Artificial Sweeteners: The Science

What are artificial sweeteners?

Artificial sweeteners or Low-calorie sweeteners (LCS) are synthetic sugar substitutes up to 8000 times sweeter than sugar but with less food energy. They are metabolized more slowly than sugar which allows for stabilization of sugar levels.

The FDA has approved 6 artificial sweeteners

• saccharin (Sweet ‘N Low)
• acesulfame (Sunett)
• aspartame (Equal)
• neotame
• tagatose and sucralose (Splenda)
• a natural low-calorie sweetener (Stevia)

History

The Facts:

Obesity: Research has associated LCS with weight gain through compensation, by promoting hypoglycemia and hunger leading to increase food intake afterwards. Although short-term weight loss has been shown with the use of sweeteners, data long-term is controversial.

Cancer: Extensive research has shown no correlation between artificial sweeteners and cancer.

Birth Defects: No research has found evidence of increased birth defects with the use of artificial sweeteners.

Neurological problems: No data supporting risk for neurological effects like Parkinson’s, hyperactivity, Alzheimer’s or seizures

Diabetes: Insulin levels tend to be lower post artificial sweeteners when compared with normal sugar. However, other hormones associated with glucose control showed no difference. The benefit in diabetes from LCS is mostly from carbohydrate substitution and not from glycemic control.

A word on Stevia…

Although considered a natural alternative, Stevia is not free of adverse effects. It has been associated with decreased sperm production and infertility in animal models. Research in humans is ongoing.

What’s next?

• Research on the long-term effects of artificial sweeteners use is ongoing.
  • Rare or delayed effects of the newer LCS’s may not been identified yet.
• In children, the use of these types of additives should only be considered when other strategies have been tried
• For weight and glycemic control benefits, the use of artificial sweeteners must be combined with lifestyle modifications including healthy diet and increased in exercise.

Final Thoughts…

• Eat less sugar. It’s a no-brainer.
• There’s no question that artificial sweeteners contain fewer calories than sugar.
• Artificial sweeteners may have a stimulating effect on appetite and, therefore, may play a role in weight gain and obesity.
• Cut back on foods with added sugar and you can reduce cravings for sugar in the first place.

Acknowledgement:

Dr. Karina Nicole Ruiz-Esteves (Medical Student at Weill Cornell Medicine)