric findings are indirect and depend strongly on comparator and study design. Interpretation is further influenced by sweetener type, dose, food matrix, exposure duration, and developmental stage. Conclusions: Current evidence does not demonstrate a consistent pediatric behavioral effect of NNS on appetite, preferred sweetness, or food choice. NNS may reduce sugar and energy intake when replacing sugar-sweetened products, but long-term developmental effects remain uncertain. Pediatric interventions directly measuring preferred sweetness and subsequent food choice are needed.