Artificial Sweeteners: Good or Bad?
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Evidence Based
Artificial Sweeteners: Good or Bad?
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Types
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Diabetes
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Cancer
Artificial sweeteners are often the topic of
heated debate.
On one hand, they're claimed to increase your risk of cancer and
harm your blood sugar and gut health.
On the other hand, most health authorities consider them safe,
and many people use them to reduce their sugar intake and lose weight.
This article reviews the evidence on artificial sweeteners and
their health effects.
Artificial sweeteners, or sugar substitutes, are chemicals added to some
foods and beverages to make them taste sweet.
People often refer to them as "intense sweeteners"
because they provide a taste similar to that of table sugar but up to several
thousand times sweeter.
Although some sweeteners contain calories, the amount needed to sweeten
products is so small that you end up consuming almost no calories.
SUMMARY Artificial sweeteners are chemicals used to
sweeten foods and beverages. They provide virtually zero calories.
The surface of your tongue is covered by many taste buds, each
containing several taste receptors that detect different flavors.
When you eat, your taste receptors encounter food molecules.
A perfect fit between a receptor and molecule sends a signal to
your brain, allowing you to identify the taste.
For example, the sugar molecule fits perfectly into your taste
receptor for sweetness, allowing your brain to identify the sweet taste.
Artificial sweetener molecules are similar enough to sugar
molecules to fit on the sweetness receptor.
However, they are generally too different from sugar for your
body to break them down into calories. This is how they provide a sweet taste
without the added calories.
Only a minority of artificial sweeteners have a structure that
your body can break down into calories. Given that only very small amounts of
artificial sweeteners are needed to make foods taste sweet, you consume
virtually no calories.
SUMMARY Artificial sweeteners taste sweet because they
are recognized by the sweetness receptors on your tongue. They provide
virtually zero calories, as your body can’t break them down.
The following artificial sweeteners are allowed for use in the
United States and/or European Union.
- Aspartame. Sold
under the brand names NutraSweet, Equal, or Sugar Twin, aspartame is 200 times sweeter than
table sugar.
- Acesulfame potassium. Also
known as acesulfame K, it’s 200 times sweeter than
table sugar. It’s suited for cooking and baking and sold under the brand
names Sunnet or Sweet One.
- Advantame. This
sweetener is 20,000 times sweeter than table sugar and suited for cooking
and baking.
- Aspartame-acesulfame salt. Sold under the brand name Twinsweet, it’s 350
times sweeter than table sugar.
- Cyclamate. Cyclamate,
which is 50 times sweeter than table sugar, was used for cooking and
baking. However, it has been banned in the United States since 1970.
- Neotame. Sold
under the brand name Newtame, this sweetener is 13,000 times sweeter than
table sugar and suited for cooking and baking.
- Neohesperidin. It’s
340 times sweeter than table sugar and suited for cooking, baking, and
mixing with acidic foods. Note that it is not approved for use in the
United States.
- Sacchari. Sold
under the brand names Sweet'N Low, Sweet Twin, or Necta Sweet, saccharin is 700 times sweeter than
table sugar.
- Sucralose. Sucralose, which is 600 times sweeter
table sugar, is suited for cooking, baking, and mixing with acidic foods.
It's sold under the brand name Splenda.
SUMMARY Many types of artificial sweeteners exist, but
not all are approved for use in every country. The most common ones include
aspartame, sucralose, saccharin, neotame, and acesulfame potassium.
Artificial sweeteners are popular among individuals who are
trying to lose weight.
However, their effects on appetite and weight vary among
studies.
Effects on appetite
Some people believe that artificial sweeteners might increase
appetite and promote weight gain.
The idea is that artificial sweeteners may be unable to activate
the food reward pathway needed to make you feel satisfied after you eat.
Given that they taste sweet but lack the calories found in other
sweet-tasting foods, they're thought to confuse the brain into still feeling
hungry.
Additionally, some scientists think you'd need to eat more of an
artificially sweetened food, compared with the sugar-sweetened version, to feel
full.
It's even been suggested that sweeteners may cause cravings for
sugary foods.
That said, many recent studies do not support the idea that
artificial sweeteners increase hunger or calorie intake.
In fact, several studies have found that participants
report less hunger and consume fewer calories
when they replace sugary foods and beverages with artificially sweetened
alternatives.
SUMMARY Recent studies have found that replacing
sugary foods or drinks with artificially sweetened ones may reduce hunger and
calorie intake.
Effects on weight
Regarding weight control, some observational studies report a
link between consuming artificially sweetened beverages and obesity.
However, randomized controlled studies — the gold standard in
scientific research — report that artificial sweeteners may reduce body weight,
fat mass, and waist circumference.
These studies also show that replacing regular soft drinks with sugar-free versions can
decrease body mass index (BMI) by up to 1.3–1.7 points.
What's more, choosing artificially sweetened foods instead of
those with added sugar may reduce the number of daily calories you consume.
Various studies ranging from 4 weeks to 40 months show that this
may lead to weight loss of up to 2.9 pounds (1.3 kg).
Artificially sweetened drinks can be an easy alternative for
those who regularly consume soft drinks and want to decrease their sugar
consumption.
However, opting for diet soda will not lead to any weight loss
if you compensate by eating larger portions or extra sweets. If diet soda
increases your cravings for sweets, sticking to water might be best.
SUMMARY Replacing sugar-containing foods and beverages
with artificially sweetened ones may help you lose some weight.
Those with diabetes may benefit from choosing
artificial sweeteners, as they offer a sweet taste without the accompanying
rise in blood sugar levels.
However, some studies report that drinking diet soda is
associated with a 6–121% greater risk of developing diabetes.
This may seem contradictory, but it's important to note that all
of the studies were observational. They didn’t prove that artificial sweeteners
cause diabetes, only that people likely to develop type 2 diabetes also like to
drink diet soda.
On the other hand, many controlled studies show that artificial
sweeteners do not affect blood sugar or insulin levels.
Thus far, only one small study in Hispanic women found a
negative effect.
Women who drank an artificially sweetened drink before consuming
a sugary drink had 14% higher blood sugar levels and 20% higher insulin levels,
compared with those who drank water before consuming a sugary drink.
However, the participants weren't used to drinking artificially
sweetened drinks, which may partially explain the results. What's more,
artificial sweeteners may have different effects depending on people's age or
genetic background.
For example, research shows that replacing sugar-sweetened
beverages with artificially sweetened ones produced stronger effects among
Hispanic youth .
This could be related to the unexpected effect seen on Hispanic
women above.
Although research results have not been unanimous, the current
evidence is generally in favor of artificial sweetener use among those with
diabetes. Still, more research is needed to evaluate their long-term effects in
different populations.
SUMMARY Artificial sweeteners can help those with
diabetes reduce their intake of added sugar. However, more research is needed
on the effects of artificial sweeteners in various populations.
Metabolic syndrome refers to a cluster of medical conditions,
including high blood pressure, high blood sugar, excess belly fat, and abnormal cholesterol levels.
These conditions increase your risk of chronic disease, such as
stroke, heart disease, and type 2 diabetes.
Some studies suggest diet soda drinkers could have up to a 36%
higher risk of metabolic syndrome.
However, higher-quality studies report that diet soda either has
no effect or a protective one.
One recent study had people with obesity and excess weight drink
either a quarter gallon (1 liter) of regular soda, diet soda, water, or
semi-skimmed milk each day.
By the end of the six-month study, those drinking the diet soda
weighed 17–21% less, had 24–31% less belly fat, 32% lower cholesterol levels,
and 10–15% lower blood pressure, compared with those drinking regular soda.
In fact, drinking water offered the same benefits as drinking
diet soda.
SUMMARY Artificial sweeteners are unlikely to increase
your risk of metabolic syndrome. Replacing sugary drinks with artificially
sweetened ones might decrease your risk of several medical conditions.
Your gut bacteria play an important role in your health, and poor gut
health is linked to numerous problems.
These include weight gain, poor blood sugar control, metabolic
syndrome, a weakened immune system, and disrupted.
The composition and function of gut bacteria vary by individual
and are affected by what you eat, including certain artificial sweeteners.
In one study, the artificial sweetener saccharin disrupted gut
bacteria balance in four out of seven healthy participants who were not used to
consuming them.
The four “responders” also showed poorer blood sugar control
after as few as 5 days after consuming the artificial sweetener.
What’s more, when gut bacteria from these people were
transferred into mice, the animals also developed poor blood sugar control.
On the other hand, the mice implanted with the gut bacteria from
“non-responders” had no changes in their ability to control blood sugar levels.
Although interesting, more studies are needed before strong
conclusions can be made.
SUMMARY Artificial sweeteners may disrupt the balance
of gut bacteria in some people, which could increase the risk of disease.
However, more studies are needed to confirm this effect.
Since the 1970s, debate about whether there is a link between
artificial sweeteners and cancer risk has raged.
It was ignited when animal studies found an increased risk of
bladder cancer in mice fed extremely high amounts of saccharin and cyclamate.
However, mice metabolize saccharin differently than humans.
Since then, more than 30 human studies have found no link
between artificial sweeteners and the risk of developing cancer.
One such study followed 9,000 participants for 13 years and
analyzed their artificial sweetener intake. After accounting for other factors,
the researchers found no link between artificial sweeteners and the risk of
developing various types of cancer.
Furthermore, a recent review of studies published over an
11-year period did not find a link between cancer risk and artificial sweetener
consumption.
This topic was also evaluated by U.S. and European regulatory
authorities. Both agreed that artificial sweeteners, when consumed in
recommended amounts, do not increase cancer risk.
One exception is cyclamate, which was banned for use in the
United States after the original mouse-bladder-cancer study was published in
1970.
Since then, extensive studies in animals have failed to show a
cancer link. However, cyclamate was never re-approved for use in the United
States.
SUMMARY Based on the current evidence, artificial
sweeteners are unlikely to increase the risk of cancer in humans.
Dental cavities — also known as caries or tooth
decay — occur when the bacteria in your mouth ferment sugar. Acid is produced,
which can damage tooth enamel.
Unlike sugars, artificial sweeteners do not react with the
bacteria in your mouth. This means they do not form acids or cause tooth decay.
Research also shows that sucralose is less likely to cause tooth
decay than sugar.
For this reason, the Food and Drug Administration (FDA) allows
products containing sucralose to claim that they reduce tooth decay.
The European Food Safety Authority (EFSA) states that all
artificial sweeteners, when consumed in place of sugar, neutralize acid and
help prevent tooth decay.
SUMMARY Artificial sweeteners, when consumed instead
of sugar, decrease the likelihood of tooth decay.
Some artificial sweeteners may cause unpleasant symptoms, such
as headaches, depression, and seizures in some individuals.
While most studies find no link between aspartame and headaches, with two noting that
some people are more sensitive than others.
This individual variability may also apply to aspartame's
effects on depression.
For instance, people with mood disorders may be more likely to
experience depressive symptoms in response to aspartame consumption.
Finally, artificial sweeteners do not increase most people's
seizure risk. However, one study reported increased brain activity in children
with absence seizures.
SUMMARY Artificial sweeteners are unlikely to cause
headaches, depression, or seizures. However, some individuals could be more
sensitive to these effects than others.
Artificial sweeteners are generally considered safe for human
consumption.
They are carefully tested and regulated by U.S. and
international authorities to make sure they are safe to eat and drink.
That said, some people should avoid consuming them.
For example, individuals with the rare metabolic disorder phenylketonuria (PKU) cannot metabolize
the amino acid phenylalanine, which is found in aspartame. Thus, those with PKU
should avoid aspartame.
What’s more, some people are allergic to sulfonamides — the
class of compounds to which saccharin belongs. For them, saccharin may lead to
breathing difficulties, rashes, or diarrhea.
Additionally, growing evidence indicates certain artificial
sweeteners like sucralose reduce insulin sensitivity and affect the gut
bacteria.
SUMMARY Artificial sweeteners are generally considered
safe but should be avoided by people who have phenylketonuria or are allergic
to sulfonamides.
Overall, the use of artificial sweeteners poses few risks and
may even have benefits for weight loss, blood sugar control, and dental health.
These sweeteners are especially beneficial if you use them to
decrease the amount of added sugar in your diet.
That said, the likelihood of negative effects can vary by
individual and depend on the type of artificial sweetener consumed.
Some people may feel bad or experience negative effects after
consuming artificial sweeteners, even though they are safe and well-tolerated
by most people.
If you'd like to avoid artificial sweeteners, try using natural sweeteners instead.
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