Sugar substitutes AKA artificial sweeteners are ingredients (low or calorie free) used to sweeten foods and beverages instead of sugar. There are a variety of foods on the market that contain artificial sweeteners. Unlike natural sugar found in food, artificial sweeteners initially thought to be a healthy alternative to sugar.

Examples of artificial sweeteners include:

  • Saccharin (Sweet’N Low, SugarTwin)
  • Acesulfame K (Sunett, Sweet One)
  • Sucralose (Splenda)
  • Aspartame (NutraSweet, Equal)

A food’s calorie content isn’t a good gauge on healthy. Just because artificial sweeteners may be considered “safe” doesn’t mean they have no side effects.

Let’s dive in at the real science behind fake sugars.

Artificial sweeteners are created through chemical synthesis or derived from plants. The most common artificial sweetener is sucralose, which is 600 times sweeter than table sugar, no wonder people like it so much!

Replacing sugar with artificial sweeteners, such as aspartame or sucra­lose, is one way people attempt to solve this conundrum, but some studies suggest that they might not be better for you than sugar. Where does that leave people who don’t want to go cold turkey on sweetness? Here’s a look at how our bodies respond to artificial sweeteners.

Concerns About Artificial Sweeteners

Studies have linked low- or no-calorie sweeteners to heart disease, type 2 diabetes, weight gain, and cancer.

There is a connection, artificial sweeteners can have a negative effect in our gut microbiome and change the microbiome—the bacteria that live in us and have significant effects on health—in ways that could increase disease risk.

It is suggested that people who consume these sweeteners are more likely to develop a taste for sugary foods and drinks throughout their lives, especially if they consume these sweeteners as children.

Also, people may not be aware just how much sugar substitutes they consume, such as “health” drinks, smoothies, yogurts, low-fat ice creams, and even English muffins. It’s possible that manufacturers are trying to keep their products sugars count low but still give them a sweet flavor. Unless you look at the ingredient list- you wouldn’t even know!

Two recent studies revealed that sugar substitutes have a correlation for headaches and migraines, and a study published in the Canadian Medical Association Journal links an increased risk of obesity and cardiovascular disease.

There is evidence that links artificial sweeteners to the development of glucose intolerance and other metabolic conditions that result in higher than normal blood glucose levels.

A 2018 study revealed that the artificial sugar, sucralose (Splenda) and maltodextrin, worsens gut inflammation in mice with Crohn’s disease. Suggesting that consumption of this product could exacerbate symptoms in patients with Crohn’s disease, according to research published in Inflammatory Bowel Diseases.

SO Maybe sugar isn’t too bad after all. It’s all in how it’s packaged.

Foods containing sugar in its natural form such whole fruit, for example, tend to be highly nutritious—nutrient dense, high in fiber, and low in glycemic load.

On the other hand, refined, concentrated sugar consumed in large amounts rapidly increases blood glucose and insulin levels, increases triglycerides, inflammatory mediators and oxygen radicals, and with them, the risk for diabetes, cardiovascular disease and other chronic illnesses.

You may be thinking what about stevia a “natural” artificial sweetener derived from a plant?


Stevia a natural sweetener derived with no calories and is 200 times sweeter than table sugar, a popular choice for many people.

This sweetener has also been associated with several health benefits, including lower blood sugar and cholesterol levels. However, stevia products vary in quality. Read those ingredients. Many varieties on the market are highly refined and combined with other sweeteners — which may alter its potential health effects.

In the Scientific Opinion written by the European Food Safety Authority, researchers noted that there is preliminary data to suggest that stevia may have inflammatory effects and could raise concern for individuals suffering from auto-immune diseases and inflammation of the digestive tract.

If you consume more sugar than recommended, you’d be better off cutting back on sugar and choosing whole fruit or less-processed sugars such as honey and maple syrup. Everyone has different goals and lifestyles. It depends more on the whole picture of your diet, activity levels, and personal goals.

Excess is a bad thing – sugar or otherwise.

When consumed in moderation though – or in its natural state AKA fruits and other plants – sugar isn’t a problem.

Carol Aguirre MS, RD/LDN