Artificial Sweeteners
How People Use Alternative Sweeteners
Sugar substitutes offer a sweet taste with fewer or no calories compared to regular sugar. Many artificial sweeteners, such as sucralose and aspartame, are hundreds of times sweeter than sugar, so only a small amount is needed to sweeten food or drinks. This makes them a popular choice in beverages, candies, chewing gum, and baked goods labeled as “sugar-free,” “diet,” or “low-calorie.”
People often use these substitutes at home, adding non-nutritive sweeteners like stevia, saccharin, or sucralose to drinks or foods such as oatmeal or fruit. Sugar alcohols—including xylitol, sorbitol, and erythritol—also add sweetness to various foods, especially in products for individuals managing diabetes. These sugar alcohols are generally less sweet than table sugar but still contribute to the overall taste.
Many people who aim to reduce calorie intake or limit sugar consumption incorporate these sweeteners into their diet as part of a weight management or blood sugar control strategy.
Common Sugar Substitutes
| Type | Example Names | Sweetness (compared to sugar) |
|---|---|---|
| Artificial sweeteners | Sucralose, aspartame, saccharin, neotame, acesulfame potassium (Ace-K), advantame | 100–13,000 times |
| Sugar alcohols | Xylitol, sorbitol, erythritol, mannitol | 0.5–1 times |
| Natural sweeteners | Stevia (stevioside), luo han guo (monk fruit) | 100–250 times |
Are Sugar Substitutes Safe to Eat?
Regulatory agencies like the U.S. Food and Drug Administration (FDA) and international health organizations evaluate the safety of food additives, including sugar substitutes, before they are allowed in food and beverages. The FDA has approved several artificial sweeteners for use, including sucralose, aspartame, saccharin, neotame, advantame, acesulfame potassium (Ace-K), as well as highly purified stevia leaf extracts and monk fruit (luo han guo) extracts.
The FDA also recognizes sugar alcohols—such as xylitol, erythritol, mannitol, and sorbitol—as generally safe for use in food. These substances are not always classified as food additives because of their naturally occurring status.
Health authorities determine an acceptable daily intake (ADI) for each sweetener, which represents the maximum amount considered safe to consume daily over a lifetime. The ADI depends on the type of sweetener and the individual’s body weight and may vary across countries.
Most healthy adults who use approved sweeteners within these guidelines do not experience significant health issues. Individuals who are pregnant can also use these sweeteners in moderation. However, certain groups should be cautious. People with phenylketonuria (PKU), a rare inherited disorder, must avoid aspartame due to its phenylalanine content, which their bodies cannot metabolize. Those with gastrointestinal conditions may experience worsened symptoms when consuming some sugar substitutes, particularly sugar alcohols.
Note: Children under 2 years of age should not consume artificial sweeteners, as their long-term effects on growth and development have not been well studied.
Possible Upsides of Replacing Sugar
Using sweeteners instead of sugar helps most people avoid raising their blood sugar levels. This makes them useful for people with diabetes or prediabetes to help manage blood glucose. Substituting sugar substitutes for added sugar may also reduce the risk of developing cavities, since many artificial sweeteners and sugar alcohols do not support the growth of bacteria that cause tooth decay.
Some people use these sugar alternatives as a way to lower their calorie intake, which can help in short-term weight loss or controlling obesity. Because foods and beverages are sweetened with low-calorie or no-calorie alternatives, people may avoid excess calories from sugar, provided they do not compensate for these saved calories with other sources.
Sugar substitutes are found in many foods marketed to people aiming for a low-calorie or carb-controlled diet, such as those with type 2 diabetes or metabolic syndrome.
Potential Risks and Problems
Most research shows that artificial sweeteners currently approved for use do not cause cancer in humans. Early studies in the 1970s linked saccharin to bladder cancer in rats, but more recent evidence has not confirmed any direct risk for people.
Some studies suggest frequent use of certain sugar substitutes, especially in diet sodas and processed foods, might be linked with higher risks of stroke, heart disease, or early death. Other lifestyle or health factors may influence these findings.
Researchers continue to study how nonnutritive sweeteners may change appetite, affect sweet cravings, or impact how hunger hormones work in the body. Some artificial sweeteners and sugar alcohols may change the way the gut and brain communicate, possibly influencing eating behavior or blood sugar management.
Sugar alcohols such as xylitol, sorbitol, mannitol, and erythritol can cause side effects in some people, including bloating, gas, and diarrhea. These symptoms often depend on the amount consumed and individual sensitivity.
Possible Side Effects and Concerns
- Stomach discomfort or diarrhea (mainly from sugar alcohols).
- Unsure effects on weight or metabolic health when used long term.
- May encourage strong cravings for sweet flavors.
- Certain groups, such as people with PKU or digestive disorders, should avoid certain sweeteners.
