Are Artificial Sweeteners Bad for You?

Everything is confusing. Sugar is bad for you but so are artificial sweeteners, so what do you do? Well, first of all, let’s examine whether artificial sweeteners are actually bad for you. They’ve gotten a bad rap over the years but the research is actually pretty mixed and some concerns have been back-walked. 

Generally speaking, yes, everything in moderation. But let’s look at what the data can tell us about the actual impact of artificial sweeteners. 

What are artificial sweeteners

Are artificial sweeteners bad for you?

Why artificial sweeteners may still not be the best choice

One other argument against artificial sweeteners

Summary / TLDR

What are artificial sweeteners?

There are three main types of artificial sweeteners. A lot of the research on artificial sweeteners is referencing traditional artificial sweeteners, but there is specific research to the other kinds as well. Most of this conversation will regard traditional artificial sweeteners and be more specific about when that is not the case.

Traditional artificial sweeteners. These are what most people think of, your aspartame, Sweet ‘n’ Low, Splenda, and so on. There are brand names and compound names but the common approved ones are acesulfame potassium, aspartame, advantame, neotame, saccharin, and sucralose. These are synthetic compounds made in a lab to provide sweetness. They provide zero nutrition and are generally considered 200 to 700 times sweeter than sugar.

Sugar alcohols. These have gained in popularity over the years and include erythritol, isomalt, lactitol, maltitol, sorbitol, and xylitol. They’re still synthetically made in a lab but typically from sugar itself (don’t ask me how that works, I don’t know) and are sweeter than sugar but not as sweet as traditional artificial sweeteners. One potential issue with these is that they can cause stomach upset for some people. Additionally, sugar alcohols do impact blood sugar, but still much less than sugar.

Novel sweeteners. These are the newest kids on the block and include sweeteners like allulose, monk fruit, and stevia. They’re naturally-derived artificial sweeteners; monk fruit and stevia are plant extracts basically. They are next to no carb so are good for blood sugar management and they are much less processed than other kinds of sweeteners.

Are artificial sweeteners bad for you?

Though a lot of the research showing artificial sweeteners cause health damage in animals, the findings have not been duplicated with humans, generally. This is a particularly difficult issue to study in humans because there can be so many confounding variables. For example, those who drink diet soda may have switched to that because their doctor told them to due to heart issues they already had. Or individuals that drink soda in general, diet or regular, may be more likely to have higher BMI, move their bodies less, and so on. 

Obviously, well-done studies try to account for these other variables in both their statistical models as well as the conclusions they draw from their results. Still some find that all associations disappear when considering these other variables. It’s just a tricky thing to research. 

I tend to look at topics like this and say, “this may be related with this,” or even, “this is likely impacting this,” rather than, “artificial sugars cause cancer.” The data just can’t state that with that much confidence. 

Some will take this situation and say, “these are probably safe,” while others will reasonably say, “we don’t know enough about this or there isn’t enough quality research to claim that these are safe, especially for vulnerable populations.”

All that said, there are some well-done studies that do show potential risk associated with artificial sugar consumption even when controlling for variables. One decent study (though not without significant limitations in my opinion) that provided follow up over an extensive period of time finds that artificial sugar consumption may be associated with an increased risk of cardiovascular disease and stroke.

Overall, it seems like there is the most support for a potential link between artificial sugar consumption and cardiovascular concerns as well as neurological issues like headaches. It also seems like some sweeteners may be more likely to cause issues than others, such as aspartame, acesulfame potassium, and sucralose. They’re also the most commonly consumed sweeteners so it could just be a data availability issue.

Because of the issues with more traditional artificial sweeteners, some people are turning to other classes of artificial sweeteners, like sugar alcohols. Though stomach upset can be found commonly with sugar alcohols, the research is widely unclear about their associations with other health issues. It seems like they’re generally safe, but there is some research to say that erythritol may cause heart issues. Again, there are some reverse causality concerns here, but it is a potential issue and very interesting results.

Overall, the evidence for links between artificial sweeteners and cancer have been found weak and not replicable in humans and the most salient concerns may be heart issues, headaches, and digestive upset. 

Why artificial sweeteners may still not be the best choice

Though we can’t necessarily say that artificial sweeteners are causing health damage (maybe they are, but it’s not clear), what we can say is that they are not quite the magic bullet for issues like diabetes and obesity that they were hoped to be. What you can draw from the research, even if not causality between artificial sugar consumption and health outcomes, is that the groups of people most needing to reduce their weight or improve their heart health, are not benefiting from the swap to artificial sugar in the ways we thought they might. 

While some people definitely are able to lose weight and improve their health by choosing artificially sweetened products over products sweetened with real sugar, the numbers are showing that a lot of people who use artificial sugar still have issues with obesity and heart disease. Again, this is an issue that is way more complicated than that, but this may reveal a deeper issue. 

The danger with artificially sweetened products is similar to the idea of Ozempic. It may help you reduce your weight or your blood glucose level for a time (or even for some people for the long term), but for a lot of people it is just masking a bigger issue. The danger with artificially sweetened products is that it allows people to continue to consume foods that are still not very good for you and may not have much nutritional value, simply because it checks the one box of not having too much sugar. 

There are many quality pieces of research showing that intake of artificial sweeteners is associated with increased BMI and cardiometabolic issues, though again, the direction of causality is difficult to parse out. But the general idea here is that artificial sweeteners aren’t necessarily reducing obesity and diabetes like proposed.

Holistic, rounded nutrition is key to healing a lot of issues with the body, including disease, and it seems like artificially sweetened foods and drinks are making it so that some people can improve one small aspect of their nutrition while overall avoiding the changes that would truly lead to better health. So while I wouldn’t necessarily say artificial sweeteners are bad for you, I also wouldn’t say artificial sweeteners are good for you and I think it depends on personal context. 

A person who does not struggle with limiting their sugar intake and generally eats healthy and moves their body will probably not suffer any negative consequences from the occasional or even regular diet soda (though there are other reasons to avoid diet soda…) or sugar free sports drink or sugar free snack. But a person who survives on processed snacks and has difficulty managing their calorie intake regardless of the type of sugar they’re eating and doesn’t move their body could get some sort of false sense of doing something to benefit their health by making a switch from regular soda to diet soda (just an example). Additionally, a lot of people can justify eating absolute junk without any nutritional value just because it’s low in sugar. 

The point is that artificial sweeteners can be a great tool for a lot of people and they’re not inherently evil, but if they keep someone from realizing the need for bigger changes needed to improve their health, then they are a negative force in that person’s life. And the research shows that this may be happening more than my little rant may initially seem justified for. 

There are some theories and a little bit of research floating around that artificial sweeteners may impact the way the brain perceives sugar intake and increase preference for sweet flavors, but the research overall doesn’t support this.  

What I will say is plausible is that by utilizing artificial sweeteners, one is not forced to control the actual problem underlying their food consumption, which is that they are prioritizing sweet foods (which are typically less nutritive and it’s just a fact that the average American eats way too much sugar) over foods that are actually going to fuel their bodies. This is a normal human thing, we want the treat, there’s no shame in that. There’s also greater access to endless sugar than ever before. However, though it is normal to want sugar instead of a piece of broccoli, it does not negate the fact that we sacrifice health when we choose sugar over nutrition. It takes discipline and intention that a lot of people don’t have to control this. Even those of us that try to prioritize limiting sugar have our moments.

One other argument against artificial sweeteners

One argument a lot of my audience may have is that while artificial sweeteners may not cause cancer, they are not natural and therefore not the best for your body. This is difficult to answer with research. If it isn’t harming you then it isn’t harming you, that’s what the research can speak more to. 

Some people say our bodies don’t process it the same or as well. This may be true but there’s not necessarily evidence of that and that’s kind of an unclear question to try to answer anyway. The body processes artificial sweeteners just like anything else we eat. It’s not like a heavy metal that accumulates in the body. 

There’s some research that says artificial sweeteners may be associated with increased lipid accumulation, but it’s not something that can be considered certainly causal. The sweeteners themselves pass through the body just like anything else and, as we’ve discussed, there are likely other factors contributing to this. One who consumes more artificial sweeteners may have other habits leading to lipid accumulation. 

I’ll state again that artificial sweeteners certainly aren’t good for you. If they help you lose weight and maintain other healthy changes in your life, then they could be a helpful tool. However, they don’t add to your nutrition and they certainly aren’t necessary. 

The healthiest choice in this conversation would be to just eat less sugar, not to substitute your sugar intake with artificial sweeteners. I’ll concede that argument as certainly true. However, I don’t begrudge anyone the occasional diet soda or whatever other artificially sweetened thing.

Another thing to consider is we don’t have much research on excessive levels of artificial sweetener consumption, which isn’t necessarily uncommon. Like if you’re having multiple diet sodas and some artificially sweetened coffee syrups and sugar free yogurt, you’re probably eating a level of artificial sweeteners that is in excess of what the research has examined. So good luck, you’re in the wild west.

Summary/TLDR

So are artificial sweeteners bad for you? Though there’s not an entirely clear answer, no, there is not enough evidence to say artificial sweeteners cause negative health outcomes. It is possible that artificial sweeteners could cause an increased risk for cardiovascular disease and ailments like headaches, but the research is not definitive on this. What is more clear is that there is no credible link between artificial sweeteners and cancer. 

It does seem that asparatame, acesulfame potassium, and sucralose have a higher potential to cause cardiovascular and neurological issues than other artificial sweeteners, but this is still just a potential and not a definite thing. 

Overall, artificial sweeteners could be a helpful tool for some but are more likely masking general consumption and lifestyle issues for most that need to be addressed. Generally speaking, like with anything, it’s good to limit your consumption of artificial sweeteners, but they’re not likely to harm you in moderation. 

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