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What Are Artificial Sweeteners, and Are They Bad for Me? 6 Possible Risks to Consider

Joanna Foley, RDPatricia Pinto-Garcia, MD, MPH
Updated on November 25, 2024

Key takeaways:

  • Artificial sweeteners are a type of food additive created to provide sweetness without adding sugar or calories.

  • Research has shown that consuming artificial sugar may actually be harmful. Side effects of artificial sweeteners may include things like weight gain, poor blood sugar control, and an unhealthy gut.

  • It’s best to limit your use of artificial sweeteners when possible, just as with sugar.

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Reviewed by Alexandra Schwarz, MD | December 6, 2023

If you’ve been trying to eat less sugar, you might have tried using artificial sweeteners instead. These products lower the sugar and calorie content in foods. And they’re widely available in manufactured food products and on grocery store shelves. In fact, recent data shows that around 1 in 3 people are likely to use artificial products as their go-to sweeteners for food and drinks.

But are artificial sweeteners actually better for you than sugar? Let’s take a closer look. 

What are artificial sweeteners? 

Artificial sweeteners are food additives intended to serve as sugar substitutes. They’re made by chemically combining different molecules in a lab. Artificial sugars are created to mimic the flavor of sugar, but they’re often hundreds of times sweeter than sugar. 

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Unlike sugar, artificial sweeteners don’t provide any calories or energy to the body, since they aren’t broken down by the digestive system. 

List of artificial sweeteners

The FDA regulates and approves artificial sweeteners, which are also known as high-intensity sweeteners.

There are currently six artificial sweeteners approved by the FDA:

  1. Saccharin

  2. Aspartame

  3. Sucralose (Splenda)

  4. Acesulfame potassium (Ace-K)

  5. Neotame

  6. Advantame 

Artificial sweeteners vs. sugar alcohols and natural sweeteners

Other alternatives to sugar include sugar alcohols, such as sorbitol, xylitol, and erythritol. Natural sweeteners like stevia are another sugar alternative. Stevia is considered a natural sweetener because it’s derived from the leaves of the stevia plant, rather than being formulated in a lab.

Like artificial sweeteners, stevia and certain sugar alcohols are calorie-free and don’t cause a big blood-sugar spike. However, some sugar alcohols do provide a small number of calories and are less sweet than artificial sweeteners and regular sugar. 

We won’t be covering the safety of sugar alcohols in this article. 

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Are artificial sweeteners bad for you? 

It’s unclear. A large number of studies have been carried out on artificial sweeteners. Yet scientists are still divided in their views on their safety. 

That said, the World Health Organization (WHO) labeled aspartame a possible cancer-causing chemical. But the WHO acknowledged that research was too limited to determine whether aspartame contributes to cancer or not. Other experts clarified that the link to cancer is based on a very small body of inconclusive evidence. 

According to the FDA’s intake limits of aspartame, you’d have to consume a lot to reach a potentially unsafe level. A 60 kg (132 lbs) person would have to consume 75 packets of an aspartame sweetener per day to reach the limit that’s considered safe. That’s equal to drinking about 9, 12-oz cans of a diet soda that contains aspartame.

From what we know so far, the risk for cancer from artificial sweeteners is probably low. We need more research to better understand the science behind this classification. 

What are the possible side effects of consuming artificial sweeteners?

There’s some early data that suggests that there might be a link between artificial sweeteners and the following six health concerns.

1. Increased appetite

Some research has suggested that artificial sweeteners may activate reward pathways in the brain that increase appetite. Evidence suggests that regularly consuming aspartame is linked with increased caloric intake, hunger, and sugar cravings. 

2. Weight gain

Most people assume that since artificial sweeteners contain no calories, they’ll help with weight management. However, there’s evidence linking long-term consumption of diet soda to: 

More research is needed to better understand the connection between artificial sweeteners and weight loss. 

3. Poorly regulated blood sugar

While artificial sweeteners don’t increase blood sugar levels, there’s some evidence that they may increase insulin levels in the blood. Because of their sweet taste, the pancreas can mistake them for sugar. It’s possible that there may be a link between long-term use of artificial sweeteners and insulin resistance. But more research is needed to better understand this relationship. 

Consuming artificial sugars may also increase the frequency of reactive hypoglycemia (low blood sugar after eating). This is because these sweeteners may cause an increase of insulin, which lowers blood sugar. So, even though artificial sweeteners don’t raise blood sugar directly, they can still lead to poorly controlled blood sugar levels.

4. Altered gut microbiome

Bacteria in the gut react differently to artificial sweeteners than they do to real sugar. For example, saccharin and sucralose have been found to change the gut microbiome. And in humans they’ve been linked to dysbiosis, which is an imbalance of good and harmful bacteria.

5. Increased risk for stroke and heart disease

A large study found that frequently consuming artificially sweetened beverages in mid and late life was associated with a higher risk of stroke and other heart-related events. But more studies are needed to understand this relationship. 

6. Increased risk for metabolic syndrome

Research has linked artificial sweeteners to the development of metabolic syndrome. Metabolic syndrome is a term for a number of risk factors that raise your risk of major health problems such as heart disease, diabetes, and stroke. These risk factors include:

  • Fat around the waistline

  • High triglyceride levels

  • Low HDL (high-density lipoprotein) cholesterol, the “good” cholesterol

  • High blood pressure

  • High blood sugar

Are artificial sweeteners better or worse for you than sugar?

There’s not a clear answer to this question. Just as with many other diet and nutrition decisions, there are both pros and cons to substituting sugar with artificial sweeteners. 

Some benefits of artificial sweeteners include:

  • Free of calories

  • Don’t raise blood sugar levels

  • Don’t add to risk of cavities

  • Sweet taste

However, some research suggests that certain people may be at higher risk of side effects when consuming artificial sweeteners. And they should be extra careful to limit their intake. These people include: 

  • Pregnant and lactating women

  • People with diabetes

  • Anyone with bowel disorders or absorption problems

  • People who’ve had or are going to have weight loss surgery 

  • Those who experience migraines and epilepsy

  • Children

But eating too much real sugar isn’t good for you either. Most people eat more sugar than they realize. If you are looking to cut back on sugar, limit your intake of both refined sugar and artificial sugar as much as possible. Here are some tips:

  • Stick to water or unsweetened tea and coffee. These are healthier than any “diet” beverage.

  • Increase your fruit intake. Fruits contain natural sugar, which can help satisfy cravings for sweets. They’re also packed with vitamin C, fiber, and other nutrients.

Frequently asked questions 

What is the healthiest substitute for sugar?

When possible, it’s safer to choose natural sugars like honey, coconut sugar, or pure maple syrup — in small amounts. These tend to be sweeter than table sugar, so you’ll need less to sweeten your food. Using natural fruit in place of sugar is also a nutritious choice. For example, you can use apple sauce, bananas, or chopped figs.

Is honey better for you than sugar?

Honey is a natural sweetener and it may have some health benefits, such as soothing a sore throat and easing a cough. It may have some antimicrobial properties. And it’s a less-processed food. But honey is sweeter than sugar, and it has more calories. It causes a slightly less spike in blood sugar levels than table sugar.

Is Splenda safer than stevia?

Both are safe to consume, according to the FDA. Stevia is considered a natural sugar because it comes from a plant. It has no calories and doesn’t raise blood sugar levels. And it’s generally considered safe. Splenda, which is a brand name for sucralose, is an artificial sweetener. There’s some concern that it can disrupt the gut microbiome, which may cause intestinal symptoms. If you’re concerned about the effects of sucralose on your gut, stick with stevia.

The bottom line

Artificial sweeteners are a popular sugar substitute for people looking to reduce their calorie or sugar intake or manage their weight. However, there’s evidence that these products can increase appetite and weight, disrupt gut health, and put you at risk of metabolic disorders like diabetes. It’s best to use artificial sweeteners as sparingly as table sugar. Instead, favor sugars from fruits or other natural sources.

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Joanna Foley, RD
Written by:
Joanna Foley, RD
Joanna Foley, RD, is a registered dietitian (RD) and the owner of joannafoleynutrition.com, a private nutrition consulting business. She has previously worked as a clinical dietitian and outpatient renal dietitian.
Laurie Tarkan
Edited by:
Laurie Tarkan
Laurie Tarkan is a senior health editor for general health and well-being at GoodRx. She has an extensive background in health journalism, and wrote regularly for The New York Times for a decade.
Patricia Pinto-Garcia, MD, MPH
Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

References

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Ruiz-Ojeda, F. J., et al. (2019). Effects of sweeteners on the gut microbiota: A review of experimental studies and clinical trials. Advances in Nutrition

Science Direct. (n.d.). Dysbiosis - an overview.

Sharma, A., et al. (2016). Artificial sweeteners as a sugar substitute: Are they really safe? Indian Journal of Pharmacology

Statista. (2023). Which of the following are you more likely to use to sweeten foods and/or beverages? 

Tandel, K. R. (2011). Sugar substitutes: Health controversy over perceived benefits. Journal of Pharmacology and Pharmacotherapeutics.

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World Health Organization. (2023). Aspartame hazard and risk assessment results released.

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GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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