Natural and artificial sweeteners are present in products in every aisle of your favorite supermarket. They are traditionally marketed towards those who are looking to satisfy their sweet tooth without giving up an increased risk of tooth decay, weight gain, and the possibility of developing or worsening diabetic state. Sugar substitutes are considered as any sweetener that is not sucrose (table sugar).
- Artificial Sweeteners include saccharin, aspartame, acesulfame potassium, neotame, sucralose (Splenda)
- Sugar Alcohols include xylitol, erythritol, hydrogenated starch, isomalt, lactitol, sorbitol
- Novel Sweeteners include stevia extract, tagatose, trehalose
- Natural Sweeteners include agave nectar, date sugar, fruit juice concentrate, honey, maple syrup, molasses
Artificial sweeteners are FDA-regulated synthetic sugar substitutes that are often much sweeter than sugar, but do not contribute any dietary calories. They are usually used in foods or beverages instead of sugar to help lower foods’ calorie content for those looking to lose or maintain weight and to help consumers with diabetes control their blood sugar levels more effectively.
Artificial sweeteners have long been scrutinized for their side effects. Here’s the history of the three top artificial sweeteners:
- Aspartame was discovered in 1965 but not approved until 1981 due to reports linking it to cancer. It is also known to contain the amino acid phenylalanine, in high dosages may lead to neurological symptoms including hallucination, panic attacks and manic episodes. Excessive intake of aspartame has been shown to lead to more severe side effects, including intellectual instabilities and seizures.
- Limited evidence suggests that sucralose may lead to the development of migraines and may stimulate the production of insulin, despite being an artificial sugar substitute. It has not been linked to carcinogenic, reproductive, or neurological side effects. According to current scientific consensus, is considered among the safest artificial sweeteners for human consumption.
- Saccharin has been linked to certain forms of cancer in laboratory and animal studies, but the lack of connection to human clinical effects has led the FDA and international health bodies to remove it from their lists of hazardous food additives. Milder side effects include pruritis (itchiness), hives, difficulty breathing, gastrointestinal problems.
Related: Aspartame vs Sucralose vs Saccharin
Natural sweeteners, including agave nectar, molasses and honey, are often touted as healthier sweetener options to processed table sugar and its substitutes. Despite being marketed as “natural,” these sweeteners, including honey and agave syrup, usually undergo some degree of processing and refining. Some supermarket-shelf honey products, for example, have a very similar overall nutritional profile to table sugar. Additionally, honey may contain small amounts of botulism toxin-producing bacteria. For this reason, it is not recommended for those who may be immuno-compromised or for children less than 1 year of age, whose immune systems have not fully developed.
Natural sweeteners are generally safe, but, as with any sweetener, moderation is recommended. Too much added sugar may contribute to a variety of health problems, including tooth decay, poor nutrition, weight gain and increased triglycerides.
Sugar alcohols (polyols) are carbohydrates that occur naturally in some fruits and vegetables, but may also be synthetically manufactured. They are usually found in processed products including candy, frozen desserts, chewing gum, fruit spreads, and even toothpaste due to their ability to add sweetness, bulk, and texture. Despite the name, they do not contain any ethanol, like what is found in alcoholic beverages. Sugar alcohols are much less sweet than artificial sweeteners and may even be less sweet than sugar, but are favored by some brands because they still possess fewer calories than sugar (about 2 calories/gram, half that of sugar) and are not associated with the major side effects of artificial sweeteners.
Sugar alcohols are not clinically shown to lead to any severe side effects, but are known to have a laxative effect when consumed in higher quantities, and may lead to bloating, intestinal gas, and diarrhea.
Novel sweeteners are hard to fit into any particular category because of their manufacturing process. For example, despite being promoted as natural sweeteners, highly-processed stevia preparations have been approved by the FDA but whole-leaf stevia and crude stevia extract have not.
Aside from being calorie-free, Stevia rebaudiana, the plant from which the popular stevia sweetener is made, has been linked to health benefits:
- The herb has been widely used by holistic and naturopathic practitioners in South America to treat diabetes, with animal studies supporting these claims. Human research has shown decreases in blood sugar when taken by healthy volunteers, but there is a lack of conclusive evidence showing the same blood sugar decrease in diabetic patients.
- In addition, stevioside, a natural glycoside from the stevia plant, has shown blood pressure-lowering effects. Some human and animal studies have supported these findings, but further clinical trials are required to compare stevia’s effectiveness to other health remedies.
Stevia has been associated with few mild side effects, including muscle pain, muscle weakness, dizziness, nausea, and abdominal fullness, although the effects usually wear off after first week of use. Higher doses taken consistently may lead to more serious side effects, such as impaired kidney function.