Nutrition

A Scientific Discussion Of Sugar Substitutes & Artificial Sweeteners | Should We Use Them?

A Scientific Discussion Of Sugar Substitutes & Artificial Sweeteners | Should We Use Them?

If you consider yourself a fitness enthusiast, more likely than not you’ve known a thing or two about sugar substitutes (SSs). They are sweet, mostly calorie-free, and ubiquitous nowadays. You can find them most often in beverages, snacks, bakeries, and supplements. They are sweet like sugar but without the highly concentrated and insulin spiking calories. Sounds too good to be true?

On the other hand, I’m sure you also have heard some rumors like SSs can cause cancer, promote weight gain, mess up your gut, and so on. Are they true or just myths? To answer those questions, I would like to present a scientific view on SSs based on currently available studies. To make things clear, when speaking of SSs, what I’m truly referring to are the noncaloric or low-caloric  SSs. SSs that are high in calories like agave nectar, honey, syrups, and molasses are in many ways very similar to sugar, thus not included in the discussion.


What Types Of Sugar Substitutes Are There?

There are many different categories of SSs. The largest category is artificial sweeteners. Under this category, the most common ones are aspartame (Equal, NutraSweet), sucralose (Splenda), acesulfame potassium (Sunett, Sweet One), and Saccharin (Sweet’N Low).  Then there are also sugar alcohols like erythritol, maltitol, xylitol, and so on. Finally, there are the so-called “natural sweeteners”. Most popular examples include Stevia extract and monk fruit extract. Apparently, each individual compound has different properties, thus different effects on the human body when consumed. However, for the sake of achieving a general view on them without going into fundamental chemical details, we don’t distinguish them individually unless necessary.


Should We Use Sugar Substitutes?

With all that said, let’s get down to the ultimate question that everyone wants to know—should we be using SSs in our daily life? Well, the situation is a little bit complicated, but the short answer is yes. Undoubtedly obesity has become an epidemic in many developed countries across the globe. We have known for a fact that the leading cause of obesity is the over-consumption of calories. SSs can be a useful tool to reduce daily caloric intake. Therefore, we should incorporate some SSs intelligently in our diet to achieve an overall lower daily caloric intake.

One study compared the effect of drinking soda sweetened with SSs or high-fructose corn syrup and concluded that SSs are beneficial for achieving lower caloric intake.1 Thus can be a useful tool for weight loss. Another similar 10-week study compared the effect of consuming sucrose(sugar) and SSs also confirmed this conclusion.2 Maybe you are not very convinced since both studies had a relatively small sample size.

Fortunately, we do have larger scale studies on this matter. One fairly recent study put 303 subjects in a 12-week weight loss program and divided them into SSs beverage group and water group.3 After 12 weeks, SSs beverage group even lost significantly more weight than water group. Another study looked at the relation between sugar-free or sugar-sweetened beverages and body weight in 641 children.4 The result shows replacement of sugar-containing beverages with noncaloric beverages reduced weight gain and fat accumulation in children.


Sugar Substitutes and Weight Loss

To be fair and precise, results of studies on using SSs to achieve reduced caloric intake and body weight are mixed. Not all studies found a positive correlation between SSs consumption and weight loss. Some studies found no difference in body weight when comparing subjects consuming sugar and SSs. Some studies even found SSs consumers tend to gain more weight. The San Antonio Heart Study examined over 3000 adults over a seven-year period in the 1980s and found drinkers of SSs sweetened beverages consistently had higher body mass index.5 However, most studies with similar conclusion are observational studies rather than controlled studies. It’s irresponsible to draw a causational conclusion from observational studies since a number of factors can come into play.

For example, it’s possible that most people who choose to drink diet beverages are already overweight. It’s also possible that psychological factors have a great impact here. People who choose diet beverages think they have saved many calories so they compensate with more food later in the day, ending up even overcompensating the calories saved by diet beverages. Nevertheless, the vast majority of current studies are still in favor of using SSs as an effective method to control daily caloric intake and thus body weight.


Side Effects Of Sugar Substitutes

So we know SSs can be useful for weight management, let’s discuss some other issues. There has been a lot of concerns regarding the consumption of SSs on a daily basis. Some people claim that SSs are not safe to consume. They can cause serious issues like various cancers. As far as research goes, we know this statement is not true at all. Tons of studies have confirmed the safety of consuming SSs within established safety dose, which is nearly impossible to exceed in reasonable usage. To put things in perspective, we use sucralose (Splenda) and a 150 lbs person as an example. For a 150 lbs person, the daily safety dose of sucralose is 341 mg, which equals more than 30 yellow packets of Splenda! A lot of studies have concluded that the possible risk of SSs to induce cancer seems to be negligible.6 The only reason why FDA has made SSs commercially available is because they are proven to be safe over and over again in a number of clinical studies. Therefore, I don’t think implementing SSs in your diet has large safety issues, if any at all.

There also are people claiming that SSs can cause glucose intolerance, promote appetite and sugar cravings, cause unbalanced hormonal profile and gut microbiome, and a lot of other issues. However, if you look into studies, you will find that those statements are either proven to be completely not valid or lacking clear evidence to support their validity.7,8,9


Take-Home Message

What can we learn from all the studies? In conclusion, my advice would be: first of all, try to reduce the sugar intake, especially refined sugar, as much as possible if you have problems managing your weight or body fat because it has been very clear that sugar has a huge negative impact on body weight and body fat gains. On the other hand, going crazy on SS is also not a smart move. Although we know they are generally safe to consume, there are still potential problems and side effects that need to be examined for the long term usage.

It goes back to the old saying: everything in moderation. We should still be cautious, but don’t be scared by SSs in diet sodas and your favorite protein powder. When sweet craving occurs, opt for naturally sweet foods like fruits first. If calories are indeed an issue for you because you are trying really hard to lose weight, incorporate some SSs instead of sugar when necessary to fight off the cravings. Just as stated in a review paper, for optimal health it is recommended that only minimal amounts of both sugar and SSs be consumed.10

 

Our articles should be used for informational and educational purposes only and are not intended to be taken as medical advice. If you're concerned, consult a health professional before taking dietary supplements or introducing any major changes to your diet.


  1. Tordoff, Micheal G., and Annette M. Alleva. “Effect of Drinking Soda Sweetened with Aspartame or High-fructose Corn Syrup on Food Intake and Body Weight.”The American Journal of Clinical Nutrition 9th ser. 51.963 (1990).
  1. Sorensen, L. B., T. H. Vasilaras, A. Astrup, and A. Raben. “Sucrose Compared with Artificial Sweeteners: A Clinical Intervention Study of Effects on Energy Intake, Appetite, and Energy Expenditure after 10 Wk of Supplementation in Overweight Subjects.”American Journal of Clinical Nutrition 1 (2014): 36-45.
  1. Peters, John C., Holly R. Wyatt, Gary D. Foster, Zhaoxing Pan, Alexis C. Wojtanowski, Stephanie S. Vander Veur, Sharon J. Herring, Carrie Brill, and James O. Hill. “The Effects of Water and Non-nutritive Sweetened Beverages on Weight Loss during a 12-week Weight Loss Treatment Program.”Obesity 6 (2014): 1415-421.
  1. Ruyter, Janne C. De, Margreet R. Olthof, Jacob C. Seidell, and Martijn B. Katan. “A Trial of Sugar-free or Sugar-Sweetened Beverages and Body Weight in Children.”New England Journal of Medicine N Engl J Med15 (2012): 1397-406.
  1. Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring, Md.). 2008;16:1894-1900.
  1. Weihrauch, M. R. “Artificial Sweeteners–do They Bear a Carcinogenic Risk?”Annals of Oncology 10 (2004): 1460-465.
  1. Ma, J., M. Bellon, J. M. Wishart, R. Young, L. A. Blackshaw, K. L. Jones, M. Horowitz, and C. K. Rayner. “Effect of the Artificial Sweetener, Sucralose, on Gastric Emptying and Incretin Hormone Release in Healthy Subjects.”AJP: Gastrointestinal and Liver Physiology 4 (2009).
  1. Ma, Jing, Jessica Chang, Helen L. Checklin, Richard L. Young, Karen L. Jones, Michael Horowitz, and Christopher K. Rayner. “Effect of the Artificial Sweetener, Sucralose, on Small Intestinal Glucose Absorption in Healthy Human Subjects.”British Journal of Nutrition Br J Nutr 06 (2010): 803-06.
  1. Ford, H. E., V. Peters, N. M. Martin, M. L. Sleeth, M. A. Ghatei, G. S. Frost, and S. R. Bloom. “Effects of Oral Ingestion of Sucralose on Gut Hormone Response and Appetite in Healthy Normal-weight Subjects.”European Journal of Clinical Nutrition Eur J Clin Nutr4 (2011): 508-13.
  1. Shankar, Padmini, Suman Ahuja, and Krishnan Sriram. “Non-nutritive Sweeteners: Review and Update.”Nutrition 11-12 (2013): 1293-299.

Our articles should be used for informational and educational purposes only and are not intended to be taken as medical advice. If you're concerned, consult a health professional before taking dietary supplements or introducing any major changes to your diet.



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