This is Part 2 in our 2-part series exploring the origin of low- and no-calorie sweeteners and their impacts on health. In Part 1, I discussed the different sweeteners currently in use in the US with a focus on trends in consumption and use. This post will focus on the sweeteners’ health impacts.
Low- and no-calorie sweeteners are widely found in our food system, and most people consume well under the Acceptable Daily Intake (ADI) levels for them. The ADI is the average amount 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.
Do lots of people substitute low- & no-calorie sweeteners for sugar?
Seventy-two percent of respondents to the International Food Information Council’s 2021 Food & Health Survey said they limit or avoid sugar in their diets. Of those, about half of them were doing it by swapping water for sugar-containing beverages—more on that strategy later. Only about 20% avoided sugar in their diets by replacing sugar with low-calorie sweeteners.
What’s the current thinking about low- and no-calorie sweeteners & health?
Despite the fact that many health authorities have recognized low- and no-calorie sweeteners as safe for the general public, 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 of the health issue regarding low- and no-calorie sweeteners. That said, more research is needed. In general, concerns over possible adverse health effects from sweeteners tend to be in the areas of appetite/weight gain, cancer, cardiovascular disease, diabetes, gut health, neurological effects, and cognition.
It would be difficult to thoroughly summarize the research in all these areas in one blog post. So instead, I’ve collected some highlights from recent research, review papers, and high-level analyses in several areas of research on these sugar substitutes, also referred to as non-nutritive sweeteners (NNSs). I discussed in-depth NNSs in Part 1 of this series (they have few, if any, calories and no nutrients) .
Appetite & Weight
- Overall, the existing literature shows mixed results on the effects of non-nutritive sweeteners on appetite and body weight.
- A 2020 review concludes that the majority of human studies report no significant effects of artificial sweeteners on body weight. There is also a distinct lack of longer-term studies in this area. There is evidence sweeteners may impact body weight regulation through effects on the gut microbiota.
- Research has also indicated consuming sodas containing non-nutritive sweeteners helps some people stave off weight gain when swapped for sugar sweetened beverages. The strategy proved more effective for men than women. Other studies have shown that in women, appetite and energy intake increases following the consumption of low- and no-calorie sweeteners.
- 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 need to occur in multiple areas of appetite and weight control, and with participants of both sexes.
- 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 says “there is no clear evidence to suggest that using sugar substitutes will help with managing blood sugar or weight or improving cardiometabolic health” over time. They suggest that using low- and no-calories sweeteners to avoid sugar is a personal choice.
- It’s clear sweeteners are not metabolically inert substances. Data suggests that low- and no-calorie sweeteners may impact blood glucose or insulin response differently depending on a person’s weight.
- Although there is no strong conclusion that confirms that non-nutritive sweeteners increase the risk for type 2 diabetes, there is also no firm conclusion that rejects the notion, either. There are several studies on both sides of the question, including meta-analyses, which “pool” the results of studies of comparable quality and method. Hence, we need more human studies.
- 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 and gut wall” immune reactions. This could be especially detrimental to people who are susceptible to or already have chronic inflammatory conditions.
- Other studies, show that after 14 days of supplementation of the diet with realistic amounts of either sucralose or aspartame, there are no differences found in the microbiota composition or its production of short-chain fatty acids. We greatly need additional study in this area. It’s a relatively new area of study, and it has wide-ranging implications on overall health.
Beverages & Sweeteners
The beverage category is one in which sugar is commonly added (as well as being present naturally in many products). And it’s no surprise that the use of low- and no-calorie sweeteners in beverages is prevalent. Guiding Stars knows it’s a category presenting unique challenges to consumers who want to make the best nutritional choices for themselves, and their families. After all, there are so many types of beverages and they differ widely from each other. Sodas are different than juices, which are different than flavored waters, which are very different than dairy-based beverages. It’s easy to see how guidance in how to select a better-for-you beverage could be extremely useful! Stay tuned for a big reveal from Guiding Stars. It will have you feeling prepared to make great beverage choices for your health, so you can sip with confidence.