Artificial Sweeteners: Sweet or Sour?

HWN Team | Insider
Artificial Sweeteners:  Sweet or Sour?

image by: Becky Stern

Artificial sweeteners may be good for us – think about our ongoing battle against diabetes, obesity and tooth decay. But is there a sour – or even a bitter side to these sugar substitutes?

Light, diet, zero, sugar-free. There are words that we often see on the labels of food products which, although taste sweet, nevertheless, do not contain sugar. So what makes that can of drink or that tub of yoghurt sweet without the additional sugar?  The answer: artificial sweeteners. But, could artificial sweeteners be sour for your health?

Artificial sweeteners are sugar substitutes or nonnutritive sweeteners. Unlike table sugar or sucrose which is usually extracted from plants, artificial sweeteners are synthesized in the laboratory. Sugar substitutes are several times much sweeter than sugar, making them cost-efficient as a food additive. One of the  leading pioneers of sugar-free food and beverages is the soft drink industry – which – having been labeled as sugar-rich and unhealthy, launched the so-called diet or light versions of soda drinks.

Propelled by chronic health issues including diabetes and obesity, the artificial sweeteners global market was estimated at $3.5bn in 2007 with Europe and the U.S. comprising about 65% of the market.1 According to the Calorie Control Council, a U.S. based Industry sponsored organization, more than 180 million Americans routinely consume sugar-free food and beverages, although other sources indicate a much lower consumption.  And Canada and Europe are not far behind!  

The Major Sweet Players

Saccharin marketed as Sweet n’ Low, Sugar Twin, is one of the first artificial sweeteners and has been used for more than 120 years. It is also one of the most controversial.

Aspartame marketed as Nutrasweet, Equal and additive number E951 in the EU, is the most successful artificial sweetener and is the brain child of Searle, which was acquired in 1984 by the chemical giant Monsanto.  It remains controversial, both in the U.S. and Europe.

Sucralose marketed as Splenda® was approved by the FDA as a tabletop sweetener in 1998, followed by approval as a general purpose sweetener in 1999. It is about 600 times sweeter than normal sugar so only a very small amount (thus little calories) is needed to sweeten food and beverage. It is also used for cooking. However, it also remains controversial.  For instance, it contains the carbohydrates dextrose and maltodextrin, so it’s not calorie free and as a result Splenda is not ideal for those who want to lose weight or those with diabetes.2

Acesulfame - K marketed as ACK, Sweet One® and Sunett®, was approved in 1988 by the U.S.  FDA for use in specific food and beverage categories. In 2002, it was approved as a general purpose sweetener. It’s 200 times sweeter than sugar and is used as food product sweetener or flavor enhancer. But, the safety of this sweetener has also been questioned.3

Xylitol the most famous of the sugar alcohols or ‘polyols’ is marketed primarily in dental products and is known for being “tooth-friendly” because cariogenic bacteria cannot ferment polyols.  Tooth-friendly products carry a special “toothy” symbol and one of the most commonly marketed products is chewing gum. Even polyols are controversial.4

Neotame is a “newer” version of aspartame and is up to 13,000 times sweeter than sucrose! It is the most potent sweetener currently approved in the market and was approved by the FDA as a general purpose sweetener in 2002. “While the web site for neotame claims that there are over 100 scientific studies to support its safety, they are not readily available to the public”. As a result , and because of its similarity to aspartame, it also remains controversial.5    

Why Use Artificial Sweeteners?

Sweeteners are low in calories - For the calorie and the weight-watchers, artificial sweeteners may seem like heaven-sent.  According to WebMD, these compounds “offer the sweetness of sugar without the same calories. They are anywhere from 30 to 8,000 times sweeter than sugar and as a result, they have much fewer calories than foods made with table sugar (sucrose). Each gram of refined table sugar contains four calories. Many sugar substitutes have zero calories per gram".6

Sweeteners may curb appetite and help lose weight - A 2009 study reported that certain sweeteners may curb appetite by triggering the release of appetite suppressing hormone glucagon-like peptide (GLP)-1. In the study, diet soda containing Sucralose was compared with carbonated water.7

Sweeteners may help those with chronic health issues such as obesity, diabetes and other metabolic diseases - Developed countries are fighting the epidemics of obesity, diabetes and cardiovascular disease. Using sugar substitutes in place of sugar is purported to be a major weapon in this battle.

Artificial sweeteners can serve a definite purpose in weight loss and diabetes control," says New York City-based nutritionist Phyllis Roxland. "It enables people that are either carb-, sugar-, or calorie-conscious to take in a wider range of foods that they would either not be allowed to eat or could only eat in such teeny amounts that they were not satisfying."

Those suffering from diabetes mellitus may now be able to eat certain foods that were previously prohibited due to their sugar content such as fudge, ice cream and gum drops . Another condition associated with abnormal sugar metabolism is reactive hypoglycemia. People with this condition must avoid eating food with high glycemic index. Artificial sweeteners may be the safer alternative.

Sweeteners are tooth-friendly - Sweeteners give the term “sweet tooth”  a new meaning. Dentists and dental hygienists have been battling caries and tooth decay caused by fermentation of sugar for decades. Some (not all!) sweeteners are supposedly tooth-friendly.

Sweeteners are sweet on the pocket - Artificial sweeteners can easily be synthesized in the laboratory and manufactured on a large-scale without the labor-intensive process of growing crops and food processing. They are therefore cheaper to produce and cheaper for food manufacturers and consumers.

How much sweeteners should we take in?

Here are the estimated ADIs according to age and sweetener type (bear in mind it’s from the manufacturers) provided by the Beverage Institute for Health and Wellness of the Coca Cola Company:8

Low-Calorie Sweeteners – Intake Guidelines (ADIs) and Relative Sweetness

  Acesulfame K Aspartame Saccharin Sucralose Cyclamate Rebiana
Intake Guidelines
U.S. FDA 15 mg/kg 50 mg/kg 5 mg/kg 5 mg/kg N/A GRAS
JECFA 15 mg/kg 40 mg/kg 5 mg/kg* 15 mg/kg 11 mg/kg 12 mg/kg**
EFSA 9 mg/kg 40 mg/kg 4 mg/kg 15 mg/kg 7 mg/kg  
ADI EquivalentBased on body weight of 150 lbs (68 kg) 25 12-oz cans of a zero-calorie drink with ace-K in the sweetener blend***** 12 12-oz cans of a zero-calorie drink sweetened solely with aspartame*** ~9 packets of tabletop sweetener*** 15 12-oz cans of a zero-calorie drink sweetened solely with sucralose** 5.5 12-oz cans of a zero-calorie drink sweetened solely with cyclamate**** ~30 packets of Truvia™ or more than 24 8-oz servings of Sprite Green****
Sweetness Relative to Table Sugar 200 times sweeter 160-200 times sweeter 300-500 times sweeter than sugar 600 times sweeter than sugar 30 times sweeter than sugar 200 times sweeter than sugar

*The Argentina food code ADI for saccharin is 2.5 mg/kg of body weight. ** ADI for steviol glycosides is 4 mg/kg/day, which based on molecular weight, translates to 12 mg/kg/day for rebiana. *** Based on U.S. FDA ADI **** Based on JECFA ADI. ***** Based on U.S. FDA ADI and an average of 40 mg ace-K per 12oz (300 ml)

The "sour" side of sweeteners

Do sweeteners cause cancer? At this juncture, the evidence for the link between artificial sweeteners and cancer is not strong enough– at least for some experts. The National Cancer Institute’ stand is that “there's no scientific evidence that any of the artificial sweeteners approved for use in the U.S. cause cancer".9

However here’s what has prompted the concern. In the 1970’s several studies reported that saccharin could cause cancer in laboratory animals, especially cancer of the bladder, uterus, ovaries, and the skin, and other organs. As a result, saccharin almost lost its market authorization in the 1970s but a strong lobbying by the food industry led to “just” a warning label which says "Use of this product may be hazardous to your health. This product contains saccharin, which has been determined to cause cancer in laboratory animals." Recently, this warning was narrowed down to a specific cancer, specifically bladder cancer in male rats.

Acesulfame K contains methylene chloride which is known to be carcinogenic. ”Long-term exposure to methylene chloride can cause headaches, depression, nausea, mental confusion, liver effects, kidney effects, visual disturbances, and cancer in humans. There has been a great deal of opposition to the use of acesulfame K without further testing, but at this time, the FDA has not required that these tests be done.”

And Saccharin and Acesulfame K are not the only ones suspected of being carcinogenic. In the 1990’s, several studies linked the sweetener aspartame to brain tumors. In 2002, the Scientific Committee on Food (ESCF) assessed the safety of aspartame, with the following concerns; the possibility of toxicity from methanol, one of the breakdown products of aspartame,  elevations in plasma concentrations of phenylalanine (Phe) and aspartic acid, which could result in increased transport of these amino acids into the brain, altering the brain's neurochemical composition and the possibility of neuroendocrine changes, particularly increased concentrations in the brain, synaptic ganglia and adrenal medulla of catecholamines derived from Phe and its hydroxylation product, tyrosine. After assessing the animal and aspartame data, the ESCF as well as the U.S. FDA concluded that there is no sufficient evidence to indicate that aspartame causes cancer.10

In 2005, the European Ramazzini Foundation (ERF) published new findings of a long-term feeding study on aspartame conducted in rats. Scientists from ERF concluded that aspartame causes cancer and that current uses and consumption of the sweetener should be re-evaluated.11 This prompted another review of the safety of aspartame by the European Food Safety Authority (EFSA) with the conclusion that the ERF did not give enough evidence to reconsider previous safety assessments of aspartame or other sweeteners currently authorized in the European Union. However, the controversy continues as the EFSA decided in 2011 to re evaluate its position on aspartame.12

Do sweeteners lead to weight gain? Several studies showed that sweetener consumption may actually lead to weight gain. The Nurses' Health Study in the 70’s found weight gain over eight years in 31,940 women using saccharin. In the early '80s, the American Cancer Society's study of 78,694 women found that after one year 2.7% to 7.1% more regular artificial-sweetener users gained weight compared to nonusers. The San Antonio Heart Study followed 3,682 adults for over eight years in the early 80's. Those who consumed more artificial sweeteners had higher BMIs, and the more that they consumed, the higher the BMI.

This seems paradoxical considering that sweeteners are touted as the answer to the prayers of weight watchers. The mechanisms behind this are not clear but several hypotheses have been put forward including  “Gaining weight by going diet”. Scientists believe that sweeteners actually increase sugar cravings. This is because the body expects the calories to come with the sweetness, and as a result, the calorie-poor sweeteners drive people to consume more calories later on.13

Do sweeteners lead to binging? There is the danger of people misinterpreting the term “zero calorie” associated with sweeteners and as a result some people may overindulge. “Artificial sweeteners do not affect blood sugar levels, but some foods containing artificial sweeteners can still affect blood sugar because of other carbohydrates or proteins in these foods. In other words, while foods that contain artificial sweeteners may be sugar-free, they may not be carbohydrate-free.”  The use of “safe” and “diet” artificial sweeteners in a can of soda or energy drink does not give you license to abuse especially because these beverages contain other stuff which may be harmful to your health.

NOTE: Everyone is in agreement that people who have phenylketonuria (PKU), a rare genetic condition in which the body cannot metabolize the amino acid phenylalanine (a component of aspartame) should not consume products containing aspartame. However, the following issues still remain controversial.

So, who is watching out for us, besides the manufacturers?

In Europe the European Food Safety Authority (EFSA) is responsible for assessing the safety of food products and, not surprisely, is currently re-evaluating aspartame. As food additives, sweeteners are required to be declared in food labels as E-numbers.14,15 The E-numbers of the most common sweeteners approved in the EU are:

E950 Acesulfame potassium
E951 Aspartame
E952 Cyclamic acid and its sodium and calcium salts, also known as Cyclamate
E953 Isomalt
E954 Saccharin and its sodium, potassium and calcium salts
E955 Sucralose
E961 Neotame
E961 Xylitol

In the U.S. the safety of food additives such as artificial sweeteners falls under the jurisdiction of the FDA. The Food Additives Amendment to the Food, Drug, and Cosmetic Act, which was passed by Congress in 1958, requires the FDA to approve food additives, including artificial sweeteners, before they can be made available for sale in the United States. However, this legislation does not apply to products that are “generally recognized as safe".

It’s worth noting that there are several consumer watchdog organizations including Citizens for Health and Food Identity Theft as well as the Center for Science in the Public Interest (CSPI) which recently raised objections in March 2011 about the artificial sweetener Sunett. Even its major competition ‘sugar’, represented by the Sugar Association has ‘weighed’ in.

Is there a more natural alternative to artificial sweeteners that you can take with your coffee or tea?

These are the so-called “natural” sweeteners, mainly derived from plants. Unfortunately, most of these sweeteners contain sucrose, fructose and calories and the pros and cons of these sweeteners are not well-known either and need to be investigated further. The main disadvantages of these natural sweeteners are; they may have distinctive flavors making them not ideal as food additives (stevia and corn syrup are exceptions), they may not be feasible for cooking and baking and they are more expensive.

Some examples are:

Stevia “sweeter and healthier than sugar, but it is also better than other sugar substitutes is how it is described in its official website. Extracted from a mountain shrub known as kaahehe, sweet leaf, honey herb, and yerba dolce, it had a very bad start with food regulators, but stevia extract was finally approved by the FDA in 2008 as “a natural and no calorie sweetener safe for use in food and beverages". It is currently one of the most commercialized “natural” sweeteners” and is widely used in soft drinks.16

Truvia marketed as a “natural sweetener” is the newly launched calorie-free version of stevia . There is some objection about how “natural” this highly commercialized processed can be. Because it’s new, data on the effects of long-term use are not available.17

Sweeteners derived from sugarcane are highly refined products and represent most of table sugar that is consumed worldwide. Less processed cane-based products include molasses, rapadura, sucanat and turbinado sugar. All contain sucrose and calories but because they are less processed, they retain most of the nutrients present in the original sugarcane juice.

Corn syrup from sweet corn has been getting bad press lately. Is it linked to obesity? High-fructose corn syrup is used as the main sweeteners for the food industry, especially in soda and other soft drinks, ice cream and pastries. The fact that it contains 55% fructose makes it so notorious. However, the term fructose should not turn people off  - it simply means “fruit sugar” - thus most of the sweetness we get from eating fruit is actually fructose.18,19

Maple syrup derived from maple trees is low in calories but rich in minerals. But! Beware of fake maple syrup.20

Honey is the least processed of all the natural sweeteners. It contains lots of minerals and antioxidants. Thanks to Winnie the Pooh, this natural sweetener is popular among children. A disadvantage is its limited use in cooking and food processing.21

Agave nectar from the agave plant is high in fructose and low in glucose. The fructose content could be as high as 90% but it is declared as a low glycemic sweetener because of its low glucose content. Talk about being confused!

Rice syrup is sweet but not as sweet as sugar. It contains complex carbohydrates that take longer to be metabolized, therefore, it has a mild influence on glycemia.

The Bottom Line

Artificial sweeteners may be good for us – think about our ongoing battle against diabetes, obesity and tooth decay. But is there a sour – or even a bitter side to these sugar substitutes?

Key opinion leaders think they are safe. But there are those who are still skeptical and remain convinced that they do more harm than good. Let us hope science and medical will give us some clear answers in the not-so-distant future. In the meantime, exercise moderation. Artificial sweeteners, low calorie or not, are no substitutes for natural nutritious food.  And always check the food labels and consider choosing a natural sweetener!


  1. Artificial sweeteners may trigger fullness hormones,
  2. Sucralose, Artificial Sweeteners -
  3. Acesulfame K, Artificial Sweeteners -
  4. Tooth-Friendly International
  5. Neotame,  Artificial Sweenteners,   
  6. Mann D, Are Artificial Sweeteners Safe?
  7. Brown RJ, Walter M, Rother KI. Ingestion of diet soda before a glucose load augments glucagon-like peptide-1 secretion, Diabetes Care. 2009 Dec;32(12):2184-6
  8. Understanding Low- and No-Calorie Sweeteners: Safety, Guidelines (ADI) and Estimated Intakes, Beverage Institute for Health and Wellness, the Coca Cola Company
  9. Artificial Sweeteners and Cancer, National Cancer Institute. 
  10. Health and Consumer Protection Directorate (2002). Opinion of the Scientific Committee on Food: Update on the Safety of Aspartame, European Commission, 10 December, 2002
  11. Soffritti M, First Experimental Demonstration of the Multipotential Carcinogenic Effects of Aspartame Administered in the Feed to Sprague-Dawley Rats, Environ Health Perspect. 2006 March; 114(3): 379–385
  12. Aspartame, European Food Safety Authority. 
  13. Yang Q. Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings,  Neuroscience 2010. Yale J Biol Med. 2010 June; 83(2): 101–108
  14. E-Number Index for Sweeteners, Sugar and Sweetener Guide
  15. Current EU approved additives and their E Numbers, Food Standards Agency, UK
  16. Stevia Sweetener
  17. Truvia
  18. Report 3 of the Council on Science and Public Health. The health effects of high fructose syrup, July 23, 2009, American Medical Association
  19. Hand B, The Truth about High Fructose Corn Syrup,
  20. Barnes L, The Truth about "Natural" Sweeteners. Does Sugar by Any Other Name Still Taste as Sweet?
  21. Barnes L, The Buzz on Honey: The Good-for-You Sweetener,

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