What you need to know about sugar substitutes?

It turns out that those cute little blue, yellow and pink* packets aren’t very cute, but the good news is that consumers today have several safe choices.

Aspartame (Equal®, NutraSweet®) is a synthetic sweetener with a controversial past steeped in politics and payoffs.  Numerous reports by scientists who are not affiliated with the manufacturer indicate that aspartame is associated with many unwanted effects.   

“Aspartame, an artificial sweetener, has been linked to behavioral and cognitive problems.  Possible neurophysiological symptoms include learning problems, headache, seizure, migraines, irritable moods, anxiety, depression, and insomnia.” [Nutritional Neuroscience, June 2018]

A new study looks at the link between artificial sweeteners and cancer.

“In this large cohort study, artificial sweeteners (especially aspartame and acesulfame-K), which are used in many food and beverage brands worldwide, were associated with increased cancer risk.”  [PLoS Med, Mar 2022]

And sucralose (Splenda®) isn’t much better.   One study found that sucralose caused non-alcoholic fatty liver disease.  [J Agric Food Chem, Apr 2021]

*Saccharin was introduced by the Monsanto company in 1902.  It was accepted as safe by the Food and Drug Administration until 1969, the year the NutraSweet company first applied for a patent on aspartame.  After that the FDA listed saccharin as a carcinogen.  [*Source: Dr. Janet Starr Hull, author of Splenda, is it safe or not? and Sweet Poison]

Many of the studies on artificial sweeteners describe how they damage the microbiome (a reference to the trillions of microorganisms that live in the gut and play a vital role in keeping us healthy).  [Nature. Oct 2014, Nat Rev Endocrinol. 2014 Nov, Cell Metab. Nov 2014, Biomedica. Sept 2021]

Damage to the intestine may lead to gluten intolerance, which has become rampant in our society. [Nature. Oct 2014]

But the greatest irony is that the chemical sweeteners that are supposed to help us lose weight appear to do the opposite!  [“Obesity has been associated with changes in the gut microbiota” 

J Obes. 2019 Oct]

What are those safe choices?

There are several sugar-free sweeteners that are proving to be popular with both dentists and dieters. 

The first are called “sugar alcohols” – which get their name from their chemical structure, not from any connection with alcoholic drinks.  The sugar alcohols sorbitol, mannitol and xylitol have been used for many years and while a small amount is unlikely to cause problems, too much can lead to gastrointestinal problems.  (Prune juice gets its laxative quality from naturally occurring sorbitol.) 


A promising sugar alcohol is erythritol, which was discovered over a hundred years ago, but did not come into use for many years.  A new sweetener on the market is allulose.  Although it has not been studied as much as other sugar alcohols, it appears to be well tolerated, although it’s best to not overdo any sugar alcohol.


Stevia has long been a favorite with health-conscious people, and for many years the Food and Drug Administration tried to prevent access to it.  But the agency’s objections appear to have evaporated once the cola giants came out with stevia sweetened drinks.


Monk fruit might be the most exciting newcomer.  It is derived from a small melon-type fruit that grows in southern China and derives its name from the fact that it was once raised by monks.  Since it’s expensive monk fruit is typically combined with the more economical erythritol.  The blend looks and tastes like sugar and can be used as a tabletop sweetener and in baking.


There are now many good tasting zero (or near zero) calorie sweeteners; you can find them in supermarkets and online.