The argument for artificial sweeteners can certainly seem appealing on the surface. All the sweet, sweet taste of sugar, but with fewer (or no) calories. What could be better?
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Well, as it turns out … sugar. Sugar is better for you than artificial sweeteners. Or even better yet — no added sugar. That’s your absolute best bet.
“Really, both sugar and artificial sweeteners are a problem for your health,” says functional medicine specialist Melissa Young, MD. “But if we’re comparing what’s worse, artificial sweeteners are far worse than sugar.”
Why are artificial sweeteners bad for you? And is there a healthier way to satisfy your sweet tooth?
Dr. Young helps us understand why we crave sugar and why artificial sweeteners aren’t so sweet for your health.
What are artificial sweeteners?
Artificial sweeteners are compounds that are designed to taste like sugar but with very few calories. Most have fewer than 3 calories per teaspoon. Compare that to one teaspoon of sugar, which has 16 calories. They’re also commonly used by people living with diabetes because they don’t affect your blood sugar level in the same way as sugar.
But Dr. Young warns that doesn’t mean artificial sweeteners are “good” for you.
Some of the most common artificial sweeteners include:
- Saccharin (Sweet n’ Low®).
- Aspartame (Equal®).
- Sucralose (Splenda®).
There’s also a wide range of sugar alcohols that manufacturers use to sweeten foods. They include things like xylitol, erythritol, sorbitol and maltitol. They come with their own health challenges. Once in your intestinal tract, sugar alcohol is fermented by colonic bacteria. That releases gas, which leads to bloating, cramps, pain and diarrhea. And one common sugar alcohol, erythritol, has been linked to increased risk for heart attack and stroke.
The U.S. Food and Drug Administration (FDA) and other health agencies around the world consider artificial sweeteners safe for human consumption.
But scientific evidence is still in progress. And the use of artificial sweeteners remains controversial.
Think of it like this: Smoking cigarettes is legal for adults, but that doesn’t mean smoking is good for you. The same is true of artificial sweeteners. Sure, they’re allowed, but that doesn’t make them a healthy choice.
The addicting science behind artificial sweeteners
You probably know sugar and sweet foods should be eaten in moderation. There’s a reason they’re at the top of that food pyramid they showed you in elementary school.
Nutritionally, sugar doesn’t have much to offer you in terms of your health. There aren’t any nutrients in it. No vitamins. No protein. None of the good things that keep your body functioning at its best.
What sugar does have going for it is that it lights up your nervous system. Eating sugar releases dopamine in your body. That’s the feel-good chemical that brings on pleasure. It’s the same chemical that’s released when people who smoke light up or when people with substance use disorder take their drug of choice.
“Sugar is absolutely addicting,” Dr. Young states. “In addition to stimulating the areas of the brain related to addiction, eating sugar drives your blood sugar up. That’s followed by a blood sugar drop. And then you crave more sugar and carbohydrates. Over and over and over again. It’s a rollercoaster.”
Artificial sweeteners also give you that sweet taste your body is wired to crave. The issue is that artificial sweeteners can be up to 700 times sweeter than sugar. The result is that they completely bombard your nervous system with that dopamine-releasing sweetness.
If eating sugar sets off a firework in your brain, artificial sweeteners light up your system like closing time at Disney World. Confetti is flying. The music is blasting. Love is in the air.
But soon, the excitement quiets down. And your brain wants that feeling back. So, you reach for more artificially sweetened foods. And you don’t worry about it all that much because — hey, it’s low-calorie, right?
“When you’re consuming artificial sweetener, your body starts to crave more of it. And it can be easier to give in to that craving because you think you’re making a healthier choice,” Dr. Young explains. “You wind up consuming more calories. That mindset and that sweetness addiction lead to effects throughout your body.”
Effects of artificial sweeteners
Again, both artificial sweeteners and regular sugar are addictive. But the research shows that long-term use of artificial sweeteners may be particularly detrimental to your body.
Early research suggested there was a connection between cancer and artificial sugar. Dr. Young says that connection hasn’t been definitively proven. But research has shown that consuming artificial sweeteners is linked to a range of other health conditions, including:
- Metabolic syndrome.
- Type 2 diabetes.
- Heart disease.
Dr. Young shares a little insight into some of the most common sugar substitutes and their effects on your health.
Aspartame vs. sugar
Aspartame (Equal) is one of the most common kinds of artificial sweeteners. It’s often found in diet soda, light yogurt, sugar-free desserts and more. You may recognize it as the sweetener in the blue packet.
But some research shows a connection between aspartame and health conditions like:
- Early menstruation.
- Mood disorders.
- Mental stress.
- Autism (when consumed during pregnancy).
Researchers note, however, that more research is needed. Additional studies can help prove whether aspartame causes these conditions or is just associated with their development.
What is known for sure is that people who have phenylketonuria should avoid aspartame. Phenylketonuria is a genetic condition that causes a buildup of the amino acid phenylalanine. Use of aspartame can increase phenylalanine. That can lead to challenges with cognitive development (intellectual disability).
Dr. Young says aspartame should also be avoided by people who have migraine or seizure disorders, as well as people who are pregnant.
What about Splenda?
Splenda (sucralose) is a little different from other artificial sweeteners. It’s a relative newcomer, created in 1992. While other sweeteners are chemically manufactured, Splenda is derived from sugar. That means it tastes more like regular sugar (though, it’s about 600 times sweeter). It’s commonly found in food items like yogurt, candy and ice cream.
Splenda starts out as sugar but is altered to pass more quickly through your system. That means it doesn’t get stored in your blood and doesn’t affect your blood sugar in the way that sugar does.
But that alteration is what makes Splenda less than ideal, Dr. Young says. To create Splenda, some of the sugar molecules are swapped out for chlorine. And chlorine isn’t something you really want to be consuming regularly.
The sweet taste of natural sugar
When it comes to sugar consumption, the less you eat the better. But for most of us, the problem is with added sugars, not natural sugars.
A lot of fruits are high in natural sugars. That’s what makes things like mangoes, bananas and pineapples taste so sweet. They’re high-glycemic index fruits. So, they’re higher in natural sugars and carbohydrates.
Your body doesn’t process natural sugars as quickly as it does added sugars or artificial sweeteners. So, eating natural sugars doesn’t give you that same rollercoaster effect. Added sugars are digested quickly, so you don’t feel full after eating them. Natural sugars, on the other hand, offer up that bit of sweetness and fiber, which fills up your stomach. And you can enjoy them without them lighting up the centers of your brain that leave you wanting more and more.
So, for most people, natural sugars are a far better alternative to either artificial sweeteners or regular table sugar.
For people living with diabetes or prediabetes, though, you still need to go easy on some natural sugars.
“People who have diabetes need to be careful even with excess consumption of fruits because they can still impact blood sugar,” Dr. Young cautions. “Fruits like berries, green apples and low-starch vegetables are better choices than high-glycemic index foods like tropical fruits.”
Better choices for sweeteners
Natural sugars are a good choice for those moments you need something sweet. There are also some other better-for-you alternatives to sugar and artificial sweeteners that you can try. But remember, all sweeteners should be consumed in small amounts.
Some sugar alternatives that don’t carry the same risks as artificial sweeteners include:
- Blackstrap molasses.
- Maple syrup.
- Coconut sugar.
- Raw honey (never give to infants under 12 months of age due to the risk of infant botulism).
“These are all slightly better alternatives, but that doesn’t give us license to overconsume,” Dr. Young states.
How to cut back on sugar and artificial sweeteners
If you’re ready to hop off the sugar rollercoaster, start by limiting packaged foods. Food labeled as “low calorie,” “no calories,” “low sugar” and “no sugar added” could be a warning that they contain artificial sweeteners.
Even foods you may not think of as “sweet” can contain a lot of sugar or sugar alternatives. That includes foods like:
- Salad dressings.
- Pasta sauce.
Reading your foods’ nutrition labels can help. The American Heart Association (AHA) recommends men and people assigned male at birth (AMAB) consume no more than 36 grams (9 teaspoons) of added sugar per day. Women and people assigned female at birth (AFAB) should get no more than 25 grams (6 teaspoons) of added sugar each day.
These are general recommendations. It’s important to note that this may likely be too much added sugar for people with insulin resistance, prediabetes or diabetes.
“Sweet and sugary foods should be a once-in-a-while thing,” Dr. Young says. “No artificial sweetener can turn an unhealthy food into a healthy one. Swapping out sugar for artificial sweetener isn’t going to give you the health benefits you’re looking for, and may prove to be dangerous to your long-term health.”