Artificial sweeteners and other sugar substitutes

Confused by the variety of sugar substitutes nowadays? Understand the pros and cons to make an informed choice.

By Mayo Clinic Staff

If you're trying to reduce the sugar and calories in your diet, you may be turning to artificial sweeteners or other sugar substitutes. You aren't alone.

Artificial sweeteners and other sugar substitutes are found in a variety of food and beverages marketed as "sugar-free" or "diet," including soft drinks and baked goods. Just what are all these sweeteners? And what's their role in your diet?

Understanding artificial sweeteners and other sugar substitutes

Sugar substitutes are sweeteners that you use instead of regular table sugar (sucrose). Artificial sweeteners are just one type of sugar substitute.

The topic of sugar substitutes can be confusing. One problem is that the terminology is often open to interpretation.

Some manufacturers call their sweeteners "natural" even though they're processed or refined. Stevia preparations are one example. And some artificial sweeteners are derived from naturally occurring substances — sucralose comes from sugar.

Artificial sweeteners

Artificial sweeteners are synthetic sugar substitutes. But they may be derived from naturally occurring substances, such as herbs or sugar itself. Artificial sweeteners are also known as intense sweeteners because they are many times sweeter than sugar.

Artificial sweeteners can be attractive alternatives to sugar because they add virtually no calories to your diet. Also, you need only a fraction of artificial sweetener compared with the amount of sugar you would normally use for sweetness.

Uses for artificial sweeteners

Artificial sweeteners are widely used in processed foods, including:

  • Soft drinks, powdered drink mixes and other beverages
  • Baked goods
  • Candy
  • Puddings
  • Canned foods
  • Jams and jellies
  • Dairy products

Artificial sweeteners are also popular for home use. Some can even be used in baking or cooking.

Certain recipes may need modification because unlike sugar, artificial sweeteners provide no bulk or volume. Check the labels on artificial sweeteners for appropriate home use.

Some artificial sweeteners may leave an aftertaste. A different artificial sweetener or a combination may be more appealing.

Possible health benefits of artificial sweeteners

Artificial sweeteners don't contribute to tooth decay and cavities. Artificial sweeteners may also help with:

  • Weight control. Artificial sweeteners have virtually no calories. In contrast, a teaspoon of sugar has about 16 calories — so a can of sweetened cola with 10 teaspoons of added sugar has about 160 calories. If you're trying to lose weight or prevent weight gain, products sweetened with artificial sweeteners may be an attractive option, although their effectiveness for long-term weight loss isn't clear.
  • Diabetes. Artificial sweeteners aren't carbohydrates. So unlike sugar, artificial sweeteners generally don't raise blood sugar levels. Ask your doctor or dietitian before using any sugar substitutes if you have diabetes.

Possible health concerns with artificial sweeteners

Artificial sweeteners have been scrutinized intensely for decades.

Critics of artificial sweeteners say that they cause a variety of health problems, including cancer. That's largely because of studies dating to the 1970s that linked the artificial sweetener saccharin to bladder cancer in laboratory rats. Because of those studies, saccharin once carried a label warning that it may be hazardous to your health.

But according to the National Cancer Institute and other health agencies, there's no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women. As a result, the warning label for saccharin was dropped.

Artificial sweeteners are regulated by the Food and Drug Administration (FDA) as food additives. They must be reviewed and approved by the FDA before being made available for sale.

Sometimes the FDA declares a substance "generally recognized as safe" (GRAS). Substances receive this designation if they meet either of these criteria:

  • Qualified professionals deem the substance safe for its intended use on the basis of scientific data. Stevia preparations are an example of this type of GRAS designation.
  • The substances have such a lengthy history of common use in food that they're considered generally safe.

The FDA has established an acceptable daily intake (ADI) for each artificial sweetener. ADI is the maximum amount considered safe to consume each day over the course of a lifetime. ADIs are set at very conservative levels.

Novel sweeteners

Novel sweeteners are hard to fit into a particular category because of what they're made from and how they're made. Stevia is an example. The FDA has approved highly refined stevia preparations as novel sweeteners but hasn't approved whole-leaf stevia or crude stevia extracts for this use.

Tagatose is also considered a novel sweetener because of its chemical structure. Tagatose is a low-carbohydrate sweetener similar to fructose that occurs naturally but is manufactured from the lactose in dairy products. The FDA categorizes tagatose as a GRAS substance.

Sugar alcohols

Sugar alcohols (polyols) are carbohydrates that occur naturally in certain fruits and vegetables — although they can also be manufactured. Despite their name, sugar alcohols aren't alcoholic because they don't contain ethanol, which is found in alcoholic beverages.

Sugar alcohols aren't considered intense sweeteners because they aren't sweeter than sugar. In fact, some are less sweet than sugar. As with artificial sweeteners, the FDA regulates the use of sugar alcohols.

Sugar alcohols contain calories. But they're lower in calories than sugar, making them an attractive alternative.

Uses for sugar alcohols

Sugar alcohols generally aren't used when you prepare food at home. But they're in many processed foods and other products, including chocolate, chewing gum and toothpaste. Sugar alcohols add sweetness, bulk and texture to food, as well as helping food to stay moist.

Sugar alcohols are often combined with artificial sweeteners to enhance sweetness. Food labels may use the general term "sugar alcohol" or list the specific name, such as sorbitol.

Possible health benefits of sugar alcohols

Like artificial sweeteners, sugar alcohols don't contribute to tooth decay and cavities, and may also help with:

  • Weight control. Sugar alcohols contribute calories to your diet — but fewer calories than regular sugar. Sugar alcohols may help weight-control efforts.
  • Diabetes. Unlike artificial sweeteners, sugar alcohols are carbohydrates and can raise blood sugar levels. But your body doesn't completely absorb sugar alcohols, so their effect on blood sugar is smaller than that of other sugars. Talk to your doctor or dietitian for guidance because sugar alcohols vary in their effects on blood sugar.

Possible health concerns with sugar alcohols

When eaten in large amounts, sugar alcohols can have a laxative effect, causing bloating, intestinal gas and diarrhea. Product labels may carry a warning about this potential laxative effect.

Natural sweeteners

Natural sweeteners are sugar substitutes that are often promoted as healthier options than sugar or other sugar substitutes. But even these "natural sweeteners" often undergo processing and refining.

Natural sweeteners that the FDA recognizes as generally safe include:

  • Fruit juices and nectars
  • Honey
  • Molasses
  • Maple syrup

Uses for natural sweeteners

Natural sweeteners have a variety of uses both at home and in processed foods. They're sometimes known as "added sugars" because they're added to foods during processing.

Possible health benefits of natural sweeteners

Natural sugar substitutes may seem healthier than sugar. But their vitamin and mineral content isn't significantly different. For example, honey and sugar are nutritionally similar, and your body processes both into glucose and fructose.

It's OK to choose a natural sweetener based on how it tastes rather than on its health claims. Just try to use any added sweetener sparingly.

Possible health concerns with natural sweeteners

Natural sweeteners are generally safe. But there's no health advantage to consuming any particular type of added sugar.

Consuming too much added sugar, even natural sweeteners, can lead to health problems, such as tooth decay, weight gain, poor nutrition and increased triglycerides. Honey can contain small amounts of bacterial spores that can produce botulism toxin. Honey shouldn't be given to children younger than than 1 year old.

Moderation is key

When choosing sugar substitutes, it pays to be a savvy consumer. Artificial sweeteners and sugar substitutes can help with weight management. But they aren't a magic bullet and should be used only in moderation.

Food marketed as sugar-free isn't calorie-free, so it can still cause weight gain. Keep in mind that processed foods, which often contain sugar substitutes, generally don't offer the same health benefits as whole foods, such as fruits and vegetables.

Sept. 25, 2018 See more In-depth