 A 2020 study suggests that the consumption of sucralose combined with carbohydrates impairs insulin sensitivity and causes a metabolic impairment which is associated with decreased neural responses to sugar.The Center for Science in the Public Interest, a consumer advocacy group for food products, downgraded sucralose from "Safe" to "Caution" in June 2013, citing an unpublished study linking sucralose consumption with leukemia risk in rats.The study has been criticized as being poorly executed and reported.