From the DukeHealth.org archives. Content may be out of date.
The Sweet 'n Low-Down on Artificial Sweeteners
Little blue, yellow, and pink packets on the table -- which one should you choose?
Artificial sweeteners can help reduce caloric intake by providing a high level of sweetness with few to no calories. But many people have questions about whether artificial sweeteners are safe, whether they truly help with weight loss, or even if these artificial “foods” can contribute to overeating. Which little packet should a health-conscious consumer choose?
Like all other food additives, artificial sweeteners must undergo a rigorous approval process based on the results of animal or human studies.
The FDA assigns a maximum acceptable daily intake, or ADI, for each sweetener. The ADI is an average level that an individual can safely consume daily.
ADIs have a large built-in safety factor: they are 1/100th of the amount that is considered safe for human consumption. In most cases, the ADI is a level far greater than what most individuals would consume under normal conditions.
For example, the ADI for sucralose would be the amount of artificial sweetener found in six cans of diet soda.
Just like other food ingredients, it is possible that certain people may have an adverse reaction to one or more artificial sweeteners. Also, people who have the rare genetic condition known as phenylketonuria, or PKU, must avoid aspartame due to its content of phenylalanine.
But for most people, if you enjoy using a packet or two of artificial sweetener in your morning coffee, tea, or oatmeal, it’s safe for you to continue.
The Hunger Beast
How do artificial sweeteners affect weight loss and hunger?
Some research had previously suggested consumption of artificially sweetened foods and beverages might actually trigger overeating and hunger in certain individuals.
However, most scientific evidence currently available indicate that artificial sweeteners do not impact appetite, hunger, or fullness.
A study released in the August 2010 issue of the journal Appetite found that zero-calorie sweeteners did not prompt overeating. The study compared the effect of stevia, aspartame, and table sugar on hunger and satiety levels.
Subjects were given a stevia-, aspartame-, or sugar-sweetened snack 20 minutes before a meal. At meals, participants were instructed to consume as much or as little as they liked.
The researchers found that subjects who consumed the artificially sweetened snacks did not compensate by eating more at their lunch or dinner meal as compared to those who consumed the sugar-sweetened snacks.
A 2015 study published in Current Obesity Reports, which separated studies by type -- observational, laboratory, randomized clinical trials and functional MRI studies -- showed inconsistent data for an increased appetite. Overall, more studies are showing that the use of artificial sweeteners lowers intake of sugar containing foods and aids in weight loss.
Can Artificial Sweeteners Increase the Risk of Diabetes?
A study published in the journal Nature in September 2014 contented that consumption of artificial sweeteners appears to induce glucose intolerance in both humans and mice by altering gut microbiota. Non-diabetic individuals in the study exhibited a positive correlation between artificial sweeteners consumption and increased hip-to-waist ratio, higher fasting blood glucose and increased Hemoglobin A1c (3). While more research is needed to confirm these findings, it is advisable to recommend that those individuals at risk if diabetes limit their intake of artificial sweeteners.
Can Artificial Sweeteners Promote Weight Loss?
While sometimes a controversial question, Duke Diet and Fitness Center dietitian Elisabetta Politi, RD, says that when artificially sweetened foods and beverages are substituted for high calorie sugar-sweetened foods, weight loss may occur, but she cautions to keep in mind this is only one variable that can contribute to weight loss.
“The position of the Duke Diet and Fitness Center on artificial sweeteners is that they can be consumed in moderation as part of an overall healthy, well-balanced diet,” she says. “For people who are looking to decrease their caloric intake, replacing a sugar-sweetened food or beverage with an artificially sweetened one may indeed be helpful in reducing caloric intake.” However, she cautions to keep in mind that artificial sweeteners may be found in foods that are not always the most nutritionally sound.
Also, consider the company that artificially sweetened foods or beverages keep. “In other words, do you have that diet soda with a burger and fries, or does it accompany a healthy meal?” Politi says.
“We say you can choose whichever color packet you like, but make sure that the rest of your plate has lots of fresh, healthy foods.”