Should we replace sugar with artificial sweeteners?

Sugar substitutes may taste sweet and seem like a good alternative in a low-sugar diet, but consuming foods and drinks containing these are not without their risks. There is an ongoing debate about the safety of consuming sweeteners and their effects on appetite, weight management and potential influence on other health issues such as digestive health. Nutrition advisor Will Jordan answers the key questions on artificial sweeteners and managing those sugar cravings.

What is an artificial sweetener or sugar substitute?

Artificial sweeteners are chemical compounds that have low or zero calories that provide a sweet taste which are used in place of sugars. ¹ They can be extracted from plants, synthesised through microorganisms, or made by controlled reactions. ² Artificial sweeteners are hyper-sweet so only small amounts are needed in food products. The commonly used and approved sweeteners in the UK include:

•           Acesulfame K (E950)
•          Aspartame (E951)
•           Erythritol (E968)
•           Saccharin (E954)
•           Sorbitol (E420)
•           Steviol glycosides (E960)
•           Sucralose (E955)
•           Xylitol (E967)

These additives are only permitted to be used in certain foods with specific amounts set by UK legislation such as aspartame being used in sweetened soft drinks. ^4 5 Consuming below the recommended amounts of artificial sweeteners is considered safe, and each artificial sweetener will have different acceptable daily intakes for the adult population. Infants and young children are not recommended to consume them as research is on-going. ⁶

Where would substitute sugar be used or commonly found?

Artificial sweeteners are used in soft drinks, desserts, dairy products, sweets, chewing gum, and low-calorie products. ² These food and drinks that are sweet but state ‘sugar free’, ‘diet’, or ‘zero calorie’ are almost certainly using artificial sweeteners, these are often ultra-processed foods. Manufacturers are required to state ‘with sweeteners’ on the label.

Do artificial sweeteners affect the body in the same way as sugar?

Artificial sweeteners work differently in the body to sugars, different sweeteners have different effects on satiety and sugar cravings. The current research is conflicting as some studies show they reduce appetite, and others report no significant differences. ^{7 8}

Most artificial sweeteners provide minimal nutritional value and generally pass through our digestive system. However, some can remain in the colon and intestines and cause potential health issues. ⁹ While the full extent of this is unknown, recent research has begun to report unfavorable outcomes in adults and children such as increased risk of Irritable Bowel Syndrome(IBS) and increased intestinal permeability and disrupted gut microbiome. ^{10 11} Artificial sweeteners may also impact insulin response, but this is still unclear and further large-scale, high-quality studies are warranted for a clear understanding of why this affect may happen in some individuals. ^{12 13}

There are some potential health risks with artificial sweeteners as metabolic disease risk may be increased, such as cardiovascular or heart disease, type 2 diabetes, and obesity. Recent studies suggest that artificial sweeteners, such as aspartame, may slow metabolism and cause weight gain. This can lead to increased risk of type 2 diabetes, and cardiovascular disease. ^{14 15}

Despite this, there is consistent research showing that artificial sweeteners may be an effective short-term intervention for weight management in controlled clinical trials with overweight or obese participants. ¹⁶ However, there is a concern that zero calorie sweeteners may build an association of sweet tastes with low calorie products and over stimulate our sweet receptors making unsweetened foods undesirable, especially in children, fuelling our sweet cravings. ¹⁷

What’s the best way to cut back on sugar?

Developing helpful eating habits is the best way to reduce sugar intake. It is recommended that adults should not have any more than 30g of free sugars, and 90g of total sugar per day. The NHS defines free sugars as sugar that are added to food and drinks, or sugars that are naturally occurring in honey, syrups, and fruit juices. ¹⁸

Despite the fact that sugars from honey, syrups and fruit juices are occurring naturally, they are still classified as free sugars as they have a low fibre content. Sugars that are found in whole fruits and vegetables do not count as free sugars as they are integral within the fruit or vegetable which is high in fibre which slows the absorption of the sugars within, making you fuller for longer. Hidden sugars are free sugars found in unassuming foods, such as pasta sauces and sweetened yoghurts, and are often ultra-processed. It is always worth looking at the label on the foods and drinks to see how much sugar is really in the products.

A one-week sugar detox can also help reduce or eliminate sugar cravings. Avoiding all sugar and artificial sweeteners that don’t naturally occur in vegetables for 7 days can help whole foods taste better and even make sugary sweets and drinks taste too sweet as taste buds readjust to natural sweetness.

Supplementation may also help with cutting back on sugar. Chromium, a trace mineral, has evidence to suggest that supplementation reduces food intake, hunger levels and tended to decrease bodyweight because of these effects. ¹⁹

Food supplements may also help with cutting back on sugar. Chromium, a trace mineral, has evidence to suggest that it may reduce food intake, hunger levels and tends to decrease body weight because of this. Additionally, Chromium is involved in glucose metabolism, removing it from our blood into our cells in individuals with diabetes. ²⁰

Cinnamon may also help to support blood sugar levels as it promotes glucose to enter cells, reducing blood sugar levels. ²¹

Conclusion:

Artificial sweeteners are considered safe by many food authorities around the world; however, this is not without controversy. Humans are not designed to consume artificial sweeteners. They provide no nutritional value and increase risk to disease. Reducing sugar intake by replacing with whole foods alongside small, meaningful lifestyle changes is more helpful for long-term health improvements rather than isolating sugar and sugar alternatives as a whole solution.

For more information, visit your local health food store for dietary, supplement and lifestyle advice. Find your local health store at www.findahealthstore.com.

Want to try the One Week No Sugar Detox? The Viridian programme includes a food supplement and a No Sugar Guide packed with facts, recipes and tips.

Author: Will Jordan, BSc (Hons) MSc, is a Nutrition Advisor at Viridian Nutrition. He holds a Master’s degree in Sports and Exercise Nutrition, BSc in Food and Nutrition. 

Will has worked on the NHS Diabetes Prevention Programme as a health coach, giving personalised advice, empowering people to make effective long-terms changes to halt or reverse the progression of pre-diabetes, preventing the development of type 2 diabetes.

References:

¹ Chattopadhyay S, Raychaudhuri U, & Chakraborty R. Artificial Sweeteners – a review. Journal of Food Science and Technology. 2011; 51, 611-621

² European Food Safety Authority. Sweeteners. EFSA. 2024; [online] available from: [https://www.efsa.europa.eu/en/topics/topic/sweeteners#:~:text=Sweeteners%20or%20sugar%20substitutes%20are,many%20times%20sweeter%20than%20sugar.] [17/12/2024]

³ Wilk K, Korytek W, Pelczynska M, Moszak M, & Bogdanski P. The Effect of Artificial Sweeteners Use on Sweet Taste Perception and Weight Loss Efficacy: A Review. Nutrients. 2022; 14 (6) 1261

⁴ Food Standards Agency. Approved additives and E numbers. 2024; [online] available from: [https://www.food.gov.uk/business-guidance/approved-additives-and-e-numbers] [17/12/2024]

⁵ NHS. The truth about sweeteners. 2023; [online] available from: [https://www.nhs.uk/live-well/eat-well/food-types/are-sweeteners-safe/] [17/12/2014]

⁶ British Dietetic Association. Policy Statement. The Use of Artificial Sweeteners. 2016; 1-8

⁷ Steinert RE, Frey F, Topfer A, Drewe J, & Beglinger C. Effects of carbohydrate sugars and artificial sweeteners on appetite and the secretion of gastrointestinal satiety peptides. British Journal of Nutrition. 2011; 105 (9) 1320-1328

⁸ Gopalakrishnan NK, Balasubramanian B, Kundapur R, Chaudhary A, Meyyazhagnan A, & Pappuswamy M. Unraveling connections with artificial sweeteners and their impact on human health: A comprehensive review. eFood. 5 (5) e184

⁹ Lee CY, So YS, Yoo SH, Lee BH, & Seo DH. Impact of artificial sweeteners and rare sugars on the gut microbiome. Food Science and Biotechnology. 2024; 33, 2047-2064

¹⁰ M. M, Vellapandian C. Exploring the Long-Term Effect of Artificial Sweeteners on Metabolic Health. Cureus. 2024; 16 (9) e70043

¹¹ Sorensen LB, Vasilaras TH, Astrup A, & Raben A. Sucrose compared with artificial sweeteners: A clinical intervention study of effects on energy intake, appetite, and energy expenditure after 10 wk of supplementation in overweight subjects. The American Journal of Clinical Nutrition. 2014; 100, (1) 36-45

¹² Yeterian M, Parikh MA, Frishman WH, & Peterson SJ. The Bittersweet Reality: The Cardiovascular Risk of Artificial Sweeteners. Cardiology in Review. 2024; DOI: 10.1097/CRD.0000000000000748

¹³ Czyewski F, Baranowska A, Baranowska K, Filipek K, Kawka J, Muciek M, Mrugala S, Mrugala W, Skierkowski B, & Zalewska N. The impact of artificial sweeteners on  the metabolic syndrome. Journal of Education, Health and Sport. 2024; 66, 50079

¹⁴ Swithers SE. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Trends in Endocrinology & Metabolism. 2014; 24 (9) 431-441

¹⁵ Debras C, Chazelas, Sellem L, Porcher R, Sruesne-Pecollo N, Esseddik Y, Szabo de Edelenyi F, Agaesse C, De Sa A, Lutchia R, Fezeu LK, Julia C, Kesse-Guyot E, Alles B, Galan P, Hercberg S, Desshausaux-Tanguy M, Huybrechts I, Srour B, & Touvier M. Artificial sweeteners and risk of cardiovascular disease: results from the prospective Nutri-Net-Sante cohort. British Medical Journal. 2022; 378, e071204

¹⁶ Nadolsky KZ. COUNTERPOINT: Artificial Sweeteners for Obesity – Better than Sugary Alternatives; Potentially a Solution. Endocrine Practice. 2021; 27 (10) 1056-1061

¹⁷ Strawbridge H. Artificial Sweeteners: Sugar-free but at what cost? Harvard Health Publishing. 2020; [online] available from [https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030] [18/12/2024]

¹⁸ NHS. Sugar: the facts. 2023; online. available from [https://www.nhs.uk/live-well/eat-well/food-types/how-does-sugar-in-our-diet-affect-our-health/] [17/01/2025]

¹⁹ Anton SD, Morrison CD, Cefalu WT, Martin CK, Coulon S, Geiselman P, Han H, White CL, & Williamson DA. Effects of Chromium Picolinate on Food Intake and Satiety. Diabetes Technology & Therapeutics. 2008; 10 (5) 405-412

²⁰ Balk EM, Tatsioni A, Lichtenstein AH, Lau J, & Pittas AG. Effect of Chromium Supplementation on Glucose Metabolism and Lipids: A systematic review of randomised controlled trials. Diabetes Care. 2007; 30 (8) 2154-2163

²¹ Hendre AS, Sontakke AV, Patil SR, & Phatak RS. Effect of cinnamon supplementation on fasting blood glucose and insulin resistance in patients in patients with type 2 diabetes. Pravara Medical Review. 2019; 11 (2) 4-8

The information contained in this article is not intended to treat, diagnose or replace the advice of a health practitioner. Please consult a qualified health practitioner if you have a pre-existing health condition or are currently taking medication. Food supplements should not be used as a substitute for a varied and balanced diet.