The Lowdown on Artificial Sweeteners: A HealthCentral Explainer

ALTudor Editor

    These days it’s hard not to notice how many foods are labeled “light” (or “lite”), “sugar-free,” “diet,” or low- cal. And it’s no longer just sweet favorites, such as soda and cookies.  Even staples, such as bread and yogurt,  have “lighter” options.


    These products are able to make their sugar-free or low-calorie claims because they’re made with artificial sweeteners. These are non-nutritive (i.e. have no nutritional value), synthetic replacements for sugar that are able to supply sweetness to foods and beverages without adding calories.  Some are manufactured synthetically, while others are derived from natural products, including sugar itself. 

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    Usually these products are used to help people control their sugar intake or lose weight,  though some  report they actually prefer the taste of artificial sweeteners over sugar.  This isn’t surprising because artificial sweeteners are often hundreds of times sweeter than real sugar.


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    The murkiness of the origins of some of these sweeteners is one of the reasons people are often confused by how to best choose and use them. Sometimes these products are called “sugar substitutes,” for example, a subtle change in name that may imply these products are healthier choices because they’re not labeled as “artificial.”  The term “sugar substitutes” also can be confusing because some people use these terms only for naturally occurring substitutes such as honey or agave nectar. 


    Other artificial sweeteners are labeled as “natural” because they are derived from a naturally occurring source (such as agave nectar or sugar), but they are manufactured in a way that requires a great deal of processing and refining.  Some of these artificial sweeteners contain calories, while others do not.   And while most do not increase blood sugar levels, others have been known to stimulate an insulin response as the body reacts to the “sweet” as it’s consumed.



    Artificial Sweeteners:  Their Side Effects and Potential Risks


    Though there are many artificial sweeteners and sugar substitutes, here is a list of the most commonly used artificial sweeteners with some of their known side effects:


    -       Aspartame (Equal, NutraSweet):  Aspartame is chemically derived artificial sweetener that is approximately 200 times as sweet as table sugar. 

    Though it has been categorized as “safe at current levels of consumption” by the U.S. Food and Drug Administration (FDA) in 2007, some people have reported dizziness, headaches, and intestinal or stomach cramping from consuming it.  Other people say suddenly stopping their intake of the sweetener causes them to suffer from headaches and irritability. 


    People with the inherited blood condition phenylketonuria (commonly known as PKU) should not use aspartame, for example, because the sweetener can cause higher levels of the protein phenylalanine in the blood.  There is some additional evidence (though some of it unproven) that aspartame may worsen symptoms in people fibromyalgia, multiple sclerosis, and systemic lupus. Some studies have also suggested a possible connection to numbness, unexplained joint pain, depression, and anxiety.


    Recent research at the Cleveland Clinic's Lerner Research Institute have also potentially linked maltodextrin, a compound found in both Equal and Splenda, with the depletion of healthy intestinal bacteria in people with Crohn’s disease.


    Other studies have linked aspartame with increased appetite, a potential connection that calls into question its usefulness as a weight-loss aid.


    -       Acesulfame K (Sweet One, Sunnett):  Acesulfame K (the symbol for potassium) is another chemically derived artificial sweetener that is also about 200 times sweeter than table sugar. It is almost always used in conjunction with other artificial sweeteners because it sometimes causes a bitter aftertaste.  Kraft Foods has, in fact, patented an additive to this sweetener than masks its aftertaste. 

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    Acesulfame K may be linked to increased insulin response in laboratory animals, while other studies say this sweetener may affect prenatal development when the mother consumes it. There is also some evidence it may influence the offspring’s preference for sweets.


    Other side effects that have been potentially linked to acesulfame K include kidney problems, liver effects, depression, headaches, and a suspected increased cancer risk.  Some experts believe this sweetener has not been as fully researched as it should be, though the FDA has not required additional testing on the sweetener as yet.


    -       Saccharin (Sweet n’ Low):  Saccharin is another chemically produced artificial sweetener that is a whopping 400 times sweeter than table sugar.  Saccharin was discovered in the late 1800s, but it did not begin to be used widely until the sugar shortages of World War I and World War II. 


    There has been a tremendous amount of controversy about saccharin’s safety, as several studies during the 20th century appeared to link the substance to an increased risk of cancer. However after much debate, research, and discussion, the Environmental Protection Agency officially stated that saccharin was “no longer considered a potential hazard to human health.”


    -       Sucralose (Splenda):  Sucralose, the newcomer to the artificial sweetener list, is about 600 times sweeter than table sugar and has the added bonus of being stable for cooking, making it a favorite sugar alternative in baking.  It is found in approximately 4,500 products, including sodas, candies, breakfast bars, and cookies. 


    The FDA has looked at over 100 animal studies on the intake of sucralose and thus far has found no health risks directly linked to its consumption.


    Sucralose is generally considered safe, but it does contain some calories.  And because sucralose has found its way into so many products these days, it’s possible for people who have diabetes who might be using the sweetener to avoid sugar to consume enough of it to affect their blood sugar levels.


    Along with the aforementioned Cleveland Clinic study, researchers at Duke University have also found that Splenda reduces healthy intestinal bacteria, which may have health implications for people who suffer from inflammatory bowel diseases such as ulcerative colititis and Crohn’s disease.  This effect may also cause sucralose to interfere with the absorption of some medications, so people who take regular doses of medications should be aware that their consumption of the sweetener could affect the doses of these meds.


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    -       Stevia:  Stevia is derived from the Stevia rebaudiana plant (also known as sweetleaf or sugarleaf), which is native to the tropical and subtropical regions of North and South America.  It is about 300 times sweeter than table sugar, and it does not appear to increase insulin level.  Some people who consume it report feeling full or suffering from nausea if they do so in large quantities, but it is generally without side effects. 


    The FDA has labeled stevia as “generally recognized as safe” for consumption, though it has not approved whole-leaf or crude stevia extracts because of concerns that ingesting them in a pure form may affect the kidneys and cardiovascular systems.


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    Despite these possible connections, most experts agree that children and pregnant women are the only groups of people who should strictly limit their intake of artificial sweeteners.  In fact, just this month, the American Heart Association and the American Diabetes Association both endorsed the use of six artificial sweeteners (including Splenda, Sweet ‘n’ Low, and Equal) to help maintain a healthy weight – provided people didn’t use the sweeteners as a way to simply treat themselves to higher calorie treats.


    Still, simply using plain sugar or other truly natural sugar substitutes, such as honey, in moderation may be your best choice.   If you’re concerned about the use of sweeteners and their effect on your health, ask your doctor or a licensed nutritionist for advice. 



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    Sources:  HealthDay News; Duke University; 3 Fat Chicks on a Diet;;; U.S. Food and Drug Administration; The Mayo Clinic; WebMD; Wikipedia; U.S. News and World Report; National Cancer Institute; Environmental Protection Agency;

Published On: July 16, 2012