Eating too much sugar has been shown to increase your risk of type 2 diabetes, obesity and cardiovascular disease. Artificial sweeteners were developed as a ‘healthy’ sugar substitute, providing an alternative way to reduce sugar and calorie intake. But, after their own share of health scares, are they really a better option? Nutritionist Jo Williams has the inside track on what artificial sweeteners are, the different types, the advantages and any potential risks.
What are artificial sweeteners?
There are many different kinds of sugar substitutes. Artificial sweeteners like aspartame, sucralose and saccharin are chemically synthesised. They are referred to as non-nutritive because they do not contain any vitamins or minerals and are poorly absorbed by the body. These sweeteners are generally used in sugar-free or diet food products because they are sweeter than table sugar with very few calories.
The other group of sweeteners are called nutritive sweeteners. They are sugar alcohols, or polyols, which are a type of carbohydrate with a chemical structure similar to sugar. They still have fewer calories than sugar and are commonly used in sugar-free chewing gum, sweets and processed snack foods. They generally end in ‘ol’ and the more common ones are sorbitol and xylitol.
Natural sweeteners are also commonly used. Stevia, for example, is extracted from a plant and does not contain any calories.
You can find a full list of all UK-approved food additives and sweeteners on the Food Standards Agency website.
Sweeteners vs sugar
Health problems such as obesity and tooth decay are linked to the amount of sugar in the diet. It is advised that ‘free’ (added) sugar intake is limited to just 30g per day (that’s about seven teaspoons). However, the average UK adult is consuming twice this amount. Sugary drinks are one of the main sources of added sugars, with a can of cola containing around 35g of sugar. Diet equivalents contain 0g of added sugar, but 200mg of aspartame on average.
As a result, sweeteners have gained popularity as an alternative way to reduce sugar intake, while maintaining the sweet taste. Reducing sugar intake also lowers the risk of tooth decay and cavities.
Natural alternatives such as honey, agave syrup and coconut sugar are often seen as healthier options, but are still just sugar in liquid form – and are very similar to sugar when comparing calories. Don’t be fooled by the ‘natural’ label, they are still considered a ‘free sugar’ – the type we are advised to cut back on.
Read more about these sugar alternatives in our guides:
Which is the healthiest sweetener?
While many artificial sweeteners have been deemed ‘safe’ by the EFSA, that does not necessarily mean they are healthy and the research surrounding sweeteners is conflicting.
There is some observational research to show the possible positive effects of using sweeteners on health for those who are overweight or at risk of diabetes. However, more recent reports suggest that consuming artificial sweeteners could do more harm than good.
In May 2023, the World Health Organisation advised people to not consume non-sugar sweeteners, including aspartame, saccharin and stevia, for weight loss. The recommendation is based on the WHOs systematic review of the most current scientific evidence , that consumption of non-sugar sweeteners is associated with increased risk of type 2 diabetes, cardiovascular diseases and all-cause mortality, as well as weight gain. A separate review published in May 2023 reports that artificially sweetened beverages are associated with higher risk of obesity, type 2 diabetes, all-cause mortality, hypertension, and cardiovascular disease incidence.
- Aspartame, the world’s most widely used artificial sweetener, is linked to a long list of health problems including cancer, increased BMI and a higher incidence of cardiovascular disease.
- Sucralose, a chemical found in popular artificial sweeteners, may cause DNA damage according to a recent study.
- Sorbitol, xylitol and erythritol are marketed as low-carb and don’t cause sudden blood sugar spikes, making them popular with diabetics and those following a keto diet. However, there is concern with the way they are metabolised, or broken down by the body, and in particular erythritol has been linked to increased risk of heart attack and stroke.
- Saccharin is the oldest artificial sweetener. It was the first to undergo scrutiny for its safety, but is still deemed safe and is widely used in the food industry despite links to increased risk of obesity and diabetes.
- Stevia is becoming increasingly popular as a healthy alternative to sugar due to its zero calorie content and more natural origins.
The bottom line
So are sweeteners a better option than sugar? Not really, must be the answer. Compared to sugar they contain fewer calories, but come with similar health risks. Neither sugar nor artificial sweeteners contain vitamins, minerals or fibre; they just deliver the sweet taste.
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For long term health, it is advised to cut back on both sugar and artificially sweetened, processed food, in favour of a healthy, balanced diet. In time, this will readjust taste buds so that cravings for sweet foods are reduced. Most of us consume far more sugar in all forms than we should. We need less, not more.
Jo Williams is a registered nutritionist (RNutr) with the Association for Nutrition with a specialism in public health. Since graduating from the University of Westminster in 2010, Jo has worked in a variety of public and private contexts, delivering weight management programmes, community cookery projects, and corporate wellness packages. Jo works as a nutritionist and health coach for Second Nature. She has contributed articles to a number of nutrition websites, including BBC Good Food.
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