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The Skinny on Artificial Sweeteners

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By: Marisol Mercado, BS, CSUN Dietetic Intern Cohort 2021-2022

What exactly are artificial sweeteners?  What are they used for?  What is known about their impact on health?  We are going to address all of those questions here and let you decide where you stand on this hot topic.   

Artificial sweeteners are substances that are hundreds to thousands of times sweeter than table sugar1 and that contain minimal to no calories,2 making them an attractive alternative to sugar.  In short, artificial sweeteners are sugar substitutes.  Sugar alcohols are also classified as sugar substitutes; however, there is an important distinction to be made.  Sugar alcohols contain calories,3 although less than sugar, whereas artificial sweeteners contain virtually none.  This is a key difference for individuals who need to closely monitor their caloric or carbohydrate intakes.  Because sugar alcohols are an entire topic of their own, from this point on the focus will be specifically on artificial sweeteners.  

There are currently six artificial sweeteners available in the US that have been approved by the Food and Drug Administration (FDA) as food additives2; their chemical names are listed below along with a few examples of their common trade names1,4: 

Additionally, the extracts of the Stevia plant and monk fruit have been granted GRAS status from the FDA for use as artificial sweeteners,2 meaning that they are “Generally Recognized as Safe” for human consumption. 

Artificial sweeteners are predominantly used in the food and beverage industry in a variety of “sugar-free” and low, or reduced calorie products.2  However, you may also find them in other places you probably would not have guessed, such as in oral hygiene products (e.g., toothpaste, mouthwash, etc.), medications, and e-cigarettes.2,4  Artificial sweeteners can also be purchased and used as tabletop sweeteners (Have you ever noticed those blue, pink, and yellow packets offered at restaurants?).  Additionally, if you love to cook, bake, or both, and are interested in reducing the amount of sugar in your recipes, you may be glad to know that most artificial sweeteners can be used as ingredients in cooking and baking, with the exception of saccharin and aspartame, which lose their sweetness when exposed to heat.1  Monk fruit is an excellent choice to use as a sugar substitute in your recipes since it is heat stable and easy to use!  Simply use ¼ of a teaspoon of monk fruit for every 1 teaspoon of table sugar.1   

Artificial sweeteners provide an option for individuals who want to continue enjoying sweet foods and beverages, but that also have to limit their sugar/caloric intakes.  To put things in perspective, if an individual drinks three 12 oz. cans of Coca-Cola Classic daily, this adds up to 420 calories from sugar; he or she is consuming enough calories to gain one pound in one week, four pounds in one month, and so on.  Keep in mind that some individuals may consume higher-calorie sodas/beverages and in higher amounts than the conservative example provided here.  Therefore, replacing sugar-sweetened beverages with sugar-free alternatives, could potentially improve the health outcomes of some individuals.     

The American Diabetes Association (ADA) and American Heart Association (AHA) released a statement in 2012 that suggested that artificial sweeteners may be beneficial in reducing calories in the diet when replacing calories from sugar, which may lead to some weight loss and a lowered risk for diet-related diseases only when the amounts of these replaced calories are not compensated for by other food sources.5  There is some evidence that suggests that artificial sweeteners may assist with weight loss efforts,6 but the bottom line is that this really depends on a variety of factors that warrant further research.5-8  Researchers investigating the relationship between artificial sweeteners and other health-related outcomes in humans have also encountered mixed results and suggest that further research is needed.8      

What is known is that national and global health authorities have set standards for the general population regarding their use.5 These standards are referred to as acceptable daily intakes (ADIs), which are the daily amounts of artificial sweeteners that are considered safe for human consumption throughout an individual’s lifetime.5 ADIs are set at conservative levels and are difficult to exceed for the majority of the population.  For example, an individual that weighs 150 lbs. would have to consume greater than 30 packets of Splenda, or greater than 68 packets of Equal per day, in order to exceed the ADIs for these artificial sweeteners!5   

Take-Home Message  

References 

  1. Sweeteners – sugar substitutes: Medlineplus medical encyclopedia. MedlinePlus. https://medlineplus.gov/ency/article/007492.htm. Accessed October 4, 2021. 
  1. Sylvetsky AC & Rother KI. Trends in the consumption of low-calorie sweeteners. Physiology & Behavior. 2015;164(Pt B):446–450.  
  1. Eat any sugar alcohol lately: Yale New Haven Health. https://www.ynhh.org/services/nutrition/sugar-alcohol.aspx 
  1. Wilson T, Murray B, Price T, et al. Non-nutritive (artificial) sweetener knowledge among university students. Nutrients. 2019;11(9), 2201–. https://doi.org/10.3390/nu11092201 
  1. Gardner C, Wylie-Rosett J, Gidding SS, et al. Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care. 2012;35(8):798–1808. https://doi.org/10.2337/dc12-9002 
  1. Laviada-Molina H, Molina-Segui F, Pérez-Gaxiola G, et al. Effects of nonnutritive sweeteners on body weight and BMI in diverse clinical contexts: systematic review and meta-analysis. Obesity Reviews. 2020;21:e13020. https://doi.org/10.1111/obr.13020 
  1. Sylvetsky AC & Rother KI. Nonnutritive sweeteners in weight management and chronic disease: a review. Obesity. 2018;26(4):635–640. https://doi.org/10.1002/oby.22139 
  1. Lohner S, Toews I, & Meerpohl JJ. Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutrition Journal. 2017;16(1):55–55. https://doi.org/10.1186/s12937-017-0278-x