Want something sweet without the calories? Wondering about the alternatives to sugar? Sugar substitutes, AKA non-nutritive sweeteners because they contain no nutrients, are natural or artificially made substances that are meant to replace sugar, providing no calories, carbohydrates, or any other nutrients. These sugar substitutes may seem like a miraculous invention, as they sweeten food without adding calories or altering blood sugar. I mean who doesn’t want to enjoy something sweet, guilt free?
But, are there consequences to this miracle? Let’s review the most common sugar substitutes on the market and weigh the pros and cons of each.
Saccharin was the first to be accidentally discovered and is the original non-nutritive sweetener. This means it is the most extensively studied with over 2000 studies under its belt. It was originally classified as an “anticipated human carcinogen” by the FDA, however it was delisted due to lack of evidence.
Saccharin is a man-made chemical that is 300x sweeter than sugar. This provides a potent sweetening flavor to anything it encounters, however many aren’t fond of the bitter flavor that accompanies it. Common brand names are Sweet N’ Low (the pink pack) and Necta Sweet.
Saccharin is not metabolized in the body and is excreted via the urine. It is known to cause reactions in people who have sulfa drug allergies.
Aspartame is the most widely used sugar substitute commonly added to diet sodas, gums, and diet or “sugar free” foods. Aspartame is 180x sweeter than sugar and the most common brand names are Equal (the blue pack) and Nutrasweet.
To get sciency about it, aspartame is made up of three main components: phenylalanine, methanol, and aspartic acid. Once it gets in the body, methanol can be either excreted through the urine or broken down to formaldehyde, a highly toxic substance.
Aspartame is a possible neurotoxin and has been found to increase oxidative stress in the brain. It can disrupt certain neurotransmitters in the brain leading to behavioral disorders, anxiety, headaches, seizures, and insomnia in sensitivity people.
Despite it’s known potential toxicity, it remains on the FDA’s “Generally Recognized as Safe” list. While some people are highly sensitive to it, aspartame is detrimental to body’s physiology and really should be avoided by everyone.
Acesulfame K (Ace-K) is a newer artificial sweetener, approved in 1998, for use in soft drinks. It is 200x sweeter than sugar. Although not found individually marketed, it is most commonly found in “diet” drinks like Pepsi One or Coke Zero Sugar.
Ace-K is excreted unchanged in the urine. It may stimulate insulin secretion and increase hypoglycemia which can be problematic for those with blood sugar imbalances. It is the least researched of the artificial sweeteners, since it is newest to the market.
Sucralose or Splenda, AKA the yellow pack, is made by replacing hydrogen in sugar with chlorine atoms. The molecular change to the sugar molecule means that only about 20-30% gets metabolized by the body. Sucralose is 600x sweeter than sugar.
Splenda is marketed as being safe for people who have diabetes. Research conducted by the company who makes it suggests that it has no significant impact on blood glucose or A1C. However, a small study of 17 subjects did find that sucralose does increase insulin secretion. This may be because the body expects sugar when it tastes something sweet and increases insulin in response.
Stevia is a natural sweetener made the leaves of a plant in the sunflower family. It is native to Paraguay and Brazil, but is now primarily grown in China and Japan. It is 250-300x sweeter than sugar. The sweetness comes from compounds called glycosides.
Stevia is heat and pH stable, making it good for baking. Stevia is found under the brand names Only Sweet, PureVia, SweetLeaf, and Truvia.
A 2018 study found that Stevia had no impact on the blood sugar, HgbA1C, or blood lipids of people with type 2 diabetes. Stevia contains an antioxidant called kaempferol that has been linked to decreased rates of certain types of cancer. A 2003 study found that stevia might also help lower blood pressure.
Sugar alcohols are made by adding hydrogen to sugar. You can easily identify them because they end in –ol, such as sorbitol, xylitol, and erythritol. They are about ½ as sweet as sugar. Sugar alcohols are not calorie-free, but are lower in calories than pure sugar and have minimal impact on blood sugar.
Like many other artificial sweeteners, they are not broken down in the body. For this reason, they can pose a problem for those that are sensitive to them. Sugar alcohols are high in FODMAPS, fermentable sugars that can lead to digestive problems, such as cramping and diarrhea. Of all of the sugar alcohols, erythritol is the one tolerated by most people.
That being said, they prevent blood sugar from rising too quickly and may be a good choice for people with diabetes or hypoglycemia.
Monk fruit, AKA lo han fruit, has been around for a long time, however has recently become popular for its potential health benefits. It comes from a Southeast Asian fruit called monk or Buddha fruit. It was approved in 2010 by the FDA as a sweetener. It is 100-250x sweetener than sugar and is thought to have antioxidant properties.
The antioxidants called mogrosides in monk fruit are what provide the sweetness. These antioxidants may have anti-inflammatory properties. Animal studies on monk fruit and diabetes suggest that it may help improve blood sugar and cholesterol. Since it is new to the market, there are no extensive human studies on all its potential health effects. However it is found in granular form and can be used as a direct replacement to sugar in baking and beverages.
My general recommendation is that you avoid sweetening your food with sugar or artificial sweeteners as much as possible. Eating sugar or even artificial sweeteners simply makes you crave more sweet foods. Retraining your brain to crave less sweets overall will help improve your weight and blood sugar.
Artificial sweeteners may have an impact on insulin secretion and modify normal metabolism. When you eat food with artificial sweeteners the body releases insulin as a response, thinking that there will be sugar arriving. But, the sugar never arrives, therefore the insulin is hanging around with nothing to do. It is theorized that this may increase the risk of insulin resistance.
Although it may seem like artificial sweeteners might help you save calories, this has not been found to be the case. Sugar substitutes have not been linked to weight loss and may actually encourage you to eat more calories overall.
A 2017 study found that using artificial sweeteners can change the makeup of the gut microbiome, decrease satiety (feelings of fullness), and increase the risk for obesity. Overall, it appears that artificial sweeteners can lead to changes in gut health, which could have further health implications long term, which continues to be studied.
But, I understand that sometimes you need something sweet. My recommendation would be to choose monk fruit, stevia, or erythritol as a sweetener. These are natural sweeteners with some additional benefits, compared to the artificially created sweeteners. Even with the possible negative health effects, these can be enjoyed in moderation when you need a little treat.