Should I Be Avoiding Artificial Sweeteners?

Artificial sweeteners are found everywhere from candy to soda. You may be wondering if you should consume them. It’s a controversial topic with conflicting information. In this article, I’ll share my thoughts on this topic.

What are artificial sweeteners?

Let’s review artificial sweeteners first. Sweeteners can be split into two categories: nutritive sweeteners or non-nutritive sweeteners. 

Sugar is considered a nutritive sweetener since it provides calories from sugars which contain carbohydrates. 

Non-nutritive sweeteners may lack calories and carbohydrates compared to nutritive sweeteners. They may also be much sweeter than nutritive sweeteners without the added sugar. This is because sugar isn’t sweetness, other molecules and compounds register as sweetness on the taste buds. 

You may find artificial sweeteners in products labeled as “diet” or “sugar-free”. However, they may be found in other types of products as well. 

Now that you have some background information, let’s dig into the research.

Possible Health Benefits

Lack of Sugar & Dental Cavities 

We all know that too much sugar can cause dental cavities. How about artificial sweeteners? 

A meta-analysis looked at the relationship between sucralose and dental caries. The authors reviewed studies that included animal and human subjects. The findings suggested that sucralose is less likely to give dental cavities than sugar (1). 

Another study analyzed the effect of sweeteners like sucralose, saccharine, and aspartame on enamel slabs with biofilm compared to sucrose (aka regular sugar). The results indicated the artificial sweeteners had resulted in less enamel erosion than sucrose. Saccharin and sucralose may also have antibacterial effects (2). 

Based on these studies, some artificial sweeteners may decrease the risk of dental cavities. A potential reason for these findings may be due to the lack of sugar in these products.

Low in Calories & Weight Loss

As I mentioned before, artificial sweeteners may have pretty much no calories. What’s the potential benefit of this?

In general, artificial sweeteners may lack calories and sugar, which may be beneficial when monitoring your calorie intake. They may also come in packets which would make it easier to control the amount you put in your food. Swapping candy made with sugar for a sugar free-candy made with artificial sweeteners may save you a lot of calories from sugar. However, it’s important to keep in mind that some artificially sweetened foods still are high in calories due to other ingredients (like fat). 

Additionally, there’s mixed evidence in regards to artificial sweeteners and weight loss. However, some studies suggest that it may aid in weight loss. 

A study analyzed a food consumption survey that included artificial sweeteners. The study suggested that there was a BMI reduction for participants who consumed them instead of the sugar-sweetened beverages (3). 

A meta-analysis of randomized control trials and prospective cohort studies also looked at this relationship. The observational studies suggested an association between a higher BMI and artificial sweeteners (4). However, the randomized trials indicated that the replacement of sweeteners for artificial sweeteners might aid in some weight loss (4). 

Lastly, a randomized control trial on overweight and obese adults examined the association between artificial sweeteners and weight loss. The results showed the reduction of beverages was associated with weight loss after replacement with artificially sweetened beverages (5). 

Artificial sweeteners lack calories, which may be beneficial for weight loss. However, research is ongoing in this area.

Lack of Carbohydrates & Blood Sugar Levels 

Artificial sweeteners contain a minimal amount of carbohydrates. For example, a packet of Splenda has less than 1 gram of carbs per packet. If you’re following a carbohydrate-restricted diet, then this may be a way to consume fewer carbs throughout the day. Please keep in mind that overconsuming sweeteners can lead to an increase in carb intake (**check out “food cravings: below for more info!). Also, artificial sweeteners may be in products like candy containing carbs, so make sure to read the label to verify. 

You may be wondering if artificial sweeteners affect blood sugar/insulin insulin levels. 

A review conducted by the American Heart Association and American Diabetes Association on artificial sweeteners noted that these substitutes may be okay to use for people living with diabetes (6). However, let’s look at some of the studies. 

Some studies suggest that artificial sweeteners lack an effect on blood sugar levels. Monitoring blood sugar levels is especially important for people with diabetes. 

A study looked at the effect of sucralose on seven healthy subjects’ insulin and blood glucose levels for four days found no effect on their insulin levels or blood glucose levels (7).

Another study analyzed the impact of aspartame and saccharin on the insulin levels of 22 people, which included individuals that were healthy, and those with non-insulin dependent diabetes. The results showed a lack of effect on insulin levels (8). 

Similarly, a study where aspartame and sucralose were given to subjects with non-insulin dependent diabetes look at their blood glucose and insulin levels to see the effects of these sweeteners. The findings suggest there was a lack of statistically significant effect on insulin and blood glucose levels (9). 

Overall, some research suggests that there is a lack of effect on insulin levels, which may be due to the lack of carbohydrates in artificial sweeteners.

Possible Health Concerns

Might Increase Food Cravings **

Recall that artificial sweeteners have low calories, or no calories, and are very sweet. Check out the FDA’s levels of sweetness list below: 

  • Saccharin:  200-700 times sweeter than sugar
  • Aspartame: 200 times sweeter than sugar
  • Sucralose: 600 times sweeter than sugar
  • Neotame: 7,000 to 13,000 times sweeter than sugar
  • Acesulfame Potassium (ACE-K): 200 times sweeter than sugar

Like I mentioned before, artificial sweeteners may be sweeter than sugar without the added calories. Despite saying this information, there is some evidence suggesting that artificial sweeteners may increase food cravings.

Some researchers have suggested that artificial sweeteners don’t completely fulfill the food reward pathway. They argue that the sweetness and lack of calories may increase food cravings (10,11). 

For example, a randomized study was conducted on 74 participants. The researchers had the participants ingest either a sucralose-sweetened beverage, a sucrose (regular sugar)-sweetened beverage, or water. They would then be asked to go to a buffet where they were asked to eat as much as they wanted after drinking these beverages. Additionally, they would need to complete a food cue test. The results suggested that the obese participants ate more calories after ingesting sucrolose sweetened beverages based on their intake at the buffet. This group also had more of a neurological response to sucralose sweetened beverages than the rest of the participants (12). 

Interestingly, a fruit fly study examined the effects of sucralose and sucrose. The study demonstrated that flies were more likely to consume excess sugar in response to being fed sucralose instead of sucrose (13). Similarly, a rat study observed the same findings but with saccharin (13).  

Overall, these studies suggest that there is a link between artificial sweeteners and food cravings, but there needs to be more research in this area. 

Gut Health 

There’s some research suggesting that artificial sweeteners may affect your gut health. 

A 12-week study done on rats looked at the effects of artificial sweeteners on gut health. The results suggested that there was a reduced number of bacteria after ingestion of Splenda at low doses (14). 

A review indicated that mice fed artificial sweeteners may have gut alterations after ingestion of the sweetener acesulfame potassium at specific doses. However, there were differences for  these effects in the male and female mice (15). 

Another study observed a change in gut microbiota in mice and some of the human participants after consuming artificial sweeteners which triggered glucose intolerance (16). 

Despite providing this information, more studies are needed on humans to determine a conclusion. 

Lack of Energy 

Generally, artificial sweeteners lack calories and nutrients. Usually, the calories may come from sugar in the form of carbohydrates in sweetened beverages. This fact may result in a reduction of many calories and nutrients. You could replace those lack of calories and nutrients with fresh ingredients to compensate for the lack of energy and nutrients. 

May be present in highly processed foods 

As I mentioned before, artificial sweeteners may be present in junk food with calories and carbohydrates. For example, a sugar-free candy like sugar-free jolly ranchers contains artificial sweeteners with no sugar, but it has carbs and calories due to other ingredients. Anything in excess may be harmful to your health. Consuming too much processed foods may increase your risk of cardiovascular, diabetes, and obesity (17). 

Aspartame & Headaches 

Some people may be sensitive to artificial sweeteners like aspartame and acquire symptoms such as headaches. There’s a lack of research suggesting that aspartame contributes to headaches unless you are sensitive to this substance (18,19). If you’re sensitive to aspartame, it may be best to reduce or restrict your intake. 

Phenylketonuria & Aspartame

Phenylketonuria (PKU)  is a disorder where the body doesn’t metabolize phenylalanine (found in many foods with protein) properly, so there is an accumulation in the body. Aspartame does contain phenylalanine, so it may be best to avoid consuming it if you have PKU. 

Safety & Cancer

Like artificial flavors and natural flavors, artificial sweeteners must be deemed safe by regulatory agencies like the FDA before being sold on shelves.

However, one of the concerns when it comes to artificial sweeteners is cancer.

Some studies suggested that these sweeteners increased the different types of cancers like lymphoma/leukemia, bladder cancer, or growth of cancerous tumors (20,21,22). 

According to the FDA and the National Cancer Institute, this area has been extensively researched and these claims were refuted. 

They noted some confounders such as high doses of artificial sweeteners, lack of similarities of specific animal studies to humans, and shortcomings (20,23,24,25,26). As of now, there’s a lack of evidence to conclude that artificial sweeteners cause cancer.

Ways to avoid

If you’re interested in avoiding artificial sweeteners, there are many options you could choose. Some of the ways you could avoid artificial sweeteners include limiting foods with the terms “sugar-free” or “diet”. You could also swap them for spices, natural sugar like fresh fruit (which has nutrients & fiber), or water. Of course, moderation is essential regardless of the food. 

Main takeaways

So should you consume artificial sweeteners? 

I would say that artificial sweeteners have conflicting research in terms of health claims. Like with all research, it’s ongoing. 

However, artificial sweeteners seem fine to eat every now and then. 

If you have sensitivities to artificial sweeteners, it may be best to avoid or limit them. 

If you choose not to consume them, then you could opt for other delicious alternatives like natural sugar from fresh fruit.

This post was co-written by apsiring dietitian Nancy V.

Click here to download your FREE 3 day Low Glycemic Index Meal Plan

References

 

  1. Mandel, Irwin D, and V Lee Grotz. “Dental considerations in sucralose use.” The Journal of clinical dentistry vol. 13,3 (2002): 116-8.
  2. Giacaman, Rodrigo A., et al. “Cariogenic Potential of Commercial Sweeteners in an Experimental Biofilm Caries Model on Enamel.” Archives of Oral Biology, vol. 58, no. 9, 2013, pp. 1116–1122., doi:10.1016/j.archoralbio.2013.03.005. 
  3. Hendriksen, Marieke A., et al. “Impact of Substituting Added Sugar in Carbonated Soft Drinks by Intense Sweeteners in Young Adults in the Netherlands: Example of a Benefit–Risk Approach.” European Journal of Nutrition, vol. 50, no. 1, 29 Apr. 2010, pp. 41–51., doi:10.1007/s00394-010-0113-z. 
  4. Miller, Paige E, and Vanessa Perez. “Low-Calorie Sweeteners and Body Weight and Composition: A Meta-Analysis of Randomized Controlled Trials and Prospective Cohort Studies.” The American Journal of Clinical Nutrition, vol. 100, no. 3, 2014, pp. 765–777., doi:10.3945/ajcn.113.082826. 
  5. Tate, Deborah F, et al. “Replacing Caloric Beverages with Water or Diet Beverages for Weight Loss in Adults: Main Results of The Choosehealthy Options Consciously Everyday (Choice) Randomized Clinical Trial.” The American Journal of Clinical Nutrition, vol. 95, no. 3, 29 Apr. 2010, pp. 555–563., doi:10.3945/ajcn.111.026278. 
  6. Gardner, Christopher, et al. “Nonnutritive Sweeteners: Current Use and Health Perspectives.” Circulation, vol. 126, no. 4, 2012, pp. 509–519., doi:10.1161/cir.0b013e31825c42ee. 
  7. Ma, Jing, et al. “Effect of the Artificial Sweetener, Sucralose, on Gastric Emptying and Incretin Hormone Release in Healthy Subjects.” American Journal of Physiology-Gastrointestinal and Liver Physiology, vol. 296, no. 4, 2009, doi:10.1152/ajpgi.90708.2008. 
  8. Teff, Karen L., et al. “Sweet Taste: Effect on Cephalic Phase Insulin Release in Men.” Physiology & Behavior, vol. 57, no. 6, June 1995, pp. 1089–1095., doi:10.1016/0031-9384(94)00373-d. 
  9.  Horwitz, D. L., et al. “Response to Single Dose of Aspartame or Saccharin by NIDDM Patients.” Diabetes Care, vol. 11, no. 3, 1 Mar. 1988, pp. 230–234., doi:10.2337/diacare.11.3.230. 
  10.  Yang Q. Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale J Biol Med. 2010;83(2):101-108.
  11. Smeets, Paul A M et al. “Functional magnetic resonance imaging of human hypothalamic responses to sweet taste and calories.” The American journal of clinical nutrition vol. 82,5 (2005): 1011-6. doi:10.1093/ajcn/82.5.1011
  12. Yunker, Alexandra G., et al. “Obesity and Sex-Related Associations with Differential Effects of Sucralose vs Sucrose on Appetite and Reward Processing.” JAMA Network Open, vol. 4, no. 9, 28 Sept. 2021, doi:10.1001/jamanetworkopen.2021.26313. 
  13.  Wang, Qiao-Ping, et al. “Sucralose Promotes Food Intake through NPY and a Neuronal Fasting Response.” Cell Metabolism, vol. 24, no. 1, 12 July 2016, pp. 75–90., doi:10.1016/j.cmet.2016.06.010. 
  14. Abou-Donia, Mohamed B., et al. “Splenda Alters Gut Microflora and Increases Intestinal P-Glycoprotein and Cytochrome p-450 in Male Rats.” Journal of Toxicology and Environmental Health, Part A, vol. 71, no. 21, 2008, pp. 1415–1429., doi:10.1080/15287390802328630. 
  15.  Bian, Xiaoming, et al. “The Artificial Sweetener Acesulfame Potassium Affects the Gut Microbiome and Body Weight Gain in CD-1 Mice.” PLOS ONE, vol. 12, no. 6, 2017, doi:10.1371/journal.pone.0178426. 
  16. Suez, Jotham, et al. “Artificial Sweeteners Induce Glucose Intolerance by Altering the Gut Microbiota.” Nature, vol. 514, no. 7521, 9 Oct. 2014, pp. 181–186., doi:10.1038/nature13793. 
  17.  Elizabeth, Leonie, et al. “Ultra-Processed Foods and Health Outcomes: A Narrative Review.” Nutrients, vol. 12, no. 7, 30 June 2020, p. 1955., doi:10.3390/nu12071955. 
  18. Van Den Eeden, S. K., et al. “Aspartame Ingestion and Headaches: A Randomized Crossover Trial.” Neurology, vol. 44, no. 10, Oct. 1994, pp. 1787–1787., doi:10.1212/wnl.44.10.1787. 
  19. Lapierre, Katherine A., et al. “The Neuropsychiatric Effects of Aspartame in Normal Volunteers.” The Journal of Clinical Pharmacology, vol. 30, no. 5, 30 May 1990, pp. 454–460., doi:10.1002/j.1552-4604.1990.tb03485.x. 
  20. Ellwein, Leon B., and Samuel M. Cohen. “The Health Risks of Saccharin Revisited.” Critical Reviews in Toxicology, vol. 20, no. 5, 25 Sept. 1990, pp. 311–326., doi:10.3109/10408449009089867. 
  21.  Soffritti, Morando, et al. “First Experimental Demonstration of the Multipotential Carcinogenic Effects of Aspartame Administered in the Feed to Sprague-Dawley Rats.” Environmental Health Perspectives, vol. 114, no. 3, 1 Mar. 2006, pp. 379–385., doi:10.1289/ehp.8711. 
  22. M., Soffritti, et al. “Sucralose Administered in Feed, Beginning Prenatally through Lifespan, Induces Hematopoietic Neoplasias in Male Swiss Mice.” International Journal of Occupational and Environmental Health, vol. 22, no. 1, 22 Jan. 2016, pp. 7–17., doi:10.1080/10773525.2015.1106075. 
  23. Weihrauch, M.R., and V. Diehl. “Artificial Sweeteners—Do They Bear a Carcinogenic Risk?” Annals of Oncology, vol. 15, no. 10, 1 Oct. 2004, pp. 1460–1465., doi:10.1093/annonc/mdh256. 
  24.  National Toxicology Program. “NTP report on the toxicology studies of aspartame (CAS No. 22839-47-0) in genetically modified (FVB Tg.AC hemizygous) and B6.129-Cdkn2atm1Rdp (N2) deficient mice and carcinogenicity studies of aspartame in genetically modified [B6.129-Trp53tm1Brd (N5) haploinsufficient] mice (feed studies).” National Toxicology Program genetically modified model report ,1 (2005): 1-222.
  25. Lim, Unhee, et al. “Consumption of Aspartame-Containing Beverages and Incidence of Hematopoietic and Brain Malignancies.” Cancer Epidemiology Biomarkers & Prevention, vol. 15, no. 9, Sept. 2006, pp. 1654–1659., doi:10.1158/1055-9965.epi-06-0203. 
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