This is Part 2 in our 2-part series exploring the origin of low- and no-calorie sweeteners and their impacts on health. IClick here if you missed Part 1 of this series.
Low- and no-calorie sweeteners are used widely in the food supply, and most people consume well under the Acceptable Daily Intake (ADI) levels for them. The ADI is the average amount that’s expected safe for a person to consume daily over a lifetime. As an example, a 132-pound person would need to consume 23 packets of sucralose sweetener to reach the ADI level. Still, consumers who are looking to decrease their sugar intake have a variety of methods by which to do so.
What’s the current thinking about low- and no-calorie sweeteners & health?
Health authorities around the world recognize that low- and no-calorie sweeteners as safe for the general public when consumed within ADI levels. Yet plenty of controversies about the effects of sweeteners on human health still exist. The consumption of sweeteners tends to be a polarizing topic in the scientific community. There are plenty of research studies on both sides. That said, more research is needed. In general, concerns over possible adverse health effects from sweeteners tend to cluster around the topics of appetite/weight gain, cancer, cardiovascular disease, diabetes, gut health, neurological effects, and cognition. All of the science in these areas won’t fit into one blog post. So here I present highlights from several pertinent areas of research.
Appetite & Weight
- Overall, the existing literature shows mixed results on the effects of non-nutritive sweeteners on appetite and body weight.
- A 2022 review concludes that replacing sugar (sucrose) with non-nutritive sweeteners can be effective for weight management, but is dependent on a caloric deficit. In other words, alternative sweeteners can help you cut calories, but they aren’t magic. Using them won’t make up for overeating elsewhere. This same review noted that neither short- nor long-term use of non-nutritive sweeteners seems to cause automatic compensatory eating. And consuming sugar-free foods and drinks can still bring a calorie savings.
- A recent review that examined research on non-nutritive sweeteners compared to water found the sweeteners had no meaningful effects on post-consumption blood sugar response. They also didn’t find any impact on hormone response (such as insulin).
- Randomized clinical trials indicate consuming non-nutritive sweeteners generate weaker “reward and satisfaction” signals compared to sugar. A current review showed that non-nutritive sweeteners elicit different responses related to reward and satiety than caloric sweeteners do. Longer term studies are needed, however.
Diabetes
- Using non-nutritive sweeteners and eating foods sweetened with them may help you reduce sugar in the diet and therefore decrease the number of calories you eat. For people heading toward type 2 diabetes, this may make weight loss or weight maintenance easier, and thereby lower the risk of developing diabetes and heart disease.
- The American Diabetes Association, along with the American Heart Association and the Academy of Nutrition and Dietetics all agree that low- and no-calorie sweeteners can help people with diabetes achieve better glucose control. But, regular sugars can also be incorporated into a diet for someone with diabetes. It’s a personal choice.
- There is no strong conclusion that confirms that non-nutritive sweeteners increase the risk for type 2 diabetes, but there is also no firm conclusion that rejects the notion. The presence of an association between non-nutritive sweetener use and the presence of type 2 diabetes does not indicate that the sweeteners cause diabetes. In fact, people with type 2 diabetes are the same group that may benefit most from the sweeteners’ ability to cut sugar and calories from a diet. Therefore, it’s not surprising that this group uses non-nutritive sweeteners. Nevertheless, more human studies are needed in this area.
Gut Health
- According to authors of a 2021 review on artificial sweeteners and gut health, evidence suggests that “artificial sweeteners may induce pro-inflammatory changes in gut bacteria”. This could be especially detrimental to people who are susceptible to or already have chronic inflammatory conditions.
- A 2023 review found that the amount of conflicting information makes it difficult to draw any definitive conclusions. Certainly, changes to the gut microbiota are found with the use of non-nutritive sweeteners, but the impact is questionable, and the relevance of those changes is not known. We greatly need additional study in this area, since the gut microbiome is connected to many areas of human health.
Beverages & Sweeteners
Sugars are commonly added to many beverages. In fact, beverages are where Americans get most of their added sugars. Lots of beverages also include natural sugars. And of course, the beverage category is one where lots of non-nutritive sweeteners show up. The category as a whole presents unique challenges for shoppings who are looking for the best options for themselves and their families. Guiding Stars created a beverage algorithm in 2022 to help bring clarity to consumers. Beverages that get 3 Guiding Stars do not include any added sweeteners nor non-nutritive sweeteners. For more information on how Guiding Stars handles beverages, click here.