Are Artificial Sweeteners Better for You Than Sugar?

Check out this answer from Consensus:

The choice between sugar and artificial sweeteners is not straightforward. While artificial sweeteners offer benefits in terms of weight management and glycemic control, they are also associated with potential health risks, including cancer and adverse effects on glucose metabolism. Natural sweeteners may provide a safer alternative, but further research is required to confirm their efficacy and safety. Ultimately, the best approach may be to limit the consumption of all sweeteners and focus on a balanced diet rich in whole foods.

The debate over whether artificial sweeteners are a healthier alternative to sugar has been ongoing for years. With the rising prevalence of obesity, diabetes, and other metabolic disorders, the need for effective dietary interventions has never been more critical. This article aims to explore the benefits and risks associated with artificial sweeteners compared to sugar, drawing on recent research findings.

Health Risks of Sugar

Excessive consumption of sugar has been linked to numerous health issues, including obesity, type 2 diabetes, and cardiovascular diseases. Recent guidelines recommend limiting the intake of added sugars to less than 10% of daily caloric consumption to mitigate these risks3. The deleterious effects of sugar on chronic diseases are well established, making the search for healthier alternatives imperative1.

Benefits of Artificial Sweeteners

Artificial sweeteners, such as aspartame, sucralose, and acesulfame-K, provide the sweetness of sugar without the associated calories. This makes them an attractive option for weight management and glycemic control. Studies have shown that replacing sugar-sweetened beverages with those containing artificial sweeteners can lead to weight loss and improved cardiometabolic health2. These sweeteners produce a low glycemic response, making them suitable for individuals with diabetes7.

Potential Risks of Artificial Sweeteners

Despite their benefits, artificial sweeteners are not without controversy. Some studies suggest that they may be associated with an increased risk of cancer. For instance, a large cohort study found that higher consumers of artificial sweeteners had a higher risk of overall cancer, particularly breast cancer and obesity-related cancers1. Additionally, artificial sweeteners may affect glucose absorption and insulin secretion, potentially worsening glycemic control5.

Natural Sweeteners as an Alternative

Natural sweeteners, such as steviol glycosides and Luo Han Guo fruit extracts, have emerged as potential alternatives to both sugar and artificial sweeteners. These sweeteners are generally recognized as safe (GRAS) and may offer health benefits, including improved lipid metabolism and antioxidant effects6. However, more research is needed to fully understand their long-term impact on health.

 

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Are artificial sweeteners better for you than sugar?

Cornelie Nienaber-Rousseau has answered Uncertain

An expert from North-West University in Nutrition

The world wide obesity pandemic has been partially attributed to the overconsumption of added natural sugars. In several countries sugar tax has been introduced, because of the notoriousness of sugars. Therefore, we have seen an explosive increase in food products including carbonated drinks containing non-caloric (non-nutritive) or low-caloric artificial sweeteners with sucralose, acesulfame potassium (acesulfame K) and aspartame being the most popular (Yang, 2010). With the introduction of sugar tax the food industry has responded with introducing hybrid carbonated beverages to the shelves. In these hybrids sugar is partially substituted for artificial sweeteners to retain the same sweetness with less sugar in an attempt to evade consumers having to pay more. The Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) do rigorous safety testing on artificial sweeteners to ensure their safety at levels people would normally use. Apart from those with phenylketonuria, for whom aspartame consumption can have dire consequences (Butchko et al., 2002), artificial sweeteners seem to be generally safe and old research (de La Hunty et al., 2006) saw weight loss when using aspartame; but new research is indicating that their long term health effects might not be so favorable.

Even though the intention when people are using artificial sweeteners instead of sugar is to reduce energy intake in order to lose weight or control it (Mooradian et al., 2017), epidemiological data found a positive association between non-caloric artificial sweetener use and weight gain as well (Brown et al., 2010; Chia et al., 2016; Fowler et al., 2008; Fowler et al., 2015). It is important to evaluate cohort/prospective or longitudinal studies to answer the question whether artificial sweeteners cause weight gain, because cross-sectional studies cannot say whether, artificial sugar intake make you fat or if overweight people are more likely to consume artificial sugars. The study of Fowler and co-researchers (2008) included a large amount of adults (5158 with a follow-up of 3682 individuals). They observed a strong dose-response relationship between diet beverage consumption and change in body mass index that were even more pronounced when other factors influencing weight (gender, ethnicity, weight category at the beginning of the study, diabetes, dieting status, exercise) were factored in. In another follow-up study Fowler and co-workers (2015) observed that diet soda intake is associated with increased waist circumference in older adults. A study by Chia et al. (2016) found that low-calorie sweetener use is associated with heavier relative weight, a larger waist, and a higher prevalence and incidence of abdominal obesity. Likewise, a comprehensive systematic review that summarized the results of 18 large, epidemiologic studies indicated that consuming artificially-sweetened beverages was associated with weight gain in children (Brown et al., 2010). Most epidemiological studies rely on diet questionnaires, which are not accurate to quantify intakes and therefore to support the findings of observational studies experimental studies should be conducted such as the one by Ebbeling and fellow researchers (2006). Ebbeling et al. randomly assigned 103 adolescent to an intervention, wherein non-caloric beverages were used to displace sugar sweetened beverages, and a control group for 25 weeks. They found that body mass index did not decrease after substituting diet beverages for sugar-sweetened beverages, except among the heaviest participants. These findings are not congruent with conventional wisdom that using artificial sweeteners would enhance weight loss or prevent gain. Additionally, non-caloric artificial sweetener seems to alter gut microbial activity (Suez et al., 2015) and the health sequelae of the changed microbiome warrants further investigation. Whether natural sugar is more/less healthy than artificial sweeteners and whether reducing natural sugars by substituting with the non-nutritive versions need to be determined in large scale experimental studies with weight including details on fat distribution, type 2 diabetes, metabolic syndrome, microbiome as possible outcomes. Diets are complex, therefore we need studies to evaluate the individual and combined (combinations of artificial sweeteners as well as combinations of natural sugar with non-nutritive artificial sweeteners) health effects.

However, the evidence that has accumulated has raised serious questions regarding non-caloric or low calorie artificial sweetener use, because it might be fueling rather than fighting weight gain and, therefore, the obesity epidemic (Fowler et al., 2008). In their reviews Yang (2010) and Frisch (2016) attempted to explain the weight gain phenomenon when using non-nutritive sweeteners. Yang (2010) argued in the light of the neurobiology of food reward that artificial sweeteners do not activate the food reward pathways in the same way as natural sugars do. Sucrose (natural sugar) compared to saccharin (non-nutritive sweetener) ingestion was associated with greater activation of the higher gustatory areas. Yang (2010) hypothesized that “sweetness decoupled from caloric content offers partial, but not complete, activation of the food reward pathways.” Yang (2010) also wrote that the activation of hedonic component may contribute to increased appetite, fuel food seeking behavior and encourage sugar cravings. Frisch (2016) reasoned that the wide-spread use of artificial sweeteners is desensitizing our palate to become accustomed to very sweet tastes that might influence our dietary choices in general. Frisch (2016) also speculated that we are creating the misconception that consumers can eat more, but consume less (energy) and that this idea can have problematic consequences. Currently scientists are trying to understand the reasons for non-caloric sweeteners leading to weight gain and future qualitative research is needed to understand how the consumption of diet or low-calorie alternative foods/beverages are influencing dietary choices.

From the current evidence, it remains uncertain whether sweeteners are fighting or feeding the obesity/diabetes problems they were intended to combat. Therefore, I recommend to reduce the intake of both natural and artificial non-caloric sweeteners as part of a well-balanced nutritious diet and not merely to replace natural sugars with artificial sweeteners.

 

Are artificial sweeteners better for you than sugar?

Jennie Brand-Miller has answered Unlikely

An expert from University of Sydney in Nutrition, Diabetes, Obesity

First, in my opinion, artificial sweeteners do NO harm. This opinion is based on post-marketing experience of the majority of low calorie sweeteners. (Some newer ones don’t have the benefit of this long perspective.) Artificial sweeteners first entered the market 50 years ago. It was assumed that they would displace the calories in added sugars, and make it easier to lose weight and maintain the weight loss – in theory. However, in practice, this has not played out – the prevalence of obesity and overweight have tripled in that timeframe despite the popularity of low calorie sweeteners and their ubiquity (as common as salt and pepper). Of course, some individuals will find them helpful. But as a public health solution, they have not been successful.

 

Are artificial sweeteners better for you than sugar?

Gideon Meyerowitz-Katz has answered Near Certain

An expert from University of Wollongong in Epidemiology, Public Health, Diabetes

There are some health concerns about artificial sweeteners. There is a worry that artificial sweeteners, while somewhat inert in the body, may influence a variety of hormonal and other bodily functions. There are also some epidemiological findings suggesting that people who have a higher intake of artificial sweeteners are less healthy than those who have less (usually in relation to soft drinks with sweeteners).

However.

While there may be some questions about sweeteners, there is certainly no suggestion that they are worse for people than sugar itself. It’s possible that artificial sweeteners might be worse for people than water – although this is something of an open question – but compared to sugar, all indications are that artificial sweeteners are probably a bit better.

 

Are artificial sweeteners better for you than sugar?

Samir Softic has answered Likely

An expert from University of Kentucky in Gastroenterology, Obesity

Artificial sweeteners do not carry caloric load as sugar does but they do not come free of unwanted effects. Artificial sweeteners can stimulate sweet taste receptors in the gut and affect food intake. However, immerging evidence shows that switching from sugar sweetened beverages to artificially sweetened ones appears to be beneficial for weight management.

 

Are artificial sweeteners better for you than sugar?

Steven Farber has answered Extremely Unlikely

An expert from Carnegie Science in Physiology, Cell Biology

The consumption of nonnutritive sweeteners may promote and/or worsen metabolic diseases, obesity, type 2 diabetes, and cardiovascular disease. A systematic review of the body of literature on the topic found that evidence from randomized clinical trials, “does not clearly support the intended benefits of nonnutritive sweeteners for weight management, and observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI and cardiometabolic risk”. CMAJ 2017 Jul 17;189(28):E929-E939. doi: 10.1503/cmaj.161390. Nonnutritive sweeteners and cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials and prospective cohort studies.

 

Are artificial sweeteners better for you than sugar?

Tim Frayling has answered Likely

An expert from University of Exeter in Genetics, Diabetes

I am not an expert in artificial sweeteners but i think it is the wrong question – there is nothing wrong with either. A better Q. is “do Artificial sweetners help reduce your calorie intake ?”

There is some evidence in RCTs in kids that they do : BMI gain is reduced if kids replace sugary drinks with calorie free drinks: https://www.nejm.org/doi/full/10.1056/NEJMoa1203034

 

Are artificial sweeteners better for you than sugar?

Bob Boakes has answered Likely

An expert from University of Sydney in Neuroscience, Nutrition

High intakes of sugar, e.g. as a result of drinking many bottles or cans of a sugary drink every day, have been shown to be unhealthy in that they can produce what is called the metabolic syndrome; this includes fatty deposits in the liver and elsewhere in the body, plus an increased risk of Type 2 diabetes. 

The only artificial sweetener that has been shown to be unhealthy for a very small proportion of the population is aspartame. People with a very special condition that makes it better to avoid aspartame are generally very aware of this.

 

Are artificial sweeteners better for you than sugar?

Kieron Rooney has answered Near Certain

An expert from University of Sydney in Biochemistry, Nutrition, Exercise Physiology

If we focus solely on a metabolic response related to sugar metabolism, weight maintenance and diabetes risk when sugar is substituted out of the diet and sweeteners replace them, then the evidence for artificial sweeteners being better for you than sugar is clear with most RCTs showing at least a reduction in body weight. However the epidemiological / observational studies don’t always support this conclusion.

Interestingly there is data – in humans – that the co-consumption of artificial sweeteners with other foods may have an interaction effect such that the absorption of energy is altered and that may be a factor in the discrepancy between the outcomes in addition to the poor dietary analyses and tracking of lifestyle factors that is common in epidemiological and observational studies.

The interaction between multiple lifestyle factors and clinical outcomes becomes a major issue for the story on artificial sweeteners and other conditions such as cancer where much of the animal data is prone to selection bias in models as well as non-physiologically high doses.

At the end of the day my feel is from an energy balance perspective, artificial sweeteners are certainly better for you than sugar – so long as one does not use them as a license to overcompensate and eat more of something else. In regard to most other health issues I feel it is a dose / exposure issue so having some in the context of an otherwise healthy diet is fine.