You have many choices to satisfy your sweet tooth besides sugar. In fact, almost half of us use sugar alternatives, with 43% turning to sugar substitutes to curb their sugar consumption.

Among sugar substitutes, artificial sweeteners such as Splenda, Equal, and Sweet’N Low are 2023’s most popular choices, with natural alternatives, like Stevia in the Raw and other stevia products, gaining in market share.

Despite our persistent beliefs about how unhealthy these sweeteners are for us, all artificial and natural sweeteners on the market in the U.S. and Europe are Generally Regarded as Safe (GRAS) by the FDA and tested thoroughly by the European Food Safety Authority and the WHO.

Because of the meticulous analysis conducted by such governmental organizations as the FDA, WHO and the European Union, we as consumers can feel confident that these sweeteners have undergone substantial scrutiny before consumption of these products is permitted.

Don’t sweeteners make us sick?

Artificial sweeteners, Splenda, Equal and Sweet’N Low, have a very storied past with the public, with about 40% of us believing sweeteners are generally unhealthy and also that some sweeteners are worse than others. These beliefs are a contributing factor to the recent decline in sales of artificial sweeteners and its associated products, like diet sodas.

Saccharin, the first artificial sweetener on the market, came under scrutiny in the 1970s because of a well-known lab test among rats that resulted in an increased incidence of bladder cancer. However, the results were later dismissed as it was found that saccharin has an entirely different effect on human bladders.

Aspartame continues to have its share of the spotlight with similar cancer concerns, mostly of the brain, but in 2006 the National Cancer Institute conducted a 5-year study of data from almost 500,000 individuals and found that higher levels of aspartame were not associated with elevated risk for brain cancer.

The agony and the irony

Surprisingly, some of these artificial, no-calorie sweeteners we use to lose or manage our weight are making us bigger, depending on the amount and duration we use them.

There is a tremendous amount of controversy on how these artificial sweeteners contribute to obesity. It is debated within the scientific community whether regular, long term consumption of artificial sweeteners leads to long-term health benefits or weight loss.

In fact, quite the opposite can be true: a 2017 meta-analysis reported in the Canadian Medical Association Journal found that the consumption of sugar substitutes was associated with increases in weight and waist circumference, and a higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events.

So if sweeteners have zero calories, how in the world is this happening? There may be three reasons for the expanding waistlines and associated illnesses…

Sweetness begets more sweetness

Dr. David Ludwig, an obesity and weight-loss specialist at Harvard-affiliated Boston Children’s Hospital, hypothesizes that those who use artificial sweeteners may end up replacing the lost calories with less nutritious and calorie-dense options, like cake or pizza, thinking that they can “spend” their otherwise consumed 300 calories if they drank two regular sodas.

Another consideration is that hyper-sweetened substances may alter the way we taste our food. Since sucralose is 600 times sweeter than sugar, our brains become more accustomed to this level of sweetness and eventually we find more natural but lesser sweet things, like fruits, less desirable. And vegetables? Forget it!

Lastly, these artificial sweeteners allow the consumer to disassociate sweet with caloric, which can be dangerous as eating sugar and sugar-like substances signal our brain to consume more sugar, thus initiating a vicious cycle. You can blame that on our primate ancestors, as sugar was a scarce commodity way back when!

Other controversies

While the research has not been peer-reviewed or widely accepted by the scientific community, there are several separate research trials of Splenda, Equal, and Sweet’N Low that have shown causal relationships between artificial sweeteners and negative gut microbiome health, stroke and Alzheimer’s disease.

One study conducted by a team of Israeli scientists in 2014 found that artificial sweeteners, such as sucralose, aspartame and saccharin, significantly altered the intestinal bacteria of mice that, in turn, negatively affected their metabolisms, leading to obesity, diabetes, and other related diseases. (If you are unfamiliar with the gut microbiome, also known as our “second brain”, be sure to read our post on gut microbiota.)

Regarding the link of artificial sweeteners to Alzheimer’s disease and stroke, the American Heart Association reported that daily consumption of diet sodas may substantially increase the risk of these diseases. However, it is important to keep in mind that this finding may be a correlation and not causation— meaning that those who drink diet sodas regularly may be in poorer health than those who don’t drink them due to overall poor diet and lack of exercise.

Do diet drinks count?

Some of us may not think we regularly use artificial sweeteners, but don’t discount all those diet drinks and zero-calorie flavored waters!

According to a 2016 study published in the Journal of the Academy of Nutrition and Dietetics, nearly half of adults and a quarter of children in the U.S. consume artificial sweeteners—and the majority do so on a daily basis, with diet drinks making up the bulk of the intake.

Both the American Heart Association and the American Diabetic Association jointly agree that people should use artificial sweeteners cautiously.

Other options are also being added to the grocery store shelves, such as xylitol and stevia-sweetened sodas and drinks.

Because of its taste and its natural origin, stevia sweetened sodas, drinks, and food items are gaining in popularity.

From just 2014 to 2017, the market value of stevia has grown 71% to $578 million from $338 million.

Here’s a list of the most popular diet drinks in the market today and their associated sweeteners:

Splenda (sucralose)

Splenda is an artificial sweetener that is made of sucralose, a synthetically derived compound from sucrose – or table sugar. Sucralose is extremely sweet – it’s about 600 times sweeter than table sugar and three times sweeter than Equal.

Sucralose in your body: Because your body has no use for it, approximately 85% of sucralose does not get digested or absorbed, thus leaving your body unchanged. Most of what remains gets absorbed in the gastrointestinal tract and then leaves the system as urine, but about 5% of the remaining sucralose will metabolize in the body.

Limitation on consumption: As per FDA guidelines, acceptable daily intake of sucralose is 5 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume upwards of 340mg of sucralose per day, which equates to 28 Splenda packets or 9 cans of diet soda. That should leave PLENTY of room for even the sweetest of sweet-tooths! 

Equal (aspartame)

Equal, or aspartame, is made from aspartic acid and phenylalanine, two amino acids that when combined in a specific structure, yield a very sweet substance that’s 200 times sweeter than table sugar.

Aspartame in your body: Unlike sucralose and saccharine, aspartame is fully absorbed in the body given its composition of amino acids, which your intestinal tract breaks down into digestive enzymes the same way it would after consuming common protein sources, such as meats, fish, eggs and dairy. Aspartame does not enter your blood stream. 

Limitation on consumption: The acceptable daily intake of aspartame as determined by the FDA is 50 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume upwards of 3,400mg of aspartame per day. This equates to 18 cans of diet soda or almost 100 blue packets…per day! Keep in mind that your body creates trace amounts of methanol when breaking down aspartame. Though small amounts are not considered toxic and are actually naturally-occurring, larger amounts can lead to headaches, weakness, dizziness and nausea.

Aspartame and health conditions: A very important note about aspartame is that it is not to be consumed by those who suffer from phenylketonuria, a condition in which a person cannot metabolize phenylalanine into tyrosine. Thankfully, in the U.S. and most countries, detection of this condition occurs in the newborn screening panel.

Sweet’N Low (saccharin)

Sweet’n Low is an artificial sweetener made of saccharin, or benzoic sulfimide, which is a synthesized compound of methyl anthranilate, sodium nitrite, hydrochloric acid, sulfur dioxide, chlorine, and ammonia. This yields a very sugary substance that’s 300-400 times sweeter than sucrose. 

Saccharin in your body: Similar to sucralose, saccharin is also not largely stored in the body.

Limitation on consumption: As per FDA guidelines, the acceptable daily intake of saccharin as determined by the FDA is 15 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume upwards of 1,000mg of saccharin per day, which equates to 28 pink packets or 16 cans of Tab (if you’re able to locate the cult fave!)

Stevia

Stevia is an all-natural sweetener that comes from a shrub called stevia rebaudiana and is primarily grown in South America and Asia. Today, 80% of all stevia comes from China, where they practice strict farming guidelines. These compounds are so sweet that it is actually 200-300 times sweeter than sugar.

Stevia in your body: Stevia has been studied and confirmed that it does not change your glycemic index or glycemic load. Research shows that it is metabolized by the liver, then passes through the body and does not accumulate anywhere.

Limitation on consumption: As per FDA guidelines, the acceptable daily intake of stevia is 4 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume up to 40 packets of stevia per day – every day.

A more “natural” artificial sweetener? There has been some conversation about stevia being considered a natural sweetener. Because there is no real definition of ‘natural’ (read our post investigating the ‘natural’ label here), the word is not meaningful. However, it is not synthetically made like other alternative sweeteners; therefore it is referred to as a ‘natural-origin’ sweetener.