Q: Should we be consuming artificial sweeteners?

You may have heard the recent news that the World Health Organization’s (WHO) cancer arm, the International Agency for Research on Cancer (IARC) is set to declare aspartame a “possible carcinogen” as early as this week. Aspartame is of course a popular artificial sweetener found in countless food products marketed as “low” or “no” sugar. This news has sparked a lot of questions from clients and patients on artificial sweeteners in general lately, and whether or not we can/should be consuming them, so I thought I’d get into it a bit more.

Photo by Mikael Stenberg on Unsplash

What are artificial sweeteners?
Artificial sweeteners are just how they sound – sugar substitutes chemically manufactured in a lab. They are highly processed and anywhere from 200 to 600 times sweeter than sugar, which means much less is needed to provide sweetness. Artificial sweeteners are also non-nutritive, meaning they have no nutrients or calories, and widely available. Artificial sweeteners are regulated by the Food and Drug Administration (FDA) as food additives, and the artificial sweeteners currently in our food system are generally recognized as safe. That’s not to say there haven’t been studies associating artificial sweeteners with various health risks and challenges, however.

Why they’re used
The most common artificial sweeteners in our foods and sold separately for use in things like coffee and at home baking are saccharin (Sweet and Low), aspartame (Equal), and sucralose (Splenda). Stevia is another popular sugar substitute, though to some it is not considered an artificial sweetener because it comes naturally from a plant. It has long been thought that artificial sweeteners do not impact blood sugar or insulin levels significantly when consumed, and that they may be helpful with blood sugar control for those with diabetes. HOWEVER...

The research
Recent studies have found consumption of artificial sweeteners do have a negative impact on insulin levels and may increase insulin resistance and blood sugar levels. Other studies have found some artificial sweeteners may also negatively impact the gut microbiome. Another review found artificial sweeteners to be consistently linked to weight gain, increased food intake, altered blood sugar control, decreased satiety signaling and alterations in the gut microbiome. Much of these findings are due to possible effects artificial sweeteners may have on taste receptors and the secretion of hormones that regulate blood sugar control and our hunger and fullness cues. Various animal studies in a review also pointed toward the likelihood that artificial sweeteners may impact the gut microflora negatively by reducing diversity of the gut bacteria. This is concerning, as we know that healthy gut bacteria help support immunity, glycemic control, hormone production and regulate the digestive system (no name a few!). In terms of cancer risk mentioned above, the full data has yet to come out (but should by July 14). Prior data has always recognized aspartame as “generally safe” in that one would have to drink between 12 and 36 cans of artificially sweetened soda every day, likely for a long time period, in order to be at increased risk for cancer.

Practice-based evidence
Replacing foods or beverages you enjoy with an artificially sweetened version may have an oppositional affect for some individuals who consciously or subconsciously offset them with other high calorie, high sugar foods. In practice, I’ve also found clients who consume artificially sweetened foods tend to feel less satiated after eating them and report and increase in cravings for sweets in general. A great example here is satisfaction levels of eating a pint of “fake” ice cream like Halo Top vs. a scoop of real ice cream. What’s more, because they are so sweet, artificial sweeteners may change the way we taste food. A recent review found consistent alterations in taste perception among individuals consuming artificially sweetened beverages, and a reduced sweet taste threshold. This can impact how we taste other more naturally sweetened foods, like fruit, and make them less appealing.

What I think
The answer to the question posed here has some nuance. Too much of any one thing may not be the best for health long-term (even Brussels sprouts!), and it’s important to take inventory of what your diet consists of. Artificially sweetened foods and beverages, in general, tend not to be very nutrient dense. I am always a fan of focusing on diet quality, and oftentimes this means swapping artificially sweetened foods with more whole, nutrient dense options. If you’re looking to cut down, it can be helpful to look at your diet as a whole, and identify the areas where you can do without artificial sweeteners and areas you may want them from time to time (e.g., in some coffee beverages or diet sodas). To be clear though, unless you have a severe food allergy, rarely does having any one thing sporadically impact health (e.g., having a Diet Coke a few times per week). Still, because the available, more recent information on artificial sweeteners is so mixed and has some concerning elements, less is always going to be more in my book, until proven otherwise.

For more information on working with me, please visit my website!

This post is for educational purposes only, and is not meant to serve as individual nutrition advice.