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Artificial Sweeteners: Pros and Cons

Artificial sweeteners do not always get a clean bill of health.

Key points

  • Artificial sweeteners have been with us for a long time and have become accepted by many as a valid way to cut calories.
  • Current research tells us that artificial sweeteners are not inert in our bodies and have definite effects on it.
  • The regular consumption of artificial sweeteners may actually lead to weight gain and metabolic issues.
Sherry Epley/iStock
Source: Sherry Epley/iStock

Many of us take advantage of artificial sweeteners in order to cut calories. It seems that we mostly like to consume them in sodas, which fill us up because of the fizziness and give us a bit of sweetness at the same time. In this way, we can also seemingly take care of a craving for sugar. We think this hit of “sweet” is going to satisfy but without the downsides of sugar.

Artificial sweeteners are touted as being inert. Meaning they do not get picked up in our bodies but, instead, pass on through, leaving us guilt-free.

A Brief History of Artificial Sweeteners

Back in the ’60s, the FDA began checking out studies done on artificial sweeteners, most notably saccharin. That’s because, initially, it was found that feeding lab rats a boatload of the stuff caused them to get cancer. After being banned for a while, saccharin was eventually deemed safe in 2000.

Meanwhile, some other artificial sweeteners had been approved by the FDA. They are aspartame (1981), acesulfame (1988), sucralose (1998), and then neotame (2014). By their common commercial names, that would be Equal, NutraSweet, Splenda, and Sweet’N Low, respectively.

Since the first approval, the use of artificial sweeteners has become almost ubiquitous—notably in cereals, puddings, yogurt, cheesecake, gum, children’s vitamins, juices, and, of course, diet sodas.

In spite of FDA approval, however, there has always been quite a bit of controversy and pushback surrounding artificial sweeteners. Much of the research supporting their safety has been questioned, and the means by which they became approved is still under scrutiny.

In spite of the initial skepticism, it seems that artificial sweeteners have become accepted, and many people consider them a great alternative to sugar.

How About Now?

Since the early 2000s, there has been a great deal of research indicating that sugar substitutes deserve greater scrutiny. There will undoubtedly be more studies done in the future, but what has come out so far is definitely worth a look.

In 2014, a large study from the University of Iowa followed about 60,000 women participating in the Women’s Health Initiative Observational Study for 8.7 years on average. Some of these women drank artificially sweetened sodas, and some did not. They found that the ones who drank two or more diet drinks a day had a 30 percent higher risk of cardiovascular disease and were 50 percent more likely to die from the disease. This is a significant finding. However, these women were also more likely to be younger, to be smokers, and had a higher prevalence of diabetes, high blood pressure, and higher body mass index.

Does this mean that we have to throw out the findings? Not exactly, but it does raise a lot of questions. Other research has connected obesity with more frequent consumption of artificially sweetened sodas. Obesity is connected to high blood pressure, diabetes, and cardiovascular disease.

But since many of the women in the study were smokers, you cannot infer that frequent consumption of artificially sweetened soda can lead to cardiovascular disease. Perhaps future research will show that people who are more focused on the sensory experience of eating and smoking also seek to try to control a sweet craving with artificial soda.

A Closer Look: Brains and Guts

Having said all that, let’s take a look at some other findings.

Several studies have shown that consuming artificial sweeteners actually leads to weight gain. How? One study published in 2013 called the reason “metabolic dysregulation.” In other words, artificial sweeteners interfere with the learned responses we have around actual sugar consumption and the use of the energy we get from it (in the form of glucose).

The gist of that process is this: The brain feels cheated. It is expecting some glucose but doesn’t get it. To make up for that, the brain signals the body to consume more calories. Hence the weight gain.

To expand on this, some researchers have done brain scans to find out what goes on in the brain when artificial sweeteners are consumed. It turns out that regular consumption of artificial sweeteners can alter the reward pathways responsible for the pleasurable response to food. The tongue registers sweet, but the body does not process any.

Several studies have shown an increase in real sugar consumption after consuming artificially sweetened sodas. This has been shown to happen in people who are already overweight and people who started out at normal weight.

Going forward, an area to watch is artificial sweeteners’ effect on our guts. Apparently, the population of our gut bacteria (the microbiome) can be part of the “metabolic dysregulation” referred to above. The thought now is that artificial sweeteners can lead to impairment of the insulin response in the gut, which can lead to an increased appetite.

Bottom Line

So far, regular consumption of artificial sweeteners has been linked to obesity, weight gain, and diabetes. It is worth noting that more people are becoming either overweight or obese (including children) in spite of wider consumption of artificial sweeteners.

The good news is that the harmful effects are only seen among people who regularly consume artificial sweeteners. The occasional diet soda is not going to hurt.

Meanwhile, if you are a no-cal soda drinker, try to wean yourself off of them. Turn to flavored seltzers or something with a small amount of real sugar in it. Also, be on the lookout for artificial sweeteners in other products, and avoid them as best you can. Your gut, brain, and body will thank you.

References

fda.gov/food additives/food-additives-petitions

Shearer, J. & Swithers, S.E. (2016). Artificial sweeteners and metabolic dysregulation: Lessons learned from agriculture and the laboratory. Rev Endocr Metab Disord. 17(2):179-86.

Kuk, J.L. & Brown, R.E. (2016). Aspertame intake is associated with greater glucose intolerance in individuals with obesity. Appl. Physiol. Nutr. Metab. 41:795-798.

Suez, J., Korem, T., Zilberman-Schapira, G., Segal, E., Elinav, E. (2015). Non-caloric artificial sweeteners and the microbiome: findings and challenges. Gut Microbes. 6:2, 149-155.

Uiowa.edu/2014/03. UI study finds diet drinks associated with heart trouble for older women.

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