What’s the Truth about Artificial Sweeteners When It Comes to Health?

Are artificial sweeteners actually a safe sugar substitute?

By Roberta H. Anding, MS, Baylor College of Medicine and Texas Children’s Hospital

If a soda is sugar-free, you can drink it all day, just like water—right? On the other end of the spectrum are those who believe that artificial sweeteners, most notably aspartame, should be avoided like the plague. According to Professor Anding, the truth lies somewhere in the middle.

Pouring sugar from soda can
The controversy about artificial sugar substitutes in diet sodas is whether or not they are safe and won’t harm your health. Photo by Evan Lorne / Shutterstock

What Are Sugar Substitutes?

Although carbohydrates are not inherently bad for you and are in fact an essential part of a balanced diet, nutritionists recommend minimizing your consumption of simple carbs—particularly sugar—as they can spike up your glucose levels and lead to obesity and chronic health issues such as diabetes. Most people now recognize that sugar is unhealthy, but they see sugar substitutes as a healthier alternative. 

Common sugar substitutes, or artificial sweeteners, include Splenda®, sucralose, and Equal® and NutraSweet® (which both contain aspartame), and also Sweet’N Low®, which contains saccharine. The compounds in artificial sweeteners have been studied more extensively than other foods we routinely consume. 

When it comes to risks associated with sugar substitutes, you may have a personal allergic response or get headaches, but in general, they are deemed safe. However, there are exceptions. 

Risks with Artificial Sweeteners

Research suggests that young children and pregnant women should avoid artificially sweetened beverages. One Norwegian study involving over 60,000 pregnant women found that women who consumed drinks containing sugar substitutes were 11% more likely to have a preterm delivery. 

A related controversial topic is diet soda and whether or not it’s deleterious to your health. Some studies have shown that drinking soft drinks increases the hunger hormone ghrelin, which in turn leads to overeating and obesity. Other studies have shown no connection between artificial sweeteners and appetite or insulin and glucose levels.

When it comes to overall health, studies have found correlations between artificially sweetened drinks and diabetes, heart disease, kidney disease, and depression. Again, though, findings are mixed.

Some scientists believe that people who drink diet sodas often have other unhealthy habits which negatively impact their overall health. On the other hand, studies which show that artificial sweeteners have no negative impact on health can also be suspect, as these studies are often industry funded. 

Research has shown that the actual ingredients in these sweeteners can sometimes affect your health. For example, acids such as citric and malic acid in diet sodas can cause tooth decay.

Better Than Regular Soda?

Overall, research shows that it is still better to drink artificially sweetened drinks than those containing real sugar. According to one study, although women who drank diet soda were more likely to develop type 2 diabetes than those who did not drink soda, they still had approximately half the risk as those who drank regular soda.

“I probably would encourage you to be optimally hydrated to stick with plain water, but knowing that’s not realistic for most of us, I think diet sodas in moderation can be a nice substitute,” Professor Anding said. “But considering Americans really struggle with moderation, what is moderation?”

Moderation, according to Professor Anding, is no more than two diet soft drinks per day. Thus, if you’re drinking six or seven sodas a day, you should consider cutting back.

The bottom line is that sugar substitutes may be the lesser of two evils, but the best option is to drink only water and avoid products with added sugar (or artificial sweeteners) when possible. If you’re craving sweets, have a piece of fruit instead, which is not only healthier but more likely to satisfy you in the long run.

This article was edited by Kate Findley, Writer for Wondrium Daily, and proofread by Angela Shoemaker, Proofreader and Copy Editor for Wondrium Daily.

Professor Roberta H. Anding is a registered dietitian and Director of Sports Nutrition and a clinical dietitian at Baylor College of Medicine and Texas Children’s Hospital. She also teaches and lectures in the Baylor College of Medicine’s Department of Pediatrics, Section of Adolescent Medicine and Sports Medicine, and in the Department of Kinesiology at Rice University.