By Deliana Infante Reviewed by Lily Ramsey, LLM

The sweet debate
Exploring artificial options
Nature's sweetness
Sweetener safety and health
Beyond taste and health
Sweet decisions
References 
Further reading

Artificial and natural sweeteners are popular sugar substitutes. While artificial sweeteners promise zero calories, their health effects are controversial.

Natural sweeteners, such as honey and stevia, offer a healthier alternative but still require moderation. Ultimately, making informed dietary choices about sugar substitutes is critical to overall health and wellness.

Image Credit: Pheelings media/Shutterstock.com The sweet debate

Artificial sweeteners are chemically synthesized sugar substitutes designed to provide the sweetness of sugar without the calories and potential blood sugar spikes.1 Common examples include aspartame, sucralose, and saccharin, which are often found in "diet" or "zero-calorie" beverages and low-sugar processed foods.1

Natural alternatives, on the other hand, are sweeteners derived from natural sources, such as plants or fruits. They include stevia, honey, agave nectar, and more.1,2 Although these sweeteners contain calories, they often have a lower glycemic index than regular sugar, meaning they're less likely to spike blood sugar levels.1,2

The prevalence of these molecules in the modern diet is hard to ignore. Fueled by a global push toward healthier eating and weight management, their use has skyrocketed; the U.S. Food and Drug Administration (FDA) alone has approved six artificial sweeteners and designated several natural alternatives as "generally recognized as safe" (GRAS).3

In addition to providing a lower-calorie alternative to sugar, these sweeteners allow people with diabetes to enjoy sweet-tasting foods without disturbing their blood sugar levels.3 However, the health implications are still a topic of much debate, underscoring the need to make informed dietary choices. Exploring artificial options

Six artificial sugar substitutes have been approved by the FDA:

Saccharin (Sweet and Low, Sweet Twin, Sweet'N Low, and Necta Sweet), aspartame (Nutrasweet, Equal, and Sugar Twin), acesulfame potassium (Sunett and Sweet One), sucralose (Splenda), neotame (Newtame), and advantame (Advantame).3

They typically have a more complex chemical structure than regular sugar, as they are synthetically-made compounds that contain nitrogen, chlorine, and sulfur elements. The most common are aspartame and sucralose.1

Aspartame is known for its intense sweetness and low-calorie profile. It is made up of aspartic acid and phenylalanine.4 When metabolized, it breaks down into these amino acids and a small amount of methanol. Although it is up to 200 times sweeter than sugar, it provides zero calories.4

Sucralose is another high-intensity artificial sweetener that is about 600 times sweeter than sugar.1,4 It is chemically produced by sucrose chlorination. Sucralose remains stable under heat and over a wide range of pH conditions. That's why it's ideal for use in cooking or processed foods.1,4 These sweeteners underwent a rigorous approval process before they came to market.5

The FDA5 and the European Food Safety Authority (EFSA)6 take strict measures to ensure the safety of artificial sweeteners entering the market.5,6 The approval process begins when a manufacturer submits a detailed application for food ingredient approval, including scientific research and evidence to support the product's safety. 5,6

The agencies then review the evidence and compare the cumulative dietary exposure estimate with toxicological information on the sweeteners. 5,6 If the substance meets the standards, it is approved.  However, its safety continues to be monitored. 5,6

It's also important to remember that each sweetener has an Acceptable Daily Intake (ADI), an estimate of the amount of a substance a person can consume daily over a lifetime without health risks.4-6 Often, these limits far exceed the amounts people consume. 4-6 Difference Between Artificial Sweeteners And Real Sugar Play Nature's sweetness

In addition to their enhanced sweetness, natural sweeteners have a unique and rich nutritional profile.  Stevia, for example, is a zero-calorie sweetener derived from the leaves of Stevia rebaudiana, but its high-intensity sweetness doesn't affect blood sugar levels.4 Another example is Siraitia grosvenorii Swingle fruit extract, commonly known as monk fruit/luo han guo.4

Then there's thaumatin, a natural sweetener derived from the fruit of the West African katemfe fruit.4 It's estimated to be 2000 times sweeter than sugar but has a different flavor profile that includes lingering sweetness and delayed onset.4

In the case of honey and maple syrup, these two natural sweeteners are composed primarily of fructose and glucose and have a moderate effect on blood sugar levels, but have interesting antioxidant and antibacterial properties.7,8 Sweetener safety and health

Scientific evidence shows that the health effects of artificial sweeteners vary. Aspartame, for example, is metabolized to methanol, which at high levels can lead to toxic health effects and has been linked to the development of cancer.4,9 On the other hand, sucralose (Splenda) has been associated with gut permeability and changes in the microbiota, negative modulation of T-cell responses, inflammation, oxidative stress, and genotoxicity.9-11

The WHO's risk assessment of aspartame concluded that there was limited evidence to change the ADI previously established.12 In the case of sucralose and the rest of the sweeteners (natural and synthetic), the WHO recommended against their consumption for weight loss unless the individual suffers from pre-existing diabetes.13 Beyond taste and health

It is important to note that dietary choices about sweeteners can have an impact beyond health. The production of artificial sweeteners often involves complex, energy-intensive industrial processes that contribute to a larger carbon footprint.

They have also recently raised public concern for their potential negative impact on aquatic life, as they are resistant to wastewater treatment and remain as a new source of pollution in water bodies.14

On the other hand, natural sweeteners, such as honey, may have their own environmental and ethical implications, particularly concerning the welfare of bees. However, this calls for attention to the growing trend of sustainable and ethically sourced sweeteners.15 Locally produced honey, organic stevia, and maple syrup, for example, have less environmental impact and often support community economies and fair trade practices.15 Sweet decisions

When choosing between artificial sweeteners and natural alternatives, health goals and dietary needs must be considered. Artificial sweeteners are low in calories and may aid in weight management for individuals with certain health conditions or diseases such as diabetes, while natural sweeteners such as honey or maple syrup have different nutritional profiles and biological activities.

For diabetes management, artificial sweeteners may be preferred due to their minimal impact on blood glucose, while natural sweeteners should be used with caution. Moderation is key, as excessive consumption of either type can interfere with weight management and glycemic control. References Chattopadhyay S, et al.(2011). Artificial Sweeteners – a review. Journal of Food Science and Technology, 51(4), 611–621. https://doi.org/10.1007/s13197-011-0571-1 Commissioner, O. of the. (n.d.). How sweet it is: All about sweeteners. U.S. Food and Drug Administration. [Online]  https://www.fda.gov/consumers/consumer-updates/how-sweet-it-all-about-sweeteners Center for Food Safety and Applied Nutrition. (n.d.-b). High-intensity sweeteners. U.S. Food and Drug Administration. [Online]  https://www.fda.gov/food/food-additives-petitions/high-intensity-sweeteners Center for Food Safety and Applied Nutrition. (n.d.-a). Aspartame and other sweeteners in food. U.S. Food and Drug Administration.  [Online] https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food Center for Food Safety and Applied Nutrition. (n.d.-c). Understanding how FDA regulates food additives and Gras ingredients. U.S. Food and Drug Administration. [Online]  https://www.fda.gov/food/food-additives-and-gras-ingredients-information-consumers/understanding-how-fda-regulates-food-additives-and-gras-ingredients Food Additives. European Food Safety Authority. (n.d.). [Online]  https://www.efsa.europa.eu/en/topics/topic/food-additives Samarghandian S, et al. (2017). Honey and Health: A Review of Recent Clinical Research. Pharmacognosy Res. 9(2):121-127. doi: 10.4103/0974-8490.204647. PMID: 28539734; PMCID: PMC5424551. Mohammed F, et al.(2023). Nutritional, pharmacological, and sensory properties of Maple Syrup: A comprehensive review. Heliyon, 9(9). https://doi.org/10.1016/j.heliyon.2023.e19216 Artificial Sweeteners and cancer. National Cancer Institute. (n.d.). [Online]  https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet#:~:text=Six%20artificial%20sweeteners%20are%20approved,sucralose%2C%20neotame%2C%20and%20advantame. Schiffman S.S, et al. (2023). Toxicological and pharmacokinetic properties of sucralose-6-acetate and its parent sucralose: in vitro screening assays. Journal of Toxicology and Environmental Health, Part B, 26(6), 307–341. https://doi.org/10.1080/10937404.2023.2213903 Zani F, et al. (2023). The dietary sweetener sucralose is a negative modulator of T cell-mediated responses. Nature, 615(7953), 705–711. https://doi.org/10.1038/s41586-023-05801-6 World Health Organization. (n.d.-a). Aspartame hazard and risk assessment results released. World Health Organization. [Online] https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released World Health Organization. (n.d.-b). Who advises not to use non-sugar sweeteners for weight control in newly released guideline. World Health Organization. [Online]  https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline Naik A.Q, et al. (2021). Environmental impact of the presence, distribution, and use of artificial sweeteners as emerging sources of pollution. Journal of Environmental and Public Health, 2021, 1–11. https://doi.org/10.1155/2021/6624569 Choudhury, N. R. (2023, August 17). Are naturally derived sweeteners more sustainable?. Food Beverage Insider. [Online]  https://www.foodbeverageinsider.com/sweeteners/naturally-derived-sweeteners-sustainability-and-eco-friendliness Further reading What are the Effects of Artificial Sweeteners on Gut Health? Sucralose: Safety and Evidence Are Sweeteners Healthy?

Last Updated: Feb 16, 2024