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Are Artificial Sweeteners Bad for Your Health?

Who doesn’t love sweet treats? We all do! But sometimes too much sugar in cakes, cookies and beverages can bring some not-so-fun health problems.

That’s where artificial sweeteners (also called sugar substitutes or artificial sugars) come in. Are they a better, healthier alternative for indulging your sweet tooth? Or could they also not be so sweet for your health?

Beril Hezer, a registered dietitian with Banner Health, helps us understand more about artificial sweeteners and whether they are a safe alternative.

What are artificial sweeteners?

Artificial sweeteners are chemicals used to replace table sugar. These sweeteners are very concentrated (up to 600 times sweeter than table sugar) and have virtually no calories. They also don’t affect your blood sugar levels in the same way as plain old sugar.

“Artificial sweeteners don’t enter the bloodstream and don’t raise blood sugar directly,” Hezer said. “They stay in your digestive tract until they pass in your stool.”

You can find artificial sugars in frozen desserts, candies, yogurt, baked goods, chewing gum, breakfast cereals, gelatins and puddings. To tell if artificial sweeteners are in a product, they’ll most likely say something like “sugar-free,” “reduced sugar,” “no added sugar” or “diet.”

You can also buy them in their purest forms in packets, liquid drops or granules.

What are the different types of artificial sweeteners?

There are three types of artificial sweeteners: synthetic sweeteners, plant-based sweeteners and sugar alcohols. The following sugar substitutes are approved by the U.S. Food and Drug Administration (FDA) and are allowed for use in the United States:

  • Aspartame (Equal, NutraSweet)
  • Saccharine (Sweet ’N Low)
  • Sucralose (Splenda)
  • Neotame (Newtame)
  • Acesulfame K (Sunett, Sweet One)
  • Advantame 
  • Purified stevia leaf extracts (Truvia, PureVia)

The FDA also allows the use of sugar alcohols, such as sorbitol, xylitol and mannitol. 

Are artificial sweeteners safe?

Artificial sweeteners are generally considered safe, but like table sugar they aren’t without problems. Here are some pros and cons to consider:

  • Blood sugar management: Artificial sweeteners aren’t carbohydrates, so they may benefit those with diabetes. They don’t raise the level of sugar in the blood.
  • Dental health: Unlike sugar, artificial sweeteners don’t contribute to tooth decay and cavities. The lack of fermentable carbohydrates means fewer chances for harmful bacteria in the mouth to produce acids that break down your enamel.
  • Fewer calories: These sugar substitutes often have low or no calories. This makes them an appealing option if you are trying to manage your weight or control your calorie intake.
  • Sense of taste: “Because they are sweeter than sugar, these ingredients may get your taste buds used to sweetness,” Hezer said. Over time, this can alter your sense of taste for nutritious food like fresh fruits and naturally sweet vegetables.
  • Gut flora: “Some studies show that long-term use of artificial sweeteners can lead to the development of glucose intolerance by altering the gut microbiome, the good bacteria in your gut,” Hezer said.
  • Digestion: Certain sugar substitutes, such as sugar alcohols, may cause bloating, gas and diarrhea when you eat large amounts.
  • Health problems: There is no link between artificial sweeteners and cancer. However, long-term use has been linked to a higher risk of heart attacks, stroke and metabolic syndrome, a cluster of conditions like high blood pressure, high blood sugar and excess belly fat. 

“Artificial sweeteners should be used with caution in high-risk people, such as pregnant and lactating women, diabetics and those who experience migraines and epilepsy,” Hezer said.

How can I balance my sugar intake and a healthy diet?

When it comes to balancing artificial sugar (or any sugar) with a healthy diet, it’s all about moderation and making informed choices. While artificial sweeteners can be a low-calorie alternative, it’s important not to rely on them alone. 

Here are a few tips:

  1. Read nutrition labels: “It’s always advised to check the nutrition fact label and ingredients to understand what you are eating or drinking,” Hezer said. Here’s what to know about some key facts you’ll find on nutrition labels.

  2. Monitor overall sugar intake: Keep track of your total sugar intake. The American Heart Association recommends nine teaspoons of added sugar per day for men and six teaspoons for women per day. 

    “To help monitor your intake, it’s best to start with getting to know your sweeteners, where you use them and how much,” Hezer said. “It’s important to have awareness of where you find sweeteners and how much you have day in and day out.”

    For example: Do you like sweeteners in your coffee or tea? If so, how many cups you drink can determine how much sweetener you will consume. If you like diet sodas or beverages, how many cans or bottles do you drink?
  3. Focus on whole, unprocessed foods: Fruits, vegetables and whole grains provide natural sweetness and essential nutrients.

  4. Stay hydrated: Drink water throughout the day to help maintain a healthy balance.

  5. Be mindful of cravings: If you find yourself craving sweets, explore healthier alternatives like fruit or a small piece of dark chocolate.

  6. Choose natural sweeteners: Some sugar alternatives that carry fewer risks are stevia, monk fruit, raw honey, coconut sugar and pure maple syrup. But remember, all sweeteners should be consumed in small amounts.

  7. Talk to a dietitian: If you have specific dietary concerns or health conditions, talk to a registered dietitian who can help you create a healthy diet plan.


Artificial sweeteners can be a short-term way to help some people enjoy sweetness without excess calories, but remember to have them in moderation. 

If you are concerned about your sugar intake, schedule an appointment with your health care provider, a registered dietitian or a Banner Health specialist

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