Disclaimer: the following information is for information purposes only. Please consult your doctor or healthcare practitioner before making any changes to your health.

Has anyone every told you artificial sweeteners were bad?

You may have heard the following about artificial sweeteners:

They cause cancer!
They cause obesity!
You should avoid them because they’re not natural. Have other, more natural sweeteners…

These are some of the talking points behind artificial sweeteners. But they get a bad rap, partially because they began in a lab, and partially their tie with old politics and inconsistent research linking to scary diseases. So, as I love to do, lets dive into the world of artificial sweeteners.

First, a brief history of artificial sweeteners

The story goes that in 1879 a researcher from Hopkins University went home one day from his lab. At dinner, he bit into his roll to find a very sweet crust. Curious at this odd sweet taste, he ran back to his lab to taste everything. Well, he found the hidden flavour that touched his hands. Turns out, one of his chemical soups had overboiled onto the counter, resulting in a sweet-tasting flavour. It was called Saccharin and was over 300x sweeter than cane sugar.

As the years progressed, in both science and politics, consumers demanded regulations on food industry products in 1906. Thus, Congress passed the Pure Food and Drugs Act which aimed to standardize consumer food goods. After it was passed, the head of the new act and renowned chemist, proposed a ban on Saccharin in 1908. But how could you ban a substance that provided so many benefits?!

Saccharin helped people lose weight.

It was a ‘sugar pill’ prescription to help with headaches and nausea.

As a preservative for canning.

Diabetics used it as a sweetener in coffee, tea, and other beverages.

It was cheaper than sugar to make and distribute.

Although there was no evidence proving saccharin was bad, the head deemed it unfit for human consumption- because it was derived from coal and tar. The head stressed that the sugar replacement was threatening people’s lives. Roosevelt ended the political discourse by responding with “Anyone who says saccharin is injurious to health is an idiot. Dr. Rixey gives it to me every day.”

From 1908 to WWI, there was a back-and-forth push and pull between banning Saccharin and allowing its consumption. Once the war started there became a sugar shortage, and Monsanto (yes the same Monsanto we have today) the largest Saccharin producer at the time, purported that it would save the country millions in replacement or sugar. In WWII as the sugar shortage occurred once more, Saccharin became the preferred sweetener once again.

As the push and pull continued throughout the decades, Saccharin was at the height of its potential ban in the ’70s. During this time, companies took advantage of this tug-of-war and produced alternatives to Saccharin’; like in 1965 with the release of Aspartame which was 200 times sweeter than sugar; Sucralose in 1976, which was 600 times sweeter than sugar. And Neotame in 2002, which was 7000 to 13,000 times sweeter than sugar.

And then there was Cyclamate. In the ’70s, an artificial sweetener called Cyclamate was banned due to its proposed link to bladder cancer. The research conducted was mostly in rats, but The Food and Drug Administration sharply removed it from store shelves in an effort to primitively stop any potential bladder cancer risk in humans.

More recently, artificial sweeteners have taken the spotlight due to their possible links to cancer, diabetes, and that the safe amount to consume is much less than what people we’re actually consuming. Unfortunately, science paints a pretty good picture, but left-over politics and new-age thinking seem to cloud what the research is telling us.

What are artificial sweeteners?

Artificial sweeteners are additives with a sugar-like sweetness that contain minimal to no calories. They are popular in the diabetic space, or for those watching their calorie intake. Although they interact with sweet-taste receptors, these sweeteners are not digested by the human body, thus not providing us with any energy.

Obesity, body weight, and BMI

Artificial sweeteners have been researched for their link to obesity. Obesity is a multifactorial disease with its roots stemming from not just food and activity, but socioeconomic status, mental health, and much more. It is an interesting theory that an additive with 0 calories could contribute to the excess calorie portion of obesity, but hey I’m not an obesity researcher. For this section, we will take a look at markers including obesity, body weight, and BMI.

In young people (18 and under), there doesn’t seem to be a strong association between consuming artificially sweetened beverages and increases in body weight. Which is a good thing, because childhood obesity is a looming problem. The following is from a systematic review of metabolic effects in youth from the International Journal of Pediatric Obesity:

At the current time, the jury remains out regarding a possible role of increased artificial sweetener use in the obesity and diabetes epidemics, whether adverse, beneficial or neutral. [In youth]

In adults, the evidence is mixed. It seems that in randomized controlled trials (RCT’s), artificial sweeteners reduced BMI and body weight, but not to a significant degree. In cohort studies, the findings are generally opposite. They are correlated with an increase BMI and weight gain.

RCT’s. “Effect of non-sugar sweetener intake on weight change (kg) in adults”

Forest plots of both RCT’s and cohort studies.

A couple of reasons why there appears to be a difference. In cohorts, it could be that those drinking non-nutritive sweeteners (AKA artificial sweeteners) are doing so while consuming more calories. In contrast, a lot of the RCTs employed hypocaloric environments, resulting in weight loss regardless of intervention.

With that in mind, replacing a caloric beverage with a drink containing artificial sweetener (with virtually 0 calories) would yield weight loss if it means the person enters a caloric deficit. Calories in and calories out are a thing, and it matters most for weight loss. But do we see this in the literature? Yes! People who consumed drinks with artificial sweeteners took in less energy, which means fewer calories.

“Effect of non-sugar sweetener intake on daily energy intake (kJ) by study duration (4 or 10 weeks)”

The takeaway: In both RCTs and cohort studies looking at markers in weight, the data is mixed. BUT, people who consumed drinks with artificial sweeteners took in less energy, which means fewer calories. Diet and other zero calorie drinks can be used to manage weight, while still enjoying a sweet-tasting beverage.

Cancer

Cancer is another word that gets lumped in with artificial sweeteners.

From the same systematic review and meta-analysis used above, artificial sweeteners causing cancers seem to be inconclusive.

“Effect of non-sugar sweetener intake on risk (odds ratio) of bladder cancer. Odds ratio of less than 1=increased risk of cancer with non-sugar sweeteners”

Another systematic review found a direct association for certain types of cancers, but not others. Again we run into the problem of co-founding- other variables that may affect the results of the data- and possibly genetics.

The takeaway: More data is required to draw a possible conclusion to the link of artificial sweeteners with cancer. As of now, the result seems inconclusive that artificial sweeteners cause cancer.

Type II diabetes

It’s an interesting thought that artificial sweeteners yielding 0 calories could cause issues with blood sugar. The theory is that the sweetness can actually produce an insulin response, and over time, type II diabetes.

Well, a systematic review and meta-analysis of RCTs deem this theory just that- a theory.

Ingestion of LES [Low energy sweeteners], administered alone or in combination with a nutrient-containing preload, has no acute effects on the mean change in postprandial glycemic or insulinemic responses compared with a control intervention. Apart from a small beneficial effect on PPG (−0.3 mmol/L) in studies enrolling patients with type 2 diabetes, the effects did not differ by type or dose of LES, or fasting glucose or insulin levels.

The British Medical Journal also reported no significant findings either.

However, no differences were observed in plasma insulin levels…or in insulin resistance and β cell function as measured by the homoeostatic model assessment of insulin resistance

The takeaway: Artificial sweeteners probably doesn’t contribute to type II diabetes, and can be used as a calorie-free substitute for sugar.

Artificial sweeteners are not ‘natural’, so they must be bad

People will argue that because artificial sweeteners don’t come from nature, or are not natural food, they are automatically bad for us.

Yes, they come from science. They are not from nature. However, if we say that anything unnatural should be avoided, by that logic we should avoid the use of insulin (the hormone type I and II diabetics need), the pacemaker, or electricity. Now, if artificial sweeteners didn’t have the above research dictating their current safety, then I wouldn’t be writing this article. But we use science as a guiding light to see where we’ve come, where we are, and where to go. And where we are, I believe based on science and research, is safe, and possibly beneficial in some circumstances.

But it’s processed food!

Processing of food exists everywhere. Even in the “natural sweeteners” like maple syrup. coconut sugar, and honey. The majority of these have processing involved so they are available to buy.

For example. the maple syrup from maple trees must be boiled down in order to retrieve the sugary sweetness we buy in stores. Coconut sugar, although from coconut flowers, requires the coconut nectar to be boiled and then ground into its brown sugar-like texture. Honey may be an exception here, as raw honey is exactly that-raw. But in many circumstances, it must be pasteurized to limit the possibility of botulism, a potentially deadly disease. The point is that processing is involved in not just artificial sweeteners, but the “natural” ones as well. It’s everywhere.

Keep in mind too that anything available for you to eat and drink has gone through rigorous testing in order to have a place in the grocery store.

Who should avoid artificial sweeteners?

There are scenarios where people should avoid certain artificial sweeteners.

Phenylketonuria is a disorder where a person does not properly metabolize the amino acid phenylalanine. Aspartame, for example, is converted into phenylalanine in the body, which can build up in the blood, and cause brain damage. Those who have the disorder should avoid it completely.

If you are someone who, when you consume something sweet, go into fuck-it mode and eat the entire fridge, then you may do best to avoid artificial sweeteners, along with whatever other sweets trigger that response for you. Artificial sweeteners are usually an X amount sweeter than sugar, but if you do okay with sweets in moderation then go for it.

Discussion

From the data above, artificial sweeteners are probably safe to consume for a healthy person. There could be specific groups that benefit the most from these drinks, such as:

Diabetics looking to keep their sugar levels stable
Someone transitioning away from sugar-sweetened beverages
Someone in a calorie deficit could use artificially sweetened drinks to curb hunger or reduce total calories

Due to their 0 calorie nature, they can certainly help with weight loss, which seems to be one of the biggest variables in disease and health- maintaining healthy body weight. Water should always be your beverage of choice, but it’s nice to enjoy a sweet beverage from time to time.

In conclusion

More information is always better to strengthen a hypothesis. From the evidence above, it appears that artificial sweeteners are probably safe to consume, and may yield specific health benefits.

Have I missed something, or do you have any feedback? Send me a comment!

References

History of artificial sweeteners- 1, 2, 3,

Obesity, body weight, and BMI- 1, 2, 3

Cancer- 1, 2,

Type II diabetes- 1, 2,

But they aren’t “natural”- 1, 2, 3, 4,

Who should avoid artificial sweeteners?- 1,

Mar 18 Are artificial sweeteners bad for your health? The sweet truth behind artificial sweeteners