Sugar-free sweeteners in food and drinks: How does it affect consumers’ health?

January 13, 2023

By Shraddha Parakh

Sweeteners impart a strong sweet flavor. They are becoming increasingly popular as individuals seek alternative ways to fulfill their sweet desire. The World Health Organization recommends that free sugars account for no more than 10% of total energy consumption. This is approximately 51g, or 13 teaspoons, for an adult consuming 8700 kJ daily on average.

The majority of sugar comes from energy-dense, nutrient-deficient discretionary foods, and drinks. Sugar is connected to a variety of potential poor health outcomes, including weight gain, dental cavities, type 2 diabetes, and maybe even depression. Because drinks account for over half of our added sugar intake, limiting our consumption is important. The reason for starting with beverages is that the body does not sense any fullness from sugary drinks, thus people do not eat less of something else when they consume them. For example, if you consume an extra slice of bread, you’re more inclined to eat less of anything else.

Artificial sweeteners

Artificial sweeteners, also known as non-nutritive sweeteners, are chemical additives that are sweeter than sugar but contain zero calories. Acesulphame K (additive number 950), Alitame (956), Aspartamine (951), Cyclamate (952), Neotame (961), Saccharin (954), and Sucralose (955) are the most widely used artificial sweeteners. Other forms of sweeteners include nutritive sweeteners, which have less energy than sugar but are not calorie-free, and natural sweeteners like Stevia, which is derived from a plant and has no energy.

Sweeteners are used to reduce the sugar content and lower the energy content of the food. They can help to reduce tooth decay and to manage energy and sugar intake. Food manufacturers utilize these sweeteners to make diet drinks, baked products, frozen desserts, candy, light yogurt, and chewing gum.

Benefits of Artificial sweeteners

Artificial sweeteners can help people fulfill a sweet taste without adding extra calories. There is no evidence that consuming artificial sweeteners causes a sweet craving or increases the intake of sweet foods. Chewing gum and candies with low- or no-calorie artificial sweeteners between food is also better for your teeth. Diet cordials and fizzy drinks have a substantially lower energy value than their sweetened counterparts, making them ideal for those who want to reduce their sugar intake. But the usage of artificial sweeteners has become controversial due to the negative health impacts observed by the people who consume them.

Impact of artificial sweeteners on the body

The harmful influence of sugar-sweetened beverages on weight and other health outcomes has become more acknowledged; as a result, many people have resorted to high-intensity sweeteners such as aspartame, sucralose, and saccharin to lower the risk of these repercussions. However, mounting research indicates that regular users of these sugar substitutes may also be at higher risk for uncontrollable weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease.

Cancer: The usage of artificial sweeteners is increasing. Since the discovery of the first artificial sweetener, saccharin, in 1879, artificial sweeteners have been fraught with controversy. Research has been conducted on Aspartame which is 200 times sweeter than sugar has been accused of having a variety of health problems ranging from nausea and dizziness to cancer and multiple sclerosis. While some studies have connected artificial sweeteners to cancer, many more have concluded that they are safe. For some people, aspartame may cause migraines and headaches. In our bodies, aspartame is broken down into aspartic acid, phenylalanine, and methanol. One common misconception regarding aspartame is that it produces methanol poisoning, which mimics multiple sclerosis.

Blood sugar levels: Unlike sugar, artificial sweeteners do not raise blood sugar levels in the short term. Regular usage of artificial sweeteners may have long-term negative effects on blood sugar control. A study discovered that taking sucralose and carbohydrate at the same time modifies the way the brain responds to glucose and can result in high blood sugar, which raises the risk of diabetes. Sucralose combined with carbohydrates may affect the gut-brain connection that regulates glucose metabolism.

Eating disorder and obesity: People with eating disorders occasionally use a lot of diet goods to cut back on their caloric intake or to add bulk to their diets without adding any more calories. Our brains, stomach microbes, and pancreas handle artificial and natural sugars differently, which can cause us to overeat, gain weight, and have difficulty digesting the natural sugars that our systems require. Artificial sweeteners should be used sparingly since they trick our minds and bodies into thinking they are treats, which can have negative health consequences.

The diet trap and obesity: Some people mistakenly believe that using artificial sweeteners helps them lose weight. These sweeteners can help replace the energy content of sugar and sweet foods, but they can’t help you lose weight. Using an artificial sweetener alone will not result in weight loss or prevent weight gain. Remember ‘sugar-free’ does not translate into ‘take a larger amount’, ‘have an extra scoop’, or ‘eat as much as you like’. Using an artificial sweetener may be part of your weight loss approach, but so are physical activity, energy balance, portion control, and healthy food choices. sweeteners encourage weight gain. Frequent ingestion of non-caloric, low-energy sweeteners triggers the body’s response to consuming more calories or energy, promoting weight gain. Artificial or non-caloric sweeteners have been demonstrated to disrupt the body’s metabolism by disrupting the relationship between calorie intake and glucose and energy balance.

Type 2 Diabetes: The use of artificially sweetened beverages raises the risk of developing type 2 diabetes. Non-caloric artificial sweeteners have been demonstrated to influence gut microorganisms, influencing their metabolism. The bacteria’s altered metabolism causes glucose intolerance. Glucose intolerance can progress to metabolic syndrome, which includes type 2 diabetes.

Anxiety: As a result of the widespread advertising for artificial sweeteners as an element that can be added to foods and beverages without having to worry about the negative effects of sugar on your health, people frequently turn to them. However, sugary drinks make us uneasy. Anxiety was induced in mice by administering only 15% of the FDA’s maximum recommended dose, however, mice exhibited significant anxious behavior. Not just the aspartame-consuming mice exhibited anxiety-like behavior but the effects were also seen in two generations of males exposed to the artificial sweetener.

Other effects: Saccharin, sucralose, and aspartame can make normal and healthy gut microbes pathogenic. These pathogenic modifications include increased biofilm development as well as increased bacterial adherence and penetration into human gastrointestinal cells.

According to the study, sucralose and aspartame make the bacteria in our stomachs bind to and kill the cells that line the intestinal wall, which allows some of the bacteria like E. faecalis to congregate in the lymph nodes, liver, and spleen, causing a multitude of diseases, including septicemia. All three sweeteners can attach to each other generating a biofilm,  making them less susceptible to antimicrobial resistance treatment and are more likely to produce toxins. These changes could result in our own gut bacteria invading and damaging our intestines, which can lead to infection, sepsis, and multiple-organ failure.

Sugar alcohol consumption is known to have a laxative effect and, in rare situations, to cause diarrhea. Excessive consumption of sweets, mints, or gum, along with various alternative sweeteners, might result in gastrointestinal discomforts such as bloating, increased wind, or diarrhea.  

What is phenylketonuria?

Any sweeteners used in a product must be declared on the food label. Labeling is especially crucial for persons who have the rare genetic illness Phenylketonuria (PKU).  You may have noticed the “Contains phenylalanine” warning on aspartame-containing foods and beverages. Phenylketonuria is an uncommon hereditary condition in which the body is unable to break down the necessary amino acid phenylalanine.  Phenylalanine accumulates in the tissues of patients with PKU, causing irreparable brain damage. At birth, we are all checked for this condition. People with PKU must adhere to a stringent phenylalanine-restricted diet, particularly during their childhood and adolescence.

Alternatives to sugar and artificial sweeteners

  1. Nutritive sweeteners: Nutritive sweeteners are based on several types of carbohydrates and are commonly classified as modified carbs. Nutritive sweeteners have fewer kilojoules than sugar, although they are not fully free of kilojoules. Sugar alcohols such as xylitol (additive number 967), sorbitol (420), mannitol (421), and erythritol are examples (968). Because they are difficult to digest, they have a lower influence on blood sugar than regular sugar, but eating too much might produce flatulence and diarrhea. Because they do not react with oral germs to build plaque and cavities, they are better for your teeth than sugar.
  2. Natural sweeteners: Natural’ sweeteners like stevia and monk fruit are gaining popularity, most likely as a result of public distrust of artificial sweeteners. Stevia is 250 to 300 times sweeter than sugar, but it has no negative effects on blood sugar levels and may even assist them in control. But, even if they come from natural sources, they might be hazardous. they aren’t always as natural as they appear. Stevia is added to food as refined steviol glycosides, so it’s not completely natural.

Acceptable daily intake (ADI)

The acceptable daily intake (ADI) is an estimate of the quantity that might be consumed every day for the rest of one’s life without causing harm.

SweetenerADI MG/KG body weight per day
Saccharin5 mg/kg of body weight
Aspartame50 mg/kg of body weight
Acesulphame K15 mg/kg of body weight
Sucralose15 mg/kg of body weight
Cyclamate7 mg/kg of body weight
Stevia4 mg/kg of body weight


Artificial sweeteners may provide temporary solutions to reduce their sugar intake and manage weight loss.  However, you should be mindful of how it affects your food and beverage choices. Consuming artificial sweeteners can be delightful, but doing so in excess is risky due to variations in how our brains and bodies process these two chemicals. Artificial sugar consumption impairs the body’s ability to digest real sugar via changes in gut bacteria and insulin levels. This can result in unfavorable health effects such as type 2 diabetes, while also making people crave more sugar, want to eat more food, and potentially acquire more weight. Artificial sweeteners, like so many other things in life, are not without their benefits, but they must be consumed in moderation.

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