You hear and see media headlines galore about how sugar substitutes may impact your health or weight loss efforts, ranging from eyebrow-raising to nerve-calming. As a dietitian with a long term interest and extensive expertise in the research and practical use of low-calorie sweeteners, it’s critically important to me that you are informed accurately on this topic. Let’s get to what I consider the 7 Need-to-Knows about Sugar Substitutes.
1. No two sugar substitutes are identical. Though they’re often grouped as sugar substitutes because they all sweeten foods, each sugar substitute is different. Each is unique in what it’s made from and how it’s made. This is particularly important to remember when you read headlines. Read closely. You’ll see some studies that include all of the low-calorie sweeteners, while others focus on just one. For more, read Sucralose, Stevia, Aspartame, What’s the Difference?
2. Sugar Substitutes can help you eat less added sugars. The advice to lighten up on added sugars is louder and clearer than ever. It’s in the 2015–2020 Dietary Guidelines for Americans 1 with the relationship stronger than ever about the detrimental effects on health of consuming too much added sugars. The American Heart Association advises consumers to eat no more than 9 teaspoons of added sugars per day for men, and no more than 6 teaspoons for women.2 (Americans, on average, eat about 270 calories, that’s 13 percent of our calories, from added sugars a day, or the equivalent of 17 teaspoons of sugar.)1
You can cut down on the amount of added sugars you eat with these actions: Use the sugar substitute you prefer to sweeten hot or cold drinks. Buy beverages sweetened with a low-calorie sweetener instead of a calorie-containing sweetener. Cook and bake with a sugar substitute that doesn’t lose its sweet taste if it’s heated. Learn to use sugar substitutes in food preparation, beverages, and cooking and baking with the help of tested recipes, such as recipes using SPLENDA® Sweetener Products. More info: How to Eat Less Added Sugar and Not Miss It.
3. Sugar substitutes can help you lose weight and keep it off. The overwhelming conclusion is that using sugar substitutes and products sweetened with them can help you eat fewer calories and in turn with weight loss and keeping pounds off. But they’re not a magic bullet for shedding pounds. Sugar substitutes can be part of a healthy lifestyle that includes careful calorie counting, selecting healthier foods, slowly changing eating habits and getting enough physical activity. Lower the amount of calories and added sugars you eat by using sugar substitutes in place of sugar in hot or cold beverages; use diet drinks instead of regularly sweetened ones, and replace sugar in cooking and baking. For more, read Dear Dietitian – Will Artificial Sweeteners Cause Me to Gain Weight? and Can Low-Calorie Sweeteners like SPLENDA® Brand Sweetener Help You Lose Weight? Facts vs. Fiction.
Since weight control is increasingly important for so many, the use of sugar alternatives are one good way to reduce calories and the amount of added sugars you eat, to make room for healthier nutrient-packed foods and beverages. Specific to children, the American Academy of Pediatrics (AAP) concludes that low-calorie sweeteners have, over time, been shown to have a good safety record, and notes that all approved no-calorie sweeteners are deemed safe by FDA. AAP adds that the use of sugar substitutes could be a tool to replace added sugar and help lower caloric intake.3
4. Sugar substitutes do not cause an increase in appetite, hunger or sugar cravings. Indeed, studies show that sugar substitutes do not affect appetite and they may even help people be more satisfied with healthier food choices, also referred to as a healthy dietary pattern.4,5 A 2015 research review drew three conclusions: 1) there was no consistent relationship to demonstrate a heightened appetite for sweet foods with the use of sugar substitutes, 2) some research shows that the use of sugar substitutes and products sweetened with them is associated with eating fewer sweets, and 3) studies in children and adults show the use of sugar substitutes can help people reduce the calorie-containing sweeteners they eat and support weight loss.5 For more details, read Drinking Beverages Sweetened with Low-Calorie Sweeteners, like SPLENDA® Sweeteners, is Associated with Healthier Diets.
5. Sugar substitutes don’t cause cancer. Safety studies required by the Food and Drug Administration (FDA) and other global regulatory agencies show that low-calorie sweeteners do not cause or promote cancer. Even though sugar substitute use has increased in the last several decades, no increase in cancer rates can be attributed to any low-calorie sweetener. Two credible U.S. health organizations have reached this conclusion. The National Institutes of Health’s National Cancer Institute concludes: “There’s no evidence that they [sugar substitutes] cause cancer in humans.”6 The American Cancer Society states: “There is no proof that these sweeteners, at the levels consumed in human diets, cause cancer…. Current evidence does not show a link between these compounds and increased cancer risk…” 7 But let’s also be clear that an increased risk of some cancers is associated with being overweight, so steps you take to help you get to and stay at a healthy weight are important for this, and for many other health reasons. For more on this topic, read: Are Sugar Substitutes Dangerous or Are They a Helpful Tool In a Healthy Lifestyle?
6. Sugar substitutes are suitable for use by people with diabetes. Yes, people with diabetes can use FDA-approved sugar substitutes safely as part of their management plan. As part of the FDA review process of each of these ingredients, specific research on the impact of the low-calorie sweetener on glucose control is required. The American Diabetes Association (ADA) has supported FDA’s safety reviews on low-calorie sweeteners and has reiterated this support annually in the ADA standards of medical care. The 2017 standards state, “For people who are accustomed to sugar-sweetened products, nonnutritive sweeteners [sugar substitutes] have the potential to reduce overall calorie and carbohydrate intake and may be preferred to sugar when consumed in moderation. Regulatory agencies set acceptable daily intake levels for each nonnutritive sweetener, defined as the amount that can be safely consumed over a person’s lifetime.” 8
7. Sugar substitutes are generally suitable for use by pregnant women, women who are breast-feeding and children. Yes, all FDA-approved low-calorie sweeteners for sale in the U.S. are safe for individuals in these groups. Research studies have shown that these sugar alternatives are safe for most people. (One exception is with aspartame for people who have phenylketonuria (PKU) because they’re unable to properly metabolize phenylalanine.) The FDA’s scientific review process, as well as that of other regulatory bodies around the globe, includes required studies and scrutiny to determine safety for the general public including pregnant women, breast-feeding women and children. However, it’s always wise to check in with your healthcare providers to get their specific nutrition advice for you and your family.
What’s the Best Sugar Substitute?
Now, armed with accurate science-based knowledge about sugar substitutes is your next question: “what’s the best sugar substitute?” Answer: whichever sugar substitute you like the best for the purpose you intend to use it. You may like the taste of one sugar substitute in your coffee or oatmeal, but you like another in iced tea or lemonade. Or you may like to use a particular sugar substitute for cooking and baking because of how it tastes and the way it performs in recipes. As I’ve said for years, Taste is in the beholder of the taste buds.
I have been compensated for my time by Heartland Food Products Group, the maker of SPLENDA® Sweetener Products. All statements and opinions are my own. I have pledged to Blog with Integrity, asserting that the trust of my readers and the blogging community is vitally important to me.
For more information, visit the Sugar Substitutes section of this blog.
Hope Warshaw, MMSc, RD, CDE, BC-ADM, is a nationally recognized dietitian and diabetes educator who applies more than 35 years of expertise as an author, freelance writer, media spokesperson, consultant and diabetes educator. Hope notes: “Healthy eating today is one tough job! The good news is that simple tweaks in your food choices and how you prepare foods can often set you on a path to healthier eating. Each positive step is a step in the right direction along the path to a long and healthy life.”
- 2015-2020 Dietary Guidelines for Americans, 8th ed. http://health.gov/dietaryguidelines/2015/guidelines
- American Heart Association. Sugar 101. http://www.heart.org/HEARTORG/HealthyLiving/HealthyEating/Nutrition/Sugar-101_UCM_306024_Article.jsp#4_need_to_reduce_added_sugars
- American Academy of Pediatrics Policy Statement. Snacks, Sweetened Beverages, Added Sugars, and Schools. Pediatrics. 2015;135(3):575-583. http://pediatrics.aappublications.org/content/early/2015/02/17/peds.2014-3902.full.pdf+html
- Drewnowski A, Rehm CD. Consumption of LCS Among U.S. Adults is Associated With Higher Healthy Eating Index (HEI 2005) Scores and More Physical Activity. Nutrients. 2014;6:4389-4403. http://www.mdpi.com/2072-6643/6/10/4389/htm
- Bellisle F. Intense Sweeteners, Appetite for the Sweet Taste, and Relationship to Weight Management. Curr Obes Rep. 2015;4:106–110. http://link.springer.com/article/10.1007%2Fs13679-014-0133-8#/page-1
- National Cancer Institute, National Institutes of Health. Do artificial sweeteners cause cancer? https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet
- American Cancer Society: Guidelines on Nutrition and Physical Activity for Cancer Prevention and Physical Activity for Cancer Prevention. http://www.cancer.org/healthy/eathealthygetactive/acsguidelinesonnutritionphysicalactivityforcancerprevention/acs-guidelines-on-nutrition-and-physical-activity-for-cancer-prevention-common-questions
- American Diabetes Association. Lifestyle Management. Diabetes Care 2017;(Supplement 1):S33-S43. https://doi.org/10.2337/dc17-S007