What Are Artificial Sweeteners, and Are They Bad for You? 5 Possible Risks to Consider

What are the benefits of artificial sweeteners?

Only small amounts of artificial sweeteners are needed. Also, they provide little or no usable energy. As a result, artificial sweeteners add very few (sometimes zero) calories to foods and beverages. They also don’t:

• Raise blood sugar levels

• Increase your risk of dental cavities

List of artificial sweeteners

The FDA regulates sweeteners used in foods and drinks. It has approved six artificial sweeteners for use in the U.S.:

• Saccharin 

• Aspartame

• Sucralose 

• Acesulfame potassium (Ace-K)

• Neotame 

• Advantame 

Artificial sweeteners vs. sugar alcohols and natural sweeteners

Artificial sweeteners aren’t the only substitutes for table sugar. Other types of sugar alternatives include: 

• Sugar alcohols: Sugar alcohols are carbohydrates that are used as sweeteners. Examples are sorbitol, xylitol, and erythritol. Despite their name, they don’t contain alcohol.

• Natural sweeteners: Natural sweeteners come from plants or other natural sources. Examples include honey, molasses, and stevia. Some natural sweeteners — such as honey — contain some beneficial compounds, like antioxidants. But they’re still considered added sugars and contain calories. 

Like artificial sweeteners, stevia and certain sugar alcohols contain few or no calories, and they don’t cause large spikes in blood sugar. But this article focuses on the safety of artificial sweeteners and doesn’t cover the safety of sugar alcohols. 

1. Increased appetite

Some research has suggested that artificial sweeteners may activate reward pathways in the brain that increase appetite. Some studies have linked regular aspartame consumption with increased caloric intake, hunger, and sugar cravings. However, findings have been mixed. 

2. Poor blood sugar regulation

Although artificial sweeteners don’t increase blood sugar levels directly, some research suggests that certain sweeteners may stimulate insulin release. Because they taste sweet, they may trigger some of the body’s normal responses to sugar. 

Researchers have also found a possible link between long-term use of artificial sweeteners and insulin resistance. In one recent study, healthy participants who consumed sucralose daily for a month showed reduced insulin sensitivity. This may be because sucralose changes the bacteria in the gut. Those changes can create substances that lead to inflammation, and that inflammation may interfere with how insulin works in the body. 

Some small studies suggest artificial sweeteners may contribute to reactive hypoglycemia (low blood sugar after eating) in certain people, but evidence is limited. It’s possible that they trigger insulin release, which could lower blood sugar even when little or no sugar is consumed. 

3. 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 artificial sweeteners may be linked to dysbiosis, an imbalance of good and harmful bacteria.

4. Increased risk for stroke and heart disease

A large study found that frequently consuming artificially sweetened beverages was associated with a higher risk of stroke and other cardiovascular events. But this doesn’t necessarily mean that artificial sweeteners caused these outcomes. More studies are needed to understand this relationship. 

5. Increased risk for metabolic syndrome

Research has found a possible link between artificial sweetener use and metabolic syndrome. However, it’s unclear how much artificial sweeteners contribute directly to the condition, or whether people already at higher risk are more likely to use them. 

Metabolic syndrome refers to 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 levels of “good” cholesterol, high-density lipoprotein (HDL)

• High blood pressure

• High blood sugar

Who is at higher risk from artificial sweeteners?

Some experts recommend that certain groups discuss artificial sweetener use with a healthcare professional. That’s because research on long-term effects in these populations is limited or because they may respond differently to certain sweeteners. 

These groups include: 

• People who are pregnant or lactating

• Anyone with bowel disorders or absorption problems

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

• People who experience migraines and epilepsy

• Children

How to reduce added sugar intake

Eating too much real sugar isn’t good for you either. Most people eat more sugar than they realize. If you’re looking to cut back on sugar, it can help to do the following:

• Avoid sweet drinks: Swap soda, energy drinks, sports drinks, and fruit juices for water. If you want to add flavor, try adding fruit chunks or herbs to plain water. 

• Read food labels: Paying close attention to food labels is important. Sugar is added to many foods where you wouldn’t expect to find it. Examples include pasta sauces, salad dressing, ketchup, crackers, and bread. Even foods marketed as “health foods” — like protein bars, granola bars, smoothies, or acai bowls — can be high in added sugar.

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

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