Teach Me

Are Artificial Sweeteners Really Worth It?

March 3, 2023 update:  
"A recent study has shown that patients with higher levels of erythritol intake experienced more heart attacks and strokes than those who had low levels of erythritol intake.  However, based on the nature of the study, we cannot be certain that the erythritol was the definite cause of increased heart problems," said Mark Tuttle, MD, an interventional cardiologist with Banner Health. “It is nevertheless a cause for concern given the widespread use of this artificial sweetener.  Further study is needed to evaluate definitively if erythritol indeed causes cardiovascular disease.”

Sugar … ah, honey, honey. You are my candy girl, and you got me wanting you.

This song is an oldie but goodie by the Archies, and while it may be about a boy’s admiration for a girl, boy, oh boy, do most of us crave sugary sweets.

In fact, according to the Department of Health and Human Services, Americans consume more than 152 pounds of sugar each year—that’s roughly three-and-a-half cans of Coke or about 42 teaspoons of sugar a day! In reality, we should only be having 13.3 teaspoons a day based on a 2,000-calorie diet. That’s a whole lotta sugar!

We all know sugar isn’t good for us. Eating too much sugar can increase a person's risk of many health problems, including weight gain, obesity, high blood pressure, type 2 diabetes, heart disease, liver disease and tooth decay.

To combat this sugar overload, many of us reach for artificial sweeteners as a calorie-free substitute. Although we may be ingesting less calories, are these substitutes really worth it? Registered dietitian, Ashley Amaral, from Banner – University Medical Center Phoenix explained.

What are artificial sweeteners?

Artificial sweeteners are sugar substitutes that are very concentrated (up to 600 times sweeter than table sugar) and have virtually no calories. Types of artificial sweeteners include synthetic artificial sweeteners (Equal, Splenda), plant-based sweeteners (Stevia, Truvia) and sugar alcohols (xylitol, erythritol, sorbitol).

“These sugars have a low caloric content as they aren’t absorbed by the body and act as a fiber being resistant to digestion,” Amaral said.

Are they safe?

If you do a Google search, you are bound to find a plethora of articles citing false claims about these sugar substitutes, saying they cause such things as obesity, Alzheimer’s, cancer, hypothyroidism and even blindness. The Food and Drug Administration (FDA) has not been swayed by this information, because the health problems reported have yet to show in large-scale human research, and to date, there is no evidence supporting a connection between consumption of artificial sweeteners and these diseases.

There have been lots of studies, “but there has been no clear evidence that links these findings to humans, so the FDA deems these safe for consumption,” Amaral said.

The FDA has established an acceptable daily intake (ADI) for each artificial sweetener. ADI is the maximum amount considered safe to consume each day over the course of a lifetime.

Possible Health Benefits:

  • Weight control
    • Artificial sweeteners have virtually no calories, so for those trying to lose weight, this may be a tempting option.
  • Diabetes
    • Artificial sweeteners aren’t carbohydrates, so they generally don’t raise blood sugar levels.

“Artificial sweeteners do have some potential health benefits, including weight and blood sugar management,” Amaral said. “Although the effectiveness of these sweeteners for long-term weight loss aren’t clear. And, if you have diabetes, it’s best to check with your doctor before consuming.”

Possible Health Concerns:

  • Alters sense of taste
    • “Over time, the consumption of artificial sweeteners can alter your sense of taste to nutritive foods, such as fruit or naturally sweet vegetables, making them taste bland and less palatable,” Amaral said.
  • Disrupts gut flora
    • Artificial sweeteners can also alter your gut flora, the good bacteria in your gut.
  • Creates laxative effect
    • Sugar alcohols have been shown to cause bloating, gas and diarrhea.

Moderation is Key

When it comes to sugar substitutes and sugar, in general, Amaral said your best bet is moderation. If you eat a healthy diet and exercise, you are OK to enjoy an occasional diet coke or soda. Amaral recommended opting for natural sugars, too, such as maple syrup, honey or raw sugar to add subtle sweetness, unless you are diabetic.

“For those who do drink soda as their primary fluid, try reducing by 50%,” Amaral said. “So, challenge yourself to try and reduce your daily sugar intake by limiting added sugars and enjoying the natural flavors.”

If you are concerned about your sugar intake, schedule an appointment with one of our registered dietitians at Banner Health who can help you understand the impact a healthy diet can play in your overall health. Visit bannerhealth.com to find a dietitian near you.