Are artificial sweeteners bad for you?

A friend and I were discussing the documentary That Sugar Film the other day and she asked me about the claim in the movie that artificial sweeteners were bad for you, too, because they actually made you eat more.

I couldn’t recall exactly what was said in the film, but decided to do a little research on my own to answer her question.

The FDA-approved artificial sweeteners are saccharin (Sweet ‘N Low), aspartame (Equal, Nutrasweet), neotame, sucralose (Splenda), acesulfame K (Sweet One) and stevia (Truvia).

Because they are “low-energy” sweeteners and don’t contain any calories, it seems a no brainer that it’s better to have a beverage or a snack made with one of these instead of sugar.

There are a few problems with that assumption, however. In a post on the topic, the Science-Based Medicine blog says:

The human body, however, is a complex system, as is human psychology, and so we have to consider the law of unintended consequences. It is possible, for example, that when people drink a diet beverage they feel they have earned the right to consume more calories elsewhere. This phenomenon is called compensation, and there is evidence for this effect.

In other words, you might think that because you are having a diet soda, you can eat more cake.

It is also possible that consuming a food or beverage that tastes sweet but contains no or few calories will trick or confuse the brain, separating the sensation of sweetness with the ingestion of calories. This may lead to a craving for more calories. There are also studies showing the existence of sweet receptors in the GI tract, and activating these receptors may stimulate appetite.

The artificial sweeteners are at least hundreds, and sometimes thousands of times sweeter than regular sugar. One theory is that when we taste “sweet” our brain signals the release of insulin to deal with what it thinks is sugar. But the insulin can’t find the sugar, so sends a signal back to the brain: “Eat the whole cake!”

Or that the hyper-sweetness dulls our taste for less sweet (that is healthy) foods, so we only want to eat cake and nothing else.

BUT, the author of the post also looks at the results of several research studies on calorie intake, weight loss, and the use of artificial sweeteners. He concluded that artificial sweeteners do help with weight loss.

In this case, despite confusing results from many types of studies, the best evidence consistently indicates that consuming LES [low-energy sweetener] results in reduced energy intake and reduced weight compared to either consuming sugar-sweetened beverages or even water. There does appear to be room for further rigorous studies, but this is the best conclusion we can currently make based upon all the evidence, and it is fairly consistent and robust.

By common sense, I mean that drinking multiple bottles or cans of diet soft drinks (or anything) every day is not healthy. Everything in moderation, right?

Related post from Science-Based Medicine: Artificial sweeteners: Is aspartame safe?

I also found a recent article in the New York Times by pediatrician Aaron Carroll, MD. He blogs on The Incidental Economist, and I always appreciate his well-researched opinions on these types of topics.

He focuses on the fears that artificial sweeteners have been linked to cancer, attention deficit disorder and other neurological problems.

In the 1980s saccharin was suspected of causing cancer, but further research did not prove this link. Saccharin is now considered safe.

As for aspartame, Dr. Carroll writes:

A 1998 randomized controlled trial could detect no neuropsychologic, neurophysiologic or behavioral effects caused by aspartame. Even a dose at 10 times the normal consumption had no effect on children with attention deficit disorder.

Note: People with the enzyme disorder PKU—phenylketonuria—should not use aspartame. There is a warning on the label.

Dr. Carroll believes the obesity and type-2 diabetes epidemics, especially in children, are major health concerns. If moderate use of artificial sweeteners helps us eat less sugar, he’s in favor of it.

When I argue these facts with my friends, they want to know if I put my money where my mouth is. I do. My wife and I limit our children’s consumption of soda to around four to five times a week. When we let them have soda, it’s almost always caffeine-free, because we want them to sleep. It’s also almost always sugar-free. There’s a potential, and probably real, harm from consuming added sugars; there are most likely none from artificial sweeteners.

In 2012, the American Heart Association (AHA) and the American Diabetes Association (ADA) published a joint statement that non-nutritive sweeteners (NNS) were probably beneficial. Like Dr. Carroll, these groups believe the risks of obesity, diabetes and heart disease outweigh any small risks associated with artificial sweeteners.

“While they are not magic bullets, smart use of non-nutritive sweeteners could help you reduce added sugars in your diet, therefore lowering the number of calories you eat. Reducing calories could help you attain and maintain a healthy body weight, and thereby lower your risk of heart disease and diabetes,” said Christopher Gardner, Ph.D., associate professor of medicine at Stanford University in California.

BUT—

Strategies for reducing calories and added sugars also involves choosing foods which have no added sugars or non-nutritive sweeteners – such as vegetables, fruits, high-fiber whole grains, and non or low-fat dairy,” Gardner said.

So what will I tell my friend?

Used in moderation, artificial sweeteners are okay.

The healthiest diet, however, is one that avoids—at least more often than not—added sugars or artificial sweeteners.

Sláinte,

Frugal Nurse

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