Dietitian Digest: What’s The Real Deal with Sugar Substitutes?

Whether your goal is to cut back on calories to help manage your weight or to reduce your sugar intake to better manage blood glucose levels, many Americans are making “the switch.” What exactly is “the switch?” In this case, it is replacing regular sugar with sugar substitutes, particularly artificial sweeteners.


Artificial sweeteners are synthetic compounds, meaning they are chemically created. Even sweeteners labeled as “natural” are synthetically created, just further adding to the confusion surrounding sweeteners in general. They taste much sweeter, ranging from 100 to 20,000 times as sweet as regular sugar. Artificial sweeteners have little to no calories, making them an appealing alternative for those needing to cut back on their overall sugar intake. Artificial sweeteners are commonly used in products such as baked goods, candy, dairy products, soft drinks, and products labeled as low sugar, low carb, or diet. Popular artificial sweeteners used in the western world today include:

  • Acesulfame Potassium (Sweet One, Sunett)

  • Aspartame (Equal, NutraSweet)

  • Saccharin (Sweet ‘N Low)

  • Luo Han Guo Fruit Extracts (Monk Fruit, PureLo)

  • Sucralose (Splenda)

  • Steviol Glycosides (Truvia, Purevia, Stevia)

While the use of these artificial sweeteners may appear to be the perfect solution, there is actually much that is not well-known or understood about them. Currently, the Food and Drug Administration has labeled these products as “Generally Recognized As Safe” (GRAS) for the average consumer. However, as these products gain more popularity, more research has been conducted to assess how regular use of artificial sweeteners can impact various aspects of our health. Areas of particular focus have included the impact on obesity, digestive health, and liver health. While research remains ongoing, several studies have shown that regular use of artificial sweeteners can potentially:

  • Change the bacteria in our gut, leading to digestive issues such as diarrhea.

  • Increase liver inflammation.

  • Lead to weight gain instead of weight loss. Various conclusions have been drawn as to why this happens, such as changes in the gut microbiome, leading to an increased sense of hunger (resulting in overeating), along with changes to hormones that aid with managing our weight.

Studies have also suggested that regular use of artificial sweeteners may increase insulin resistance, which can further complicate managing and maintaining stable blood sugar levels for those with diabetes.


So, what’s the solution? Well, the answer is not simple or straightforward. Although there are potential risk factors of using artificial sweeteners as we reviewed above, using these types of products can still be a great alternative if it helps you cut back on your overall sugar intake. Many health experts state that the benefits of using artificial sweeteners outweigh the risks, especially when compared to the use of regular sugar. That is because excessive regular sugar intake can have greater health implications, such as higher risk for obesity, diabetes, and cardiovascular disease, as well as poor dental and mental health. So, the gold star answer is to consider cutting down on sugar intake, both regular and artificial, overall. Consume foods with natural sugars, such as fresh fruit, if you are craving something sweet. You will also get the benefit of other vitamins and additional fiber, which will support liver health, gut health, heart health, weight management, and diabetes. If you do choose to use artificial sweeteners, consider keeping to these choices:

  • Monk Fruit

  • Stevia/Stevia Products

  • Erythritol (Note: For some, this sugar alcohol can still lead to digestive issues, such as bloating and gas, so use in limited quantities)

-Collette Romstedt, MA, RDN, LDN, ACSM EP

Registered Dietitian and Certified Exercise Physiologist



0 comments