In this article we take a look at the science of artificial sweeteners so that you can make an informed decision about the products you consume.

By Dr. Adam M. Gonzalez
SHIFTED’s Chief Scientific Officer

Artificial sweeteners have been described as everything ranging from a “miracle sugar substitute” to a “toxic chemical”.  Here is what you need to know about the use of artificial sweeteners. 

Key Points: 

• Sugar-sweetened foods and beverages have been associated with weight gain due to their meaningful contribution towards total energy intake, driving a caloric surplus. 
• Artificial sweeteners can take the place of added sugars to reduce calories and the glycemic impact of the food item while providing the desired sweetness. 
• Based on the latest science, there does not seem to be negative health effects from using artificially sweetened beverages
• If used in moderation, artificial sweeteners can be part of a healthy diet.  
• To date, the evidence suggests that substituting sugar-sweetened beverages with beverages sweetened with artificial sweeteners leads to a reduction in calorie intake and small improvements in body composition and cardiometabolic risk factors.

Sugar:  What’s the deal?

Simple sugars and foods containing added sugar are plentiful in the American diet, and it’s very easy for excess sugar consumption to lead to a caloric surplus leading to unwanted weight gain.  For good reason, high sugar foods get a bad reputation since they are typically calorie dense, high in fat, and have low amounts of protein, vitamins, minerals, and fiber. 

The major sources of added sugars include sugar-sweetened beverages, energy drinks, candy, sauces, desserts, pastries, cookies, and other snacks.  Indeed, observational research has suggested associations between high sugar intakes and obesity [1, 6]. 

However, it is important to note that that there is nothing unique with regard to sugar consumption and its health consequences, provided that sugar is substituted isocalorically for other carbohydrates [5].  For example, one study showed that when following a hypocaloric diet, similar weight loss can be achieved even when a majority of carbohydrate intake comes from high sugar foods [7]. 

In other words, the weight gain associated with regular consumption of high sugar foods is likely due to a meaningful contribution towards total energy intake when the diet is not controlled, rather than any inherent negative effect of sugar itself.  

Simply put, high sugar foods tend to make you overeat calories, and it is difficult to regularly consume high amounts of simple sugars as part of a satiating diet that meets the needs for vitamins, minerals, and other macronutrients. 

Therefore, it is very practical to recommend limiting consumption of high sugar foods, particularly when dieting.  The American Heart Association recommends that men do not exceed 36 grams of added sugar per day and women do not exceed 25 grams of added sugar per day.  Just one can of regular soda (which contains up to 40 grams of added sugar) can send you over this recommendation.  However, these general recommendations need to be individualized based upon calorie and carbohydrate requirements.

Artificial sweeteners: A benefit or a risk?  

So, you want you have your cake and eat it to?  That’s where artificial sweeteners become enticing. 

Artificial sweeteners can take the place of added sugars to reduce calories and the glycemic impact of the food item while providing the desired sweetness.  Artificial sweeteners can be hundreds of times sweeter than sugar and contain few to no calories.  Sounds too good to be true, right?  

Each artificial sweetener is a distinct compound with a unique chemical structure and metabolism kinetics [2].  Therefore, it makes sense to view the benefits and risks of each one separately. 

Artificial sweeteners are regulated in the United States by the Food and Drug Administration (FDA), and several have been approved for use in food products and are considered Generally Recognized as Safe (GRAS), including sucralose, aspartame, saccharin, and acesulfame potassium. 

The FDA also establishes safety limits for artificial sweeteners known as the acceptable daily intake (ADI) – a conservative amount that a person can consume daily without risk of adverse effects.  The ADI is set at approximately 100 times below the level at which toxic or adverse effects are observed in animal studies.  For example, the ADI for sucralose (i.e., Splenda) is 5 mg/kg/day.  Therefore, it is considered safe by the FDA for a 70 kg person to consume 350 mg of sucralose per day.  For reference, one packet of Splenda contains 12 mg of sucralose.  

But, why is there so much concern about the safety of using artificial sweeteners?  Some early observational studies on artificial sweeteners showed correlations between artificial sweetener use and negative outcomes including obesity and type 2 diabetes.

This may look scary, but it might be a case of reverse causality.  In other words, instead of artificial sweeteners causing people to become overweight, it could be that people who are overweight are more likely to consume artificial sweeteners because they are trying to lose weight. 

When examining the well-controlled randomized controlled research trials, the research consistently shows that swapping sugar-sweetened beverages with artificially sweetened beverages results in weight loss and improved glycemia [4].  To date, the evidence suggests that substituting sugar-sweetened beverages with beverages sweetened with artificial sweeteners leads to a reduction in calorie intake and small improvements in body composition and cardiometabolic risk factors [3, 8]. 

Most importantly, these effects are observed without evidence of adverse effects.  Interestingly, artificially sweetened beverages even showed to outperform water for reducing weight and some cardiometabolic risk factors [3].  In summary, artificial sweeteners offer a neutral to positive effect on weight management without posing any significant risk of side effects.  

The bottom line

If used in moderation, artificial sweeteners can be part of a healthy diet.  There is nothing magical about them – they simply cause people to consume less calories while satisfying their “sweet tooth”.  Based on the latest science, there does not seem to be negative health effects from using artificially sweetened beverages. 

References:

[1] Berkey C. S.; Rockett H. R.; Field A. E.; Gillman M. W.; Colditz G. A. Sugar‐added beverages and adolescent weight change. Obesity research 2004, 12, 778-788.  https://pubmed.ncbi.nlm.nih.gov/15166298/

[2] Magnuson B. A.; Carakostas M. C.; Moore N. H.; Poulos S. P.; Renwick A. G. Biological fate of low-calorie sweeteners. Nutrition Reviews 2016, 74, 670-689. https://pubmed.ncbi.nlm.nih.gov/27753624/

[3] McGlynn N. D.; Khan T. A.; Wang L.; Zhang R.; Chiavaroli L.; Au-Yeung F.; Lee J. J.; Noronha J. C.; Comelli E. M.; Mejia S. B. Association of low-and no-calorie sweetened beverages as a replacement for sugar-sweetened beverages with body weight and cardiometabolic risk: a systematic review and meta-analysis. JAMA network open 2022, 5, e222092-e222092. https://pubmed.ncbi.nlm.nih.gov/35285920/

[4] Nadolsky K. Z. Counterpoint: Artificial Sweeteners for Obesity—Better than Sugary Alternatives; Potentially a Solution. Endocrine Practice 2021, 27, 1056-1061. https://pubmed.ncbi.nlm.nih.gov/34481971/

[5] Rippe J. M.; Angelopoulos T. J. Sugars and health controversies: what does the science say? Advances in Nutrition 2015, 6, 493S-503S. https://academic.oup.com/advances/article/6/4/493S/4568634

[6] Schulze M. B.; Manson J. E.; Ludwig D. S.; Colditz G. A.; Stampfer M. J.; Willett W. C.; Hu F. B. Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. Jama 2004, 292, 927-934. https://pubmed.ncbi.nlm.nih.gov/15328324/

[7] Surwit R. S.; Feinglos M. N.; McCaskill C. C.; Clay S. L.; Babyak M. A.; Brownlow B. S.; Plaisted C. S.; Lin P.-H. Metabolic and behavioral effects of a high-sucrose diet during weight loss. The American journal of clinical nutrition 1997, 65, 908-915.  https://pubmed.ncbi.nlm.nih.gov/9094871/

[8] Toews I.; Lohner S.; de Gaudry D. K.; Sommer H.; Meerpohl J. J. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. BMJ 2019, 364. https://pubmed.ncbi.nlm.nih.gov/30602577/

Author Bio

Adam M. Gonzalez is an associate professor in the Department of Allied Health and Kinesiology at Hofstra University.  He earned a Ph.D. in Exercise Physiology from the University of Central Florida in 2015 and holds certifications as a Certified Strength and Conditioning Specialist (CSCS), along with a Certified Sports Nutritionist Certification (CISSN). 

His primary research interests include exercise and nutritional strategies to optimize body composition, maximize health, and enhance adaptations to exercise.  He was also awarded the 2022 Nutritional Research Achievement Award by the National Strength and Conditioning Association.