Artificial Sweeteners – Good or Evil?

Just how bad are artificial sweeteners?

According to the media, they are linked to higher risk for health issues like weight gain, obesity, diabetes and heart disease, cause cancer and is horrible for your gut.

Are artificial sweeteners bad for your gut?

No. The recent news article making the rounds is based on this study.

This study used E Coli bacteria, which is not representative of your gut microbiome, and was carried out in a petri-dish. The study found NO EFFECT for most of the artificial sweeteners. In fact, it found that sucralose may actually be protective. Based ont the results, only Aspartame and Saccharine MAY be growth inducing at doses above 4mg/ml, which is far removed from real life conditions. For reference, most soft drinks only have 0.1-0.15mg/ml of artificial sweeteners.

As of now, I am unaware of any strong evidence indicating otherwise.

Do artificial sweeteners cause weight gain?

No. According to a 2016 systematic review of human randomized controlled trials, artificial sweetener did not increase energy intake or body weight. In fact, it was observed that replacing sugar with artificial sweeteners might actually lead to reduced energy intake and body weight!

Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies.

Findings from observational studies showed no association between LCS intake and body weight or fat mass and a small positive association with BMI; however, data from RCTs, which provide the highest quality of evidence for examining the potentially causal effects of LCS intake, indicate that substituting LCS options for their regular-calorie versions results in a modest weight loss and may be a useful dietary tool to improve compliance with weight loss or weight maintenance plans.

Do artificial sweeteners cause cancer?

There is no conclusive evidence that indicates so. The fear mongering articles are mainly based on rat studies, and the results have shown to either be only applicable to rats or using unrealistic doses.

For example, this rat study concluded that splenda (sucralose) was not only not biologically inert but also carcinogenic . However,  the amounts used in mice were equivalent of 70 to 2,000 cans of diet soda, or 400 to 12,000 packets of Splenda, a day.

On the whole, there is not enough evidence to conclude that artificial sweeteners cause cancer.

Artificial sweeteners and cancer risk in a network of case-control studies.

The present work indicates a lack of association between saccharin, aspartame and other sweeteners and the risk of several common neoplasms.

Systematic review of the relationship between artificial sweetener consumption and cancer in humans: analysis of 599,741 participants.
Although there is limited evidence to suggest that heavy consumption may increase the risk of certain cancers, overall the data presented are inconclusive as to any relationship between artificial sweeteners and cancer.

Do we consume too much artificial sweeteners?

No. Global intake is well below acceptable daily intake (ADI) except for the exceedence of the ADI observed in diabetic children that was based on a small sample population (n = 9).

Do artificial sweeteners raise blood sugar?

No. A recent 2018 review of 29 randomised controlled trials found that Nonnutritive sweeteners (NNSs) did not elevate blood sugar levels. The review was focused on Stevia, Sucralose, Aspartame and Saccharin. Below is a description of the various trials’ participants.

Regarding NNS consumption, 280 participants consumed aspartame, 214 consumed saccharin, 105 consumed stevia, and 142 consumed sucralose. Regarding health status, 526 participants reported no chronic condition, 69 reported type 2 diabetes, and 146 did not report their disease status. Age across all studies ranged from 9 to 69 years old, with an average of 38 years old

Further reading:

Sugar Substitutes: Not All Are Equal

A general overview of the popular sweeteners in the market.