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Pros and cons of artificial sweeteners

Research looking into the potential health effects of artificial sweeteners has offered up a mixed bag. Dreamstime/TNS
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By Howard LeWine, M.D.
Posted on September 01, 2022

Q: I hear so much about the evils of sugar. Are artificial sweeteners a good alternative, especially to help me lose weight?

A: While they are not magic bullets, smart use of non-nutritive sweeteners could help you reduce added sugars in your diet, therefore lowering the number of calories you eat. Reducing calories could help you attain and maintain a healthy body weight.

In fact, the American Diabetes Association (ADA) and American Heart Association (AHA) have given a cautious nod to the use of artificial sweeteners in place of sugar to combat obesity and diabetes.

The FDA has approved six artificial sweeteners: saccharin, acesulfame, aspartame, neotame, sucralose and advantame. It has also approved one natural low-calorie sweetener, stevia.

Research looking into the potential health effects of artificial sweeteners has offered up a mixed bag. Some studies have actually linked these products to higher rates of weight gain and diabetes. But others have found an association with weight loss and lower body mass index, and no adverse health effects.

Why might artificial sweeteners potentially cause weight gain instead of weight loss? These products change the way we taste food. Non-nutritive sweeteners are far more potent than table sugar and high-fructose corn syrup. A miniscule amount produces a sweet taste comparable to that of sugar, without comparable calories.

Artificial sweeteners are extremely sweet — hundreds to thousands of times sweeter than table sugar. So, people who habitually consume them may end up desensitized to sweetness.

Healthful, satiating foods that are less sweet, such as fruits and vegetables, may become unappetizing by comparison. As a result, the overall quality of the diet may decline. The calories removed from the diet by the sugar-for-sweetener swap may sneak back in, in the form of refined carbohydrates and low-quality fats.

In other words, use of artificial sweeteners can make you shun healthy, filling and highly nutritious foods, while consuming more artificially flavored foods with less nutritional value.

Artificial sweeteners may play another trick too. Research suggests that they may prevent us from associating sweetness with caloric intake. As a result, we may crave more sweets, tend to choose sweet food over nutritious food, and gain weight.

Even with FDA approval of artificial sweeteners, there remains some doubt about the long-term safety of daily high doses of these products.

Studies leading to FDA approval have ruled out cancer risk, for the most part. However, those studies were done using smaller amounts of diet soda than the 24 ounces a day consumed by many people who drink diet soda.

Personally, I have taken a moderate approach. I use an artificial sweetener in my daily morning coffee, and try to limit simple sugars throughout the rest of the day.

© 2022 Harvard University. Distributed by Tribune Content Agency, LLC.

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