The Sour Side of Sugar Substitutes

Ari Cofer Fact Checked
A woman drinking tea at a table
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Maybe a cold diet soda at lunch is your favorite afternoon treat. Or maybe you chew sugar-free gum like it’s your full-time job. Perhaps it’s a simple pack (or two) of artificial sweetener in your coffee to start the day. Tastes good, and since it’s not sugar, it feels harmless enough, right? 

Unfortunately … wrong. Prepare for a hard, sugar-less pill to swallow: Artificial sweeteners are not healthy or beneficial. In fact, they sometimes do much more harm than good — and the only “good” is tricking your body (and brain) into thinking you’re making the better decision by reaching for the sugar substitute. 

The sour truth about sugar sweeteners 

According to Dr. Debra Bell, the co-director of education for the UW Medicine Osher Center for Integrative Health, there are no foods with artificial sweeteners that are good for your health. 

And as it turns out, many more foods use artificial sweeteners than most people realize. Aspartame, saccharin, acesulfame potassium, sucralose, sorbitol and xylitol are often buried in the list of other hard-to-pronounce ingredient names, leaving many unaware that they’re sugar substitutes. 

Artificial sweeteners are used in food products like diet soda, sugar-free gum and low-fat yogurt, but they are also used in products you might not have guessed, like toothpaste and throat lozenges.  

About 5,000 foods and drinks currently use aspartame, but here’s the kicker: some don’t say aspartame on the package and may use a brand name instead. 

The opposite of health benefits 

You might think, “I need the sugar substitutes so I don’t eat a ton of sugar and gain weight,” which is a valid thought. That’s how these substitutes are marketed — a way to have your (sugar-free) cake and eat it too. 

But, if you’re a generally healthy person, you might not need a sugar substitution at all.  

“For people who don’t have diabetes or some kind of significant blood sugar dysregulation, I recommend that they don’t use artificial sweeteners,” says Bell. “There’s really no reason to be substituting that in.” 

Studies show some evidence that artificial sweeteners actually make people feel hungrier. Why is this? Well, the tongue tastes something sweet, but there’s no rise in glucose levels within the body. Which then leads to the proverbial, “Just one more.” 

“There is messaging to the brain that something tastes sweet,” Bell says, “but there’s no physiologic bump in glucose that interferes with the body’s messaging on hunger or to stop feeling hungry.” 

Bell also notes that we know that artificial sweeteners don’t reduce calorie intake, and now there is pretty sound data in humans showing that it’s not effective for helping with weight loss. 

But wait, isn’t that why many people opt out of their sugar-containing foods and reach for the artificially sweetened option? Well, the World Health Organization recently advised against consuming artificial sweeteners as part of a weight-loss strategy, since they haven’t shown to reduce body fat long-term.  

Some studies show artificial sweeteners can interfere with your body’s microbiome. While the effects of these changes are still being studied, changes in our microbiome have been linked to a variety of conditions from diabetes to depression. Another study found the sweetener erythritol was associated with an increased risk of heart attack — more tallies to add to the reasons to potentially strike sugar substitutes off your grocery list.  

But wait … there’s more. Other studies have found that those who suffer from migraines should stay away from artificial sweeteners due to the way aspartame can interfere with neurotransmitters in the brain. Additionally, sweeteners have a potential link to stroke and dementia

Finally, while alternative sweeteners aren’t inherently healthy, not everyone who uses sugar substitutes will experience negative effects from them. It’s most important to have the information so you’re able to make informed decisions on your dietary choices.  

So, what’s the sugar substitute … substitute? 

Ultimately, Bell simply recommends using organic sugar and cooking with maple syrup, molasses, applesauce or fruit concentrate to sweeten foods. However, sugary foods should be a treat — not an all-the-time thing.  

Bell also suggests expanding your palate a little bit. Sometimes indulging a sweet craving is the best feeling, but you may not have to depend on your foods being sweet for it to be good. 

“We have to learn about nutrition and taste, which doesn’t involve sweet,” she says. “We need to look to other foods and seasonings which allow us to enjoy our foods in positive ways without having sweet as a flavor.” 

Should you throw away your diet soda? 

Don’t let this put a bitter taste in your mouth — at the end of the day, you should continue making the choice you feel is best for you. 

“It’s always a personal decision, but I think it should be an educated decision,” says Bell. 

But there’s no sugar-coating — next time you reach for that artificial sweetener, remember your body might treat you a little bit sweeter if you try something else instead. 

Barbara Clements contributed to this article. A version of this story originally appeared in the UW Medicine Newsroom