Are Artificial Sweeteners Good or Bad? - Verywell Health

Artificial sweeteners offer a solution for people who have a sweet tooth and don't want the excess calories of refined sugar or other natural sweeteners like honey, dates, and maple syrup. But do artificial sweeteners pose a health risk? 

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What Are Artificial Sweeteners?

Low-calorie sweeteners, which include artificial sweeteners and non-nutritive sweeteners, are used in beverages, foods, candy, toothpaste, and some medications. They contain few calories or none at all.

Non-nutritive sweeteners are extracted from plants or herbs such as the stevia plant and monk fruit extract. Artificial sweeteners, on the other hand, are made of chemical compounds that include sulfonamides, sucrose byproducts, peptides, and their derivatives.

Artificial sweeteners have a higher sweetness potency than sugar and are used to flavor certain foods and beverages. Some of these sweeteners can be 200 times to 13,000 times sweeter than table sugar. Because of their sweetness, smaller portions are needed to flavor foods or beverages, resulting in less calories per gram.

Sugar alcohols or polyols like sorbitol, xylitol, lactitol, erythritol, mannitol, and maltitol are carbohydrates, but not classified as low-calorie sweeteners. They are less calorie-dense than table sugar, with a sweetness potency that is 25% to 100% sweeter than sugar.

Sugar alcohols are found in foods like cookies, candy, chewing gum, and ice cream, as well as toothpaste and cough medicine. They do not cause a spike in blood glucose or increase the risk of tooth decay.

Types of Artificial Sweeteners

The Food and Drug Administration (FDA) has approved eight artificial sweeteners to date:

• Acesulfame potassium is used with other artificial sweeteners and may be found in sugar-free sodas. It is marketed as Sunett or Sweet One, and can be found in your local grocery store.
• Aspartame is found in a wide range of foods, beverages, candy, as well as vitamins and laxatives. It is marketed as Equal or NutraSweet. Aspartame boasts a flavor intensity that is 200 times sweeter than sugar. Aspartame must not be consumed by people who have phenylketonuria (PKU), a rare genetic disorder.
• Neotame is 7,000 to 13,000 times sweeter than sugar. Found in foods and beverages, it's not as common as other low-calorie sweeteners.
• Saccharin was discovered in 1879 and commercialized shortly after its discovery. Saccharin is 200 to 700 times sweeter than sugar. It is marketed as Sweet'N Low, Sweet Twin, and Sugar Twin.
• Sucralose is known for its versatility. It can replace sugar in baked goods and other recipes, and is found in processed foods and baked beverages as well as canned fruit and dairy products. Its sweetness is 600 times greater than sugar. Sucralose is marketed as Splenda and Equal Sucralose.
• Stevia is a non-nutritive sweetener with almost no calories. It is derived from the leaves of the stevia plant and is 200 to 300 times sweeter than sugar. Stevia is found in a variety of foods and beverages. You can find it at your local grocery store marketed as Truvia, Stevia in the Raw, SweetLeaf, Sweet Drops, Sun Crystals, and PureVia.
• Luo han guo, or monk fruit extract, is a non-nutritive sweetener. It has no calories and is 10 to 250 times sweeter than sugar. It's often blended with other non-nutritive sweeteners like Stevia. You can find it in your local grocery and health food stores marketed as Monk Fruit in the Raw.
• Advantame is the most recent non-nutritive sweetener approved by the FDA—in 2014. It is 20,000 times sweeter than sugar and not regularly used. Unlike aspartame, it is safe for people with phenylketonuria.

The Effects of Artificial Sweeteners

While artificial sweeteners allow us to reduce calories from our diets while enjoying the sweet flavor, they also make it easy to overindulge on sweet foods and beverages.

Both the American Heart Association and American Diabetes Association approve of replacing sugar with artificial sweeteners to fight obesity, metabolic syndrome, and diabetes, and to reduce the risk of heart disease, but they recommend caution and to continue to monitor your calorie consumption.

However, animal studies have shown that artificial sweeteners can cause the pounds to creep up, and, more alarmingly, lead to brain tumors, bladder cancer, and other conditions. The scientific community is split whether artificial sweeteners are safe under all conditions or unsafe at any dose.

Regardless, research has shown that artificial sweeteners can affect different parts of your body.

Gut Health

Although non-caloric artificial sweeteners aren't absorbed, they may still reach gut microbiota, which may affect its makeup and function and contribute to the development of metabolic syndrome.

In one study, researchers added either saccharin, sucralose, or aspartame to the drinking water of 10-week-old mice. Eleven weeks later, the mice that drank the sugar-water solution developed glucose intolerance, unlike other mice that consumed water, glucose, or sucrose alone.

The researchers concluded that glucose intolerance due to saccharine consumption altered the gut microbiota.

Cancer

Early studies indicated that a combination of cyclamate and saccharin caused cancer in animal studies. However, according to the FDA, carcinogenicity studies showed there was no link between cancer and these artificial sweeteners in humans.

Other studies of FDA-approved artificial sweeteners have shown that there is no association between these sweeteners and several types of cancer and humans.

Appetite, Cravings, and Weight

A study found that participants who often drank artificially sweetened beverages had higher BMIs. Another one found that 2.7% to 7.1% more of the regular artificial sweetener users gained weight compared to non-users.

Studies have also shown that water sweetened with aspartame increased appetite in normal-weight adult males and increased hunger compared to glucose or water alone. In another study, aspartame, acesulfame potassium, and saccharin were all linked to eating more, with aspartame having the greatest effect due to its lack of a bitter aftertaste. 

A correlation exists between cravings and certain flavors like sweetness. Artificial sweeteners can make you want and seek out foods that are sweetened. To reduce that dependence, experts suggest weaning off or eliminating sugar or artificial sweeteners over a period of time. 

Diabetes

A serving of most non-nutritive sweeteners has little or no calories. And because these sweeteners have a flavor intensity profile that can be 200 to several thousands greater than table sugar, a fraction of the amount is needed to sweeten food.

However, studies have shown that overeating foods that contain artificial sweeteners can lead to changes in glucose metabolism, or the way your body digests and uses sugar. Overconsumption of artificial sweeteners has been linked to excessive weight gain and health complications like type 2 diabetes.

Headaches

A few studies have looked into the link between artificial sweeteners and headaches, and have shown that headaches in a small percentage of individuals can be caused by aspartame or sucralose.

The link between aspartame and migraine sufferers is stronger, according to the Headache & Facial Pain Center at the University of Cincinnati Gardner Neuroscience Institute. Headaches may be triggered after prolonged use of sweeteners in diet beverages and not necessarily with one serving.

Dental Health

Cavities develop due to oral bacteria. The bacteria that predominantly causes cavities are mutans streptococci, streptococcus sobrinus, and lactobacilli, which produces acid when fermentable carbohydrates like sucrose, fructose, and glucose are present. The mineral content of your teeth becomes sensitive to the increased acidity from lactic acid production.

Artificial sweeteners, unlike sugar, are not fermented by the oral bacteria, which produce waste that settles on the surface of your teeth and are responsible for the decrease in oral pH.

Who Should Not Consume Them

Artificial sweeteners have been deemed safe to consume by the FDA, but aspartame should be avoided by people with phenylketonuria, which prevents phenylalanine (an essential amino acid) from breaking down.

The American Medical Association also recommends avoiding saccharin if you're pregnant because of possible slow fetal clearance.

Side Effects

Sugar alcohols (sorbitol, mannitol, xylitol, erythritol) are derived from fruits and berries. Consuming sugar alcohols may affect blood glucose levels. If consumed in excessive amounts, with the exception of erythritol, sugar alcohols' side effects may include bloating and diarrhea.

Other artificial sweetener side effects may lead to migraines or headaches, skin problems, depression, weight gain, muscular issues, and blurred vision.

Frequently Asked Questions

Why are artificial sweeteners bad?

Although animal studies have shown an association between artificial sweeteners—primarily saccharine—and cancer, the FDA and the National Cancer Institute state that there is no scientific evidence that artificial sweeteners lead to cancer or other health conditions.

However, studies have shown that artificial sweeteners can increase appetite and cravings for food items sweetened by these sweeteners. Even though they themselves contain few or no calories, the added calories from other ingredients can lead to weight gain. 

What are artificial sweeteners?

Artificial sweeteners are synthetic sugar substitutes that are used as food additives to replace common table sugars. Some sweeteners are classified as non-nutritive sweeteners that are extracted from certain plants or fruits that have nearly no calories. Others are sugar alcohols derived from fruits and berries.

Which artificial sweeteners are safe?

Eight artificial sweeteners have been deemed as safe by the FDA. Those include acesulfame potassium, aspartame, neotame, saccharin, sucralose, stevia, monk fruit extract, and advantame.

How are artificial sweeteners made?

Artificial sweeteners are created by chemical synthesis or extracted from plants or fruits.

Can you have artificial sweeteners if you're pregnant?

Of the eight FDA-approved artificial sweeteners, the American Medical Association recommends that people who are pregnant should avoid saccharin.

What should you use instead of artificial sweeteners?

You can sweeten food and beverages with honey or maple syrup instead of table sugar and artificial sweeteners. You can also bake food with sweet fruits like bananas, apples, pears, blueberries, and ripe mangos.

Which artificial sweeteners cause diarrhea?

Typically, artificial sweeteners derived from sugar alcohol cause bloating and diarrhea.

Summary

Artificial sweeteners may contain zero or few calories, but studies have shown they may promote weight gain and increase the risk of certain health conditions. While the FDA says these sweeteners will not cause cancer, they are linked to increased cravings of sweet foods, cavities, and changes in the gut microbiome. Moderation is key even if you are eating artificial sweeteners rather than table sugar.

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