Are artificial sweeteners bad for you?

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What are artificial sweeteners?

Artificial sweeteners are otherwise known as non-nutritive sweeteners. The name speaks for itself; they’re compounds, which have a sweet taste but provide no nutritive benefit, as in, no calories.

They were first introduced to the market in the 1950’s. A number of years later, cyclamate, a type of artificial sweetener, was banned in the USA due to a study that claimed it caused cancer in animals [1]. There has been ongoing debate since, about the safety of artificial sweeteners and their effects on human health, even though this ban was lifted a long time ago.

As more scientific studies have been done in this area, it’s safe to say artificial sweeteners are safe to consume daily and over a life time, and do not cause cancer [1].

In the current food chain, non-nutritive sweeteners are used in a range of beverages, supplements, biscuits, cakes, lollies, cereals, bars and much more. Sweeteners and products containing sweeteners are typically marketed to dieters and those looking for a quick weight loss solution.

You only have to walk through the ‘health food’ isle of the supermarket to view all the sugar free items. They’re everywhere and in some instances hard to avoid if you’re looking for ways to reduce your sugar intake or (god forbid) starting another diet.

What are the types of artificial sweeteners?

Artificial sweeteners are both synthetic and natural compounds that provide a sweet taste without calories. They include; 

  • Cyclamate
  • Sacharine
  • Sucralose
  • Thaumatin
  • Neophesperidine
  • Steviol gicosides (For the purposes of this article I’m including stevia, even though it’s a natural ingredient)
  • Neotame
  • Aspartame
  • Polyalcohols (sorbitol, mannitol, xylitol, erythritol)

 

Common brands you may recognise are;

  • Equal and Nutrasweet, which contain aspartame.
  • Sweet’n’low containing saccharin.
  • Nativa; containing steviol gicosides, a plant derivative.
  • Polyalcohols sorbitol and mannitol found in sugar free gum and lollies.

 

When issues surrounding artificial sweeteners are reported in the media they’re often grouped together, even though they‘re not the same as one another. When you read reports about sweeteners, question what type of sweetener they’re talking about.

Stevia, for example, is a naturally derived sweetener, which is safe to consume. There are no studies to date that show negative effects to human health. Polyalcohol sweeteners, such as mannitol, found in mushrooms, are another form of non-nutritive sweetener. This sweetener is also not harmful to human health.

Most of the studies that questioned cancer links looked at only two types of sweeteners; saccharin and aspartame.

Will artificial sweeteners give you cancer?

In short, no they won’t. Original research papers that described a link between artificial sweeteners and cancer used animals as their test subjects. It’s well known that animals, although great to use in preliminary studies, are not the same as using humans.

In another large case controlled study in the USA, 3010 human test subjects showed no association between using artificial sweeteners (saccharin) and bladder cancer. Another study on 500,000 human test subjects in the NIH-AARPDiet and Health Study showed no link between aspartame and brain cancer risk [1].

If you want to know more about additional studies performed all around the world on this topic showing no association between artificial sweeteners and cancer, see reference [1] pg 50 for study citations.

Rest assured that in Australia our national regulatory body’s (Food Standards Australia and New Zealand) role is to monitor food ingredients such as these. They have reviewed and tested the use of artificial sweeteners and consider them safe for consumption. Read more about this here.

At the time when animal studies where the only scientific papers available, popular media made a royal mess of perpetuating the myth that artificial sweeteners cause cancer. Remember, journalists aren’t scientists and they often get scientific messages wrong, which create news stories.

Science also needs to be looked at in the context of what other journal papers are saying and examine scientific rigour. Just because one study shows an association doesn’t make it true. Studies need to be replicated in humans and results replicated over time in order to come to a consensus.

Here is a recent example of bogus media story on the subject;

Could artificial sweeteners like Splenda trigger cancer? Daily Mail March 2016 – study performed on rats.

Will artificial sweeteners help you manage diabetes?

Using non-nutritive sweeteners as a direct sugar replacement instead of eating an excessive amount of sugar is a message endorsed by Diabetes Australia. Sweeteners contain zero calories and zero carbohydrates and so do not effect immediate blood sugars. In some instances they can help create variety in the diet, without the additional sugar intake.

Diabetes Australia does highlight however, that you don’t need to get rid of all sugar in your diet, if you’re diabetic. For example the occasional spread of jam on toast, is ok. However, if you’re going to use a lot of sugar in your daily diet, like eating cakes every morning tea, you might benefit from switching to a non-nutritive sweetener.

Keep in mind that products that are deemed ‘low’ or ‘no sugar’, ‘diet’ or ‘low joule’, aren’t carbohydrate free. You will need to read the nutrient panel to ensure the product isn’t high in alternative starchy carbohydrates, saturated fats or salt.

The above nutrients and sugar still need to be monitored and controlled if you have been diagnosed with any of the following metabolic conditions;

  • Diabetes T1 & T2
  • Insulin resistance
  • Glucose intolerance
  • PCOS

 

There have been studies, misreported in the media, concerning artificial sweeteners and their effects on glucose intolerance. Glucose intolerance is often labelled as pre-diabetes. One particular study; Artificial sweeteners induce glucose intolerance by altering gut macrobiota [2], was a study performed using rat test subjects, not humans. The mice were given the maximum acceptable daily intake of saccharin recommended for humans (5mg/kg of body weight) adjusted to their body weight, which isn’t a normal amount a person would consume.

Researchers suggested that saccharin, in those high doses, had an antibiotic effect on the gut microbiome of the rodents. These same changes are often seen in the gut microbiome of type 2 diabetics and overweight people.

The same researchers then performed a similar study on a small group of 7 people that saw similar changes in gut flora. The results of the 5 out of the 7 people showed changes in gut flora after 5 days of using saccharin, and had a decline in glucose tolerance. However, as the sample size was so small, the results were not significant enough to draw any conclusion and certainly not transferable to the wider population [3]. That didn’t stop media outlets running stories titled “Artificial food sweeteners linked to diabetes” .

The truth to this study is that only one artificial sweetener; saccharin, showed changes in the microbiome of mice and the human trial is nothing to write home about. The study design was filled with flaws. Saccharin is typically used in commercially made diet products, but it’s certainly not the most common one.

In Australia, most diet and low sugar products are now made from stevia (a natural sweetener) or aspartame an artificial sweetener, not saccharin. Even if saccharin did cause glucose intolerance, it would be highly unlikely you would be exposed to the amounts used in the study due to the availability of the product. In other words, artificial sweeteners DO NOT cause or increase the risk of type 2 diabetes.

One thing to note is that artificial sweeteners do play a role in dental health too. Sugar consumption can contribute to dental carries, whereas artificial sweeteners do not [4]. 

Will artificial sweeteners help you lose weight?

Artificial sweeteners shouldn’t be relied upon for weight loss. It can be a successful tool when you implementing other lifestyle changes. This is because there are so many other things in your life that can affect your weight. Most notably, other food items in your diet, the quantity you eat and activity levels.

A can of 375ml Coke contains 138kcal of calories, namely sugar (35g). Theoretically, if you replace a can of normal Coke, with Diet coke you will not be ingesting additional 138kcal. Say you have several cans of Coke per day, or several teaspoons of sugar in your coffee and you replaced it with artificial sweetener, then yes, more than likely it will help you lose weight if you don’t compensate intake by eating something else.

There have been many studies that looked at the use of artificial sweeteners within weight loss programs. One in particular used 303 men and women. Researchers broke study participants into two groups. One group was told to use water as their main drink, whereas the other was allowed to use non-nutritive sweetened beverages. Both groups performed regular exercise and received basic dietary advice. The trial lasted 12 weeks.

The group what was allowed to use non-nutritive sweeteners showed a significantly larger weight loss (5.95kg) compared to the water only group (4.09kg) [5]. This suggests that artificial sweeteners can be used successfully as part of a holistic weight loss program.

It has been suggested that people may compensate calorie or sugar intake when they have been deprived of actual sugar. Whilst this is plausible, not everyone will do this and it certainly hasn’t been shown in any studies. Artificial sweeteners will only help you lose weight if you don’t compensate later and eat those additional calories.

Another example of where compensation might occur is through the use of diet products. Often, dieters will buy diet products in order to cut back calories, inadvertently compromising on the taste and enjoyment of food. These items don’t quite satisfy cravings, causing the dieter to go in search for more food.

Diet or low sugar products also have a health halo. They’re perceived as healthier food items. Dieters are sometimes led to believe that these products can be consumed in infinite amounts. Sugar free, doesn’t equate to calorie free.

Products can use sugar replacements, as a gimmick to reduce sugar content, whilst still being calorific. They often still contain carbohydrate, fat and protein. It pays to read the label.

Do artificial sweeteners increase appetite?

Research suggests that artificial sweeteners may not satisfy appetite [6], which is not the same as increasing appetite.

There is a theory, that because sweeteners like stevia are 200x sweeter than sugar [7] our taste buds will become acclimatised sweeter foods. You will inevitably crave more sweets. This has never been proven and may or may not be the case for certain individuals. The best way to put this theory to rest is to ask yourself; do you feel you crave more sweet foods after using artificial sweeteners?

Anecdotally, when I have asked clients this question, they say no. And personally, for me it doesn’t either. I use stevia in all coffees and in smoothies. I also use diet cordial containing aspartame on a daily basis. I naturally have a sweet tooth and when I use these products, I feel like I don’t need sweet foods. However, when I run out of cordial or stevia I go in search for something sweet and of course coffee doesn’t taste so great, so I put sugar in it. It doesn’t change the way or the amount I eat, but using them eliminates a few teaspoons of sugar a day.

On the flip side, if you’re stuck in a yoyo dieting cycle, what I often see is that individuals will use artificially sweetened diet products during sugar cravings for a certain period of time. When motivation is weens, once the deprivation has set in, they end up eating the “healthier” diet products and also everything else they wanted too. This includes full sugar products.

In this case, I would suggest eat what you really want first, rather than pseudo diet products. Satisfy the craving and move on. It’s often better to enjoy the one off treat, in a controlled manner, than to continue to deprive yourself and binge later.

Artificial sweeteners are safe to use, but you shouldn’t deprive yourself from all sweet foods all the time. You shouldn’t also feel reliant on sweeteners to get you though a diet regime. It’s a good idea to think about the types of food you are eating and why you think you need so many sweet foods. It could be possible that your diet is missing vital macronutrients; you may have too much stress in your life or not enough sleep.

Instead of looking at how you can cheat calories through using diet products, instead heal your relationship with food. Ask yourself why are you eating these types of food and if you really enjoy them.

Diet food products are sometimes a useful weight loss solution, in certain situations, for certain people. They are by no means the solution to weight loss for everyone or the best choice.

Are artificial sweeteners safe to use?

The original research papers that raised concerns about the safety of artificial sweeteners and cancer risk was derived from studies conducted on animals, more specifically rats. When it comes to the physiology of humans, rats do not compare.

Putting aside the inaccuracy of basing a cause and effect outcome using a rat model and applying it to humans, rats in the study were fed much greater amounts of artificial sweeteners, than what could possibly be consumed by a human in one day. This study, at the time, achieved a great deal of media coverage and the myth surrounding artificial sweeteners and cancer still prevails today.

The risk of a human developing cancer from using artificial sweetener is quite low or non-existent. Artificial sweeteners have undergone rigorous testing from Food Standards Australia and New Zealand (FSANZ), our national food authority, and they have been deemed safe to consume.

The side effects from using artificial sweeteners? 

Up until now the only documented side effects of sweeteners in humans occur when consuming sweeteners such as; mannitol, sorbitol and xylitol, which are usually found in sugar free lollies and chewing gum. They may cause digestive upset if used in large quantities greater than 10 g/day.

Symptoms such as flatulence, cramping, bloating and diarrhoea may occur when unabsorbed sugar alcohols are partially fermented by gut bacteria.

Some people can also experience headaches if they have food chemical insensitivities. The same people who get headaches from sweeteners may also get them from drinking wine, eating chocolate or cheese because they also contain the similar chemical compounds called amines. If this is you see an Accredited Practicing Dietitian for help.

Only Polyalcohols (sorbitol, mannitol, xylitol and erythritol) based sweeteners will cause these side effects if eaten in excess. Naturally derived stevia will not. If you do have concerns switch to your natural alternative.

I am of the strong belief that everyone should feel comfortable with what they put in their mouth. I also believe that drinking diet sodas and eating diet products aren’t as useful as what people believe them to be. So if you don’t want to use artificial sweeteners, that ok, you don’t have to. There are plenty of other ways to cut back sugar intake and enjoy foods you love.

If you do want to use sweeteners, that ok too. Ingredients like this are created to provide options and alternatives for different people, they are tools to use in conjunction with other lifestyle changes. So I’ll let you make up your own mind on this one.

Do you use artificial sweeteners? Do you get crave more sweet foods after using them?

  1. Pilar Riobó Serván1, R.S.P.a.J.S.R.g., Low and no calorie sweeteners (LNCS); myths and realities. Nutrtricion Hospitalaria, 2014. 30(2): p. 49-55.
  2. Suez, J., et al., Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 2014. 514(7521): p. 181-6.
  3. Miller, R., Could low-calorie sweeteners be contributing to the diabetes epidemic? Nutrition Bulletin, 2015. 40(1): p. 33-35.
  4. Matsukubo, T. and I. Takazoe, Sucrose substitutes and their role in caries prevention. Int Dent J, 2006. 56(3): p. 119-30.
  5. Peters, J.C., et al., The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. Obesity (Silver Spring), 2014. 22(6): p. 1415-21.
  6. Renwick, A.G. and S.V. Molinary, Sweet-taste receptors, low-energy sweeteners, glucose absorption and insulin release. Br J Nutr, 2010. 104(10): p. 1415-20.
  7. Grembecka, M., Natural sweeteners in a human diet. Rocz Panstw Zakl Hig, 2015. 66(3): p. 195-202.
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