The truth about artificial sweeteners


by Lisa Marsh, MS, RD, LD, CNSC

May 30, 2022

Artificial sweeteners, also called non-nutritive sweeteners or sugar substitutes, have been a controversial topic for decades. Do they cause cancer? Will they make me gain weight? Can they raise my blood sugar?

To help alleviate the confusion, here are answers to common questions about artificial sweeteners. But first, let’s review some of the basics.

What are artificial sweeteners?

Artificial sweeteners are manufactured sugar substitutes. They may be made from naturally occurring substances, such as a plant, herb or sugar itself. Artificial sweeteners are considered intense sweeteners because they are several times sweeter than regular sugar.

These sugar substitutes are attractive alternatives since they contain almost no calories. In addition, you need only a small amount compared to table sugar to achieve the same sweetness amount.

Artificial sweeteners are widely used in processed foods, such as soft drinks and other beverages, baked goods, candy, puddings and yogurts, canned foods and sweet spreads like jam.

Are artificial sweeteners bad for your health?

Concerns regarding artificial sweeteners began in the 1970s when studies showed a link between the artificial sweetener saccharin and bladder cancer in laboratory rats. But, according to the National Cancer Institute and other health agencies, there’s no firm scientific evidence that any artificial sweeteners approved for use in the United States cause cancer or any other serious health conditions. Several studies prove that artificial sweeteners are generally safe in limited quantities, even for pregnant women.

A particular study followed 9,000 people for 13 years and investigated their artificial sweetener consumption. The researchers determined there was no link between artificial sweeteners and the risk of developing cancer. Another more recent review of studies published over 11 years did not find an association between artificial sweetener consumption and cancer risk.

Artificial sweeteners are regulated by the Food and Drug Administration (FDA). The FDA limits the amount one should consume, called the acceptable daily intake (ADIs) for each sweetener. The ADI is the amount at which the FDA has deemed “reasonable certainty of no harm.”

The average adult doesn’t typically exceed the ADI for any artificial sweeteners listed. To put this in perspective, the artificial sweetener aspartame, used in most diet sodas, one 20-ounce bottle contains 333 mg of aspartame. A 175-pound person could safely consume 11 to 12 bottles per day (but of course, you probably shouldn’t!)

Types of artificial sweeteners

Here’s a list of approved sweeteners, along with the recommended acceptable daily intake:

Acesulfame K

A combination of organic acid and potassium. Unlike similar sweeteners, it is stable when heated. So, many baked goods contain acesulfame potassium. (ADI 15 mg/kg)


Approved as a general use sweetener. Very little is needed since it contains a high intensity of sweetness. (ADI 50 mg/kg)

Luo han guo extract

Swingle fruit extract, also known as monk fruit. (No ADI determined)


Approved as a general sweetener, but rarely used in foods. (ADI 18 mg/kg)


The oldest approved non-nutritive sweetener. It is approved as a food additive for gums, cosmetics and pharmaceuticals. (No ADI determined)


A derivative of the sucrose molecule. (ADI 5 mg/kg)


Extracted from the stevia plant. It is stable in dry and liquid forms (ADI 4 mg/kg).

Will artificial sweeteners help you lose weight?

One of the main reasons people choose to consume artificial sweeteners is to aid in weight loss or weight management. Reducing the overall daily intake of calories is challenging for most people.

Replacing calories from sugary foods with zero-calorie sweeteners seems like an easy fix. However, artificial sweeteners’ effect on weight, appetite and calorie intake has been scrutinized recently.

Some researchers believe artificial sweeteners cause an increase in appetite and disruptions in your body’s natural ability to decipher caloric intake.

However, many of these studies aren’t conclusive because of the notion of reverse causality, which makes it difficult to determine a cause-and-effect relationship. Meaning:  were the subjects gaining weight when drinking diet sodas or drinking diet sodas because they were gaining weight?

Regardless, many high-quality research studies show that replacing sugar with artificial sweeteners helps to reduce body weight, body fat and waist circumference.

The best way to lose weight, in my opinion, is to moderately reduce your daily calorie intake (around 300-400 calories) and increase your calorie expenditure through exercise (200-300 calories expended). This will create a bigger daily calorie deficit and is more sustainable long-term.

Artificial sweeteners and diabetes

Artificial sweeteners do not raise blood sugar levels, as confirmed by research like this study that examined glucose response after ingestion of either unsweetened, aspartame-sweetened, or saccharin-sweetened beverages in healthy versus non-insulin-dependent diabetic subjects. So, when used instead of sugar, they can help people with diabetes stay within their daily carbohydrate goals.

Some studies show drinking diet soda is linked with an increased risk of developing diabetes, but the studies were only observational.

Although the research is mixed, the current evidence is generally in favor of artificial sweetener use among those with diabetes. It is important to keep in mind that “sugar-free” or “reduced sugar” products are not always low in carbohydrates or calories. Diabetic-friendly foods may still contain other types of sugars such as refined flour, milk or fruit that count toward your daily carb allowance.

Reviewing the food label is key to determining how many carbs and calories you consume.

Which artificial sweetener is the best?

There is a lot to consider when deciding which artificial sweetener is best for you. Overall, using the smallest amount possible of any sweetener is recommended. You want to reduce your overall dependency on sugary foods and beverages. Like salty or fatty foods, you train your palate to what you crave. So, if you are consistently consuming very sweet foods, you will likely continue to crave them.

Sugar alcohols and digestion

Some people may be sensitive to certain artificial sweeteners called sugar alcohols. Sorbitol, xylitol, lactitol, mannitol, erythritol and maltitol are found in sugar-free candies, cookies, ice cream, beverages and chewing gums. They may cause diarrhea, stomach cramps, gas and bloating in some people, especially if you eat a lot of them. It is best to avoid this type of artificial sweetener if you are sensitive to them.

Natural artificial sweeteners

If you are looking for a more ‘natural’ artificial sweetener, you can opt for those derived from organic substances. Stevia is made from the plant, Stevia rebaudiana, which originates in South America. The leaves produce chemicals called steviol glycosides. It contains a concentrated sweet flavor 200 to 400 times sweeter than table sugar.

Monk fruit, also called swingle fruit or lo han guo, is the fruit from a flowering plant originating in Southeast Asia. It is typically modified to a dried form since the fruit spoils quickly. You will find monk fruit as a sugar-like powder or liquid extract. It also contains a highly sweet flavor, 100 to 250 times sweeter than sugar. Monk fruit sweetener is more costly and difficult to find in grocery stores. Also, some people may not enjoy the taste or texture of monk fruit sweetener compared to regular sugar.

There are other artificial sweeteners considered more processed, such as:

  • Saccharin
  • Aspartame
  • Sucralose

Your choice comes down to flavor preference. Some produce a bitter aftertaste that people can’t tolerate. In this case, it may be better to opt for a natural sweetener like honey, maple syrup or coconut sugar, but in a smaller amount.

Bottom line on artificial sweeteners

If your goal is to work towards eating a healthier, less processed diet, then choose whole foods, such as fruits and vegetables. Many are naturally sweet and have the added benefit of essential vitamins and minerals your body needs every day. This is in contrast to artificial sweeteners, which have no nutritional value.

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About the Author

Lisa Marsh, MS, RD, LD, CNSC, is a clinical dietitian with the Baylor Scott & White HealthTexas Provider Network. She provides nutrition assessment and dietary counseling for the Personal Edge Executive Wellness Program and Signature Medicine. Lisa's professional interests include nutrition counseling and consultation for the treatment of diseases and conditions related to an individual's diet and eating behaviors. Lisa's methods are geared toward lifestyle and behavioral changes unique to each individual.

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