Anecdotally I get gut dybiosis (microbiome imbalance) that notably only occurs when using artificial sweeteners and stops when I stop taking it, I’ve talked to many others who have noticed the same thing. Gut dysbiosis can cause chronic systemic inflammation which is rather bad for the body, not sure if it’s worse than the sugar it replaces, but it shouldn’t be assumed that the problem is solved by low calories. I think it’s important to limit both, preferably to near zero.

I wonder if any Romans evidence had any evidence of population-level delirium from lead consumption...