Artificial Sweeteners: Are They Bad for You?

Written by Mariia Roza

Written by Mariia Roza

Mariia Roza is a weight loss and fitness writer at Unimeal. She is an expert in nutrition, wellness, longevity, and sports.

on June 10, 2021

Medically reviewed by Dr. Olena Avdiievska, MD, RDN

Medically reviewed by Dr. Olena Avdiievska, MD, RDN

Dr. Olena Avdiievska is a nutritional and medical expert at Unimeal. She is an MD and RDN in Dietology and nutrition and a university professor with 76 scientific publications. 

Unimeal provides articles with trustworthy and experts-proved information. Our health content is reviewed by professional nutritionists and trainers to extract for users the most verified and medically checked data.

Do sweeteners cause metabolic syndrome? Can they stimulate hunger? Are they safe for our gut microbiome and health overall? And are there any other advantages of artificial sweeteners apart from their low-calorie density? Let’s try to find out.

The main problem with the artificial sweeteners vs. sugar controversy is that we know perfectly well how detrimental¹Rippe J. M., Angelopoulos T. J. (2016, November). Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. Nutrients. DOI:10.3390/nu8110697 sugar can be for our health. It causes insulin intolerance, tooth decay, cardiovascular diseases, and obesity. Still, there is not enough scientific data on the effect of artificial sweeteners on our health. 

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High-intensity sweeteners, approved by FDA

In the U.S., there are only eight artificial sweeteners permitted²Food Additives & Petitions. (2018, February 8). Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States. U.S. Food and Drug Administration. Retrieved from https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states by the government. They are frequently used in food and even mouth personal hygiene products and can be found all around the world. These are:

• Acesulfame K
• Advantame 
• Aspartame
• Monk fruit extract
• Neotame
• Saccharin 
• Sucralose 
• Stevia

Some artificial sweeteners are not considered high-intensity and are also approved by FDA. These are sorbitol, xylitol, lactitol, mannitol, erythritol, and maltitol. They are sugar alcohols that still contain calories and thus are not as efficient in creating a calorie deficit as the sweeteners listed above.

What is the acceptable daily intake of various sweeteners?

Even though the government approves some sweeteners, there are still limitations on their use. Thus, FDA has established the acceptable daily intake (ADI) of the sweeteners. If you keep up with the recommendations and don’t exceed the acceptable volumes, you won’t see any side effects of consuming sweeteners.

• Acesulfame potassium: You can have up to 15 milligrams per one kilogram of your body weight. If you weigh 60 kilograms, this would be 60 tablespoons of acesulfame K per day.
• Advantame: You can have up to 32.8 milligrams of this sweetener per one kilogram of your body weight.
• Aspartame: Up to 50 milligrams per kilogram of body weight is allowed. This approximately equals 75 tabletop packets of aspartame if you weigh about 60 kilos.
• Monk fruit extract: FDA doesn’t specify the acceptable daily intake for this sweetener as, for the moment, its side effects are unknown. Our recommendation would be to consume everything, including the monk extract, in moderation. 
• Neotame: The most popular brand name of this sweetener is NewTame. You can have only 0.3 milligrams of Neotame per kilogram of your weight per day which equals 23 tabletop packets if you weigh 60 kilos.
• Saccharin: You can eat up to 15 milligrams per kilogram of body weight a day.
• Sucralose: 5 milligrams per kilogram of body weight is the acceptable daily intake for sucralose.
• Stevia: You can have up to 4 milligrams of stevia extract per one kilogram of body weight.

Possible effects on the body of overeating artificial sweeteners

Overdose of anything, including water or salt, can lead to serious health problems. The same is with sweeteners. The most frequent symptoms of their overconsumption are nausea, diarrhea, bloating, migraines, headaches, and dizziness.

Cases of personal intolerance and high sensitivity to some components of various sweeteners are also possible. The allergic symptoms can include swelling and hives³Tandel K. R. (2011, October-December). Sugar Substitutes: Health Controversy Over Perceived Benefits. Journal of Pharmacology and Pharmacotherapeutics. DOI:10.4103/0976-500X.85936.

Are artificial sweeteners bad for you? Myths and controversies

Nutritionists still debate whether artificial sweeteners can cause health risks. Even though large meta-analyses⁷Ingrid Toews. (2019, January 2). Association Between Intake of Non-Sugar Sweeteners and Health Outcomes: Systematic Review and Meta-Analyses of Randomized and Non-Randomized Controlled Trials and Observational Studies. BMJ. DOI:10.1136/bmj.k4718 of studies and surveys show no link between particular health issues and risks with the sweeteners consumption, scientists emphasize that this topic is not yet well-researched and more surveys should be conducted before we can make a conclusion. 

Disclaimer: More professional surveys should be conducted to prove or debunk some beliefs about artificial sweeteners. Information given in this paragraph is primarily rumors, speculations, and disingenuous research.

Do artificial sweeteners cause cancer?

The myth, linking artificial sweeteners to cancer has arisen after the 1970s study⁴Price J. M., Biava C. G., Oser B. L., et al. (1970, February). Bladder Tumors in Rats Fed Cyclohexylamine or High Doses of a Mixture of Cyclamate and Saccharin. Science. DOI:10.1126/science.167.3921.1131 on mice. The mice were fed high dosages of cyclamate and saccharine for up to two years. The subjects have discovered bladder tumors. After this study, cyclamate was banned from the U.S. market. 

When scientists have provided this data to the public, they haven’t emphasized one crucial detail. That mice are not humans. Today we know that mice and humans metabolize saccharine and other sweeteners differently. Moreover, multiple studies⁵Gallus S., Scotti L., Negri E., et al. (2007, January). Artificial Sweeteners and Cancer Risk in a Network of Case-Control Studies. Annals of Oncology. DOI:10.1093/annonc/mdl346, including the analysis⁶Mishra A., Ahmed K., Froghi S., et al. (2015, December). Systematic Review of the Relationship Between Artificial Sweetener Consumption and Cancer in Humans: Analysis of 599,741 Participants. International Journal of Clinical Practice. DOI:10.1111/ijcp.12703 of almost 600,000 people, have demonstrated no correlation between artificial sweeteners consumption and cancer. 

Cyclamate is still banned in the USA despite studies showing this sweetener’s safety. And all the charges against the FDA-approved sweeteners in increasing cancer risks have been dismissed. In simple words, no, artificial sweeteners do not cause cancer!

Artificial sweeteners and weight gain

Some dietitians⁸Yang Q. (2010, June). Gain Weight by “Going Diet?” Artificial Sweeteners and the Neurobiology of Sugar Cravings. Yale Journal of Biology and Medicine. PMID:20589192 assume that non-nutritive sweeteners can cause hunger urges and sugar cravings. They explain this phenomenon by the fact that when you consume something sweet, your brain is ready to obtain energy, and when it doesn’t, it urges you to eat calorie-dense foods.

The University of Sydney research⁹The University of Sydney. (2016, July 12). Why Artificial Sweeteners Can Increase Appetite. ScienceDaily. Retrieved from https://www.sciencedaily.com/releases/2016/07/160712130107.htm of 2016 has suggested that consuming sweeteners can make you eat more because it stimulates hunger. This is due to the link between the reward centers and energy content centers in our brains.

What makes these speculations even worse is that some peer-reviewed scientific journals like Physiology and Behavior publish papers like “Oral stimulation with aspartame increases hunger.” And when we look inside the article, we see that the research was conducted on a group of ten males and ten females, and the supposed hunger increase equals 0.3% to 0.5%, which depends on multiple factors, including the sex of the subject. But the name of the article must have made you alert, right?

With this being said, it’s worth mentioning that more reliable randomized controlled trials conducted by CHOICE¹⁰Tate D. F., Turner-McGrieve G., Lyons E., et al. (2012, March). Replacing Caloric Beverages with Water or Diet Beverages for Weight Loss in Adults: Main Results of the Choose Healthy Options Consciously Everyday (CHOICE) Randomized Clinical Trial. The American Journal of Clinical Nutrition. DOI:10.3945/ajcn.111.026278 on a large group of obese or overweight people have demonstrated that the sole replacement of caloric beverages with water or drinks with non-caloric sweeteners results in a weight loss of 2% to 2.5% of body mass. 

It looks like we have speculations vs. scientific observations. Choose your side wisely!

Artificial sweeteners and gut health

Some researchers¹¹Suez J., Korem T., Zilberman-Schapira G., et al. (2015). Non-Caloric Artificial Sweeteners and the Microbiome: Findings and Challenges. Gut Microbes. DOI:10.1080/19490976.2015.1017700 state that artificial sweeteners can alter the gut microbiome. In particular, sucralose, aspartame, and saccharin were blamed for changing the diversity and the balance of gut microbiota. This disruption can be the reason behind glucose intolerance¹²Nettleton J. A., Reimer R. A., Shearer J. (2016, October 1). Reshaping the Gut Microbiota: Impact of Low-Calorie Sweeteners and the Link to Insulin Resistance? Physiology and Behavior. DOI:10.1016/j.physbeh.2016.04.029 and metabolic diseases, including type two diabetes.

Artificial sweeteners and diabetes

All research conducted on the ability of artificial sweeteners to cause type 2 diabetes has shown no connection between the two. What makes the myth about artificial sweeteners and diabetes link spread worldwide are observational surveys¹³Nettleton J. A., Lutsey P. L., Wang Y., et al. (2009, April). Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA). Diabetes Care. DOI:10.2337/dc08-1799 indicating that the risk of type 2 diabetes is higher among those who drink soft drinks with sweeteners. Fortunately, most of such research states that correlation doesn’t mean causation. Chances are, people with excess body weight and those prone to diabetes are trying to minimize their body mass or diabetes risks by switching their sugary drinks with beverages with artificial sweeteners.

What are the benefits of artificial sweeteners?

The primary benefit of sweeteners is that they’re not sugar! Non-nutritive sweeteners are much sweeter than sugar and contain almost zero calories. This can surely help with weight loss¹⁴Gardner C., Wylie-Rosett J., Gidding S. S., et al. (2012, July 14). Nonnutritive Sweeteners: Current Use and Health Perspectives. A Scientific Statement from the American Heart Association and the American Diabetes Association. Diabetes Care. DOI:10.2337/dc12-9002 and maintenance. Also, artificial sweeteners don’t cause tooth decay and don’t make your insulin spike.

Summing up

Artificial sweeteners are everywhere: in manufactured sauces, canned products, chewing gum, desserts, “diet” products, meats, and even toothpaste. They’re FDA-approved and are a source of sweetness for those who can’t eat sugar because of health issues.

Scientists are still debating about sweeteners’ safety, though. One of the possible explanations for a large number of myths and speculations concerning artificial sweeteners is that they’ve been massively produced and consumed for less than a century, and researchers still don’t have enough data from long-lasting research on large groups proving that sweeteners are safe in a long-term perspective. 

The main argument of researchers who’re against sweeteners is that if we don’t see health hazards yet, it doesn’t mean they don’t exist. 

What makes the situation even more complicated is that the sugar industry is a multi-billion business, and food manufacturers are affected by research conducted by scientists. Their interest might interfere with scientific objectivity and lead to a conflict of interests¹⁵Mozaffarian D. (2017, May). Conflict of Interest and the Role of the Food Industry in Nutrition Research. JAMA. DOI:10.1001/jama.2017.3456.

At the moment, there is no solid scientific evidence against sweeteners approved by FDA. On the other hand, there are numbers and facts which show that consuming non-caloric sweeteners instead of sugar can decrease your daily calorie intake and lead to weight loss. 

So, what should you do? Our advice is to minimize the sugar content in your diet and keep your artificial sweeteners consumption in moderation.