Why This Dietitian Would Tell You to Skip Artificial Sweeteners

A registered dietitian offers her opinion on why she limits non nutritive sweeteners.

As a dietitian, I take a relatively unrestrictive approach to food. I firmly believe food should be simple and enjoyable; there is a place for almost anything in our diets if they make our bodies feel good (this can be physically or emotionally). That being said, if there was one “food” I would ever pick to demonize in any way, it would probably be sugar substitutes, or non-nutritive sweeteners as they are known in the science world.

Editor’s note: The content on BarBend is meant to be informative in nature, but it shouldn’t take the place of advice and/or supervision from a medical professional. The opinions and articles on this site are not intended for use as diagnosis, prevention, and/or treatment of health problems. Speak with your physician if you have any concerns.

artificial sweeteners jar
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What Are Non-Nutritive Sweeteners?

When I say non-nutritive sweeteners (NNS), I am referring to those colorful packets that give our coffee an insane amount of sweetness for virtually no calories. What happens is that the human body is not able to fully digest and absorb these compounds. Without digestion, there is no absorption, so these sweeteners provide a sweet, sugary taste without the calories from regular sugar.(1) Sounds like a sweet (pun definitely intended) deal right? Keep reading…

Where Are They Found?

There are many varieties of NNS on the market. The main issue is that NNS are no longer limited to our morning coffee. Today, NNS use is widespread throughout the food AND beverage supply. A U.S. study done in 2016 found that one-fourth of children and almost half of adults report using NNS at least once daily.(2) They are hidden in just about any product that is labeled as “sugar-free” or “lite”. Given the high rates of exposure, it is really important to understand how these sweeteners can affect us.

diet coke
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What Are the Potential Problems With Artificial Sweeteners?

As NNS use has become more widespread, the body of research on their effects is growing. As a result, many health professionals are now urging clients to steer clear of the colorful packets. One of the main causes for concern is the way these compounds can affect our gut microbiota. A 2018 study published in Inflammatory Bowel Diseases found that use of Splenda actually promoted gut dysbiosis in healthy mice and increased inflammatory markers in mice with Crohn’s disease.(3) Another 2014 study showed that 11 weeks of NNS supplementation in mice led to glucose intolerance (a precursor to diabetes) due to changes in the gut bacteria.(4) It is widely accepted by all researchers that a healthy gut makes for a healthy body, so the damage these compounds may be causing to our GI systems is something to be wary of.

[Learn more: The Surprising Benefits of Probiotics for Athletes.]

Another concern is the way these NNS may affect our appetites after their consumption. There have been many studies that suggest exposure to a strong sweet taste without absorbing any actual calories leaves us with bigger appetites and increases our consumption later in the day.(5)(6)(7) So while you may be saving some calories now, researchers think you may actually compensate, and even overcompensate, for the deficit later.

Along with increased appetite, there is the belief that constant exposure to intensely sweet foods de-sensitizes our perception of sweet. For instance, if you drink a lot of NNS sweetened beverages (i.e. Diet Coke), you may no longer feel like a mango is very sweet. Whereas on the other hand, if you aren’t exposed to so much sweetness, you may actually be able to get your sweet fix from a date rather than a Reese’s.

splenda
Iryna Imago/Shutterstock

Are Artificial Sweeteners Better for Weight Loss?

While some studies show that in the short term, NNS can be beneficial for weight management (simple calorie reduction), there is a plethora of research that shows consistently that those who consume more NNS have higher body weights.(8) While these are mostly correlation studies and therefore they cannot prove causation, it is something to look at. The higher body weights in the NNS users cannot be ignored, and may be due to one of the aforementioned issues with NNS.

There was even a statement released by the American Heart Association and the American Diabetes Association where both organizations stated “‘at this time, there are insufficient data to determine conclusively whether the use of NNS to displace caloric sweeteners in beverages and foods reduces added sugars or carbohydrate intake, or benefits appetite, energy balance, body weight, or cardio-metabolic risk factors.”(9)

stevia leaf
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Are Some Artificial Sweeteners Better Than Others?

I say you are best going with something like a stevia or monk fruit extract. Stevia comes from an ultra-sweet leaf and monk fruit (or luo han guo) comes from a small gourd, meaning they are both naturally occurring. Just be wary of the stevia or monk fruit you buy — many brands mix them with sugar alcohols (anything that ends in -ol like xylitol), which can sometimes cause stomach aches, though this isn’t a universal experience.

I prefer a liquid stevia, as usually there is the least processing done and no additives compared to the powder forms (think of it like you are squeezing the leaf and taking the liquid that comes out). Additional bonus: there are studies that show stevia actually can be good for weight management and does not induce hunger the way other NNS do.(10)(11)(12)

mangoes
sta/Shutterstock

The Main Goal Should Be to Reduce the Sugar, Not Replace It

In an ideal world, we would all train our taste buds to prefer fewer sweet things. Studies suggest that by limiting the amount of exposure you have to ultra-sweet foods, the less you crave them. One 2016 study published in the American Journal of Clinical Nutrition found that following a low sugar diet for just four weeks can increase perceived sweetness.(13) Making small changes in the amount of sweetener you use is the best way to ultimately reduce your intake without leaving you feeling deprived.

As always with nutrition research, we must take this all with a grain of salt. Some of these are rodent studies, and no, we are not mice. Some are correlational studies, which cannot prove causation. Some exposure studies tend to amp the dosage higher than a typical human would eat.

Additionally, there are always going to be human factors that we cannot control for. For instance, maybe those who are overweight are using more NNS because they are trying to lose weight? Just like the chicken or the egg, without causation we truly don’t know.

My thought process on NNS is the same as all foods. Let’s stick to the real stuff (vegetables, legumes, nuts, fruits) that we know is good for us most of the time. Regardless of what study comes out, I promise you that any food that has been processed or altered will never be as healthy as a food in its natural form.

“Taken as a whole, current evidence suggests that a focus on reducing sweetener intake, whether the sweeteners are caloric or non-caloric, remains a better strategy for combating overweight and obesity than use of artificial sweeteners.” – Swithers, 2015

Editor’s note: This article is an op-ed. The views expressed herein and in the video are the author’s and don’t necessarily reflect the views of BarBend. Claims, assertions, opinions, and quotes have been sourced exclusively by the author.

Featured image via melissamn/Shutterstock

References

1. Nutritive and Nonnutritive Sweetener Resources. United States Department of Agriculture. https://www.nal.usda.gov/fnic/nutritive-and-nonnutritive-sweetener-resources. Accessed September 9, 2018.
2. Sylvetsky AC, Jin Y, Clark EJ, Welsh JA, Rother KI, Talegawkar SA. Consumption of Low-Calorie Sweeteners among Children and Adults in the United States. J Acad Nutr Diet. 2017;117(3).
3. Rodriguez-Palacios A, et al. The Artificial Sweetener Splenda Promotes Gut Proteobacteria, Dysbiosis, and Myeloperoxidase Reactivity in Crohn’s Disease-Like Ileitis. Inflamm Bowel Dis. 2018 Apr 23;24(5):1005-1020.
4. Suez J, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014 Oct 9;514(7521):181-6.
5. Rogers PJ, et al. Uncoupling sweet taste and calories: comparison of the effects of glucose and three intense sweeteners on hunger and food intake. Physiol Behav. 1988;43(5):547-52.
6. Tordoff MG, et al. Oral stimulation with aspartame increases hunger. Physiol Behav. 1990 Mar;47(3):555-9.
7. Rogers PJ, et al. Uncoupling sweet taste and calories: comparison of the effects of glucose and three intense sweeteners on hunger and food intake. Physiol Behav. 1988;43(5):547-52.
8. Sylvetsky AC, Rother KI. Nonnutritive sweeteners in weight management and chronic disease: a review. Obesity. 2018;26(4):635-640.
9. Gardner C, et al. Nonnutritive sweeteners: current use and health perspectives: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care. 2012 Aug;35(8):1798-808.
10. Ahmad U, et al. Antihyperlipidemic efficacy of aqueous extract of Stevia rebaudiana Bertoni in albino rats. Lipids Health Dis. 2018 Jul 27;17(1):175.
11. Ferrazzano GF, et al. Is Stevia rebaudiana Bertoni a Non Cariogenic Sweetener? A Review. Molecules. 2015 Dec 26;21(1):E38.
12. Saad A et al. A Review on Potential Toxicity of Artificial Sweeteners vs Safety of Stevia: A Natural Bio-Sweetener. Journal of Biology, Agriculture and Healthcare. 2014:4(15):137-147.
13. Wise PM, et al. Reduced dietary intake of simple sugars alters perceived sweet taste intensity but not perceived pleasantness. Am J Clin Nutr. 2016 Jan;103(1):50-60.

Marissa Meshulam, MS, RD

Marissa Meshulam, MS, RD

Marissa Meshulam is a Registered Dietitian Nutritionist currently living and working in NYC. Born and raised in Chicago, IL, Marissa moved to NYC in 2018 to finish school to become an RD. She has a BS in Nutrition and Dietetics from the University of Wisconsin and a Masters of Science in Clinical Nutrition from New York University.

While completing her dietetic internship at the Bronx VA Hospital, Marissa saw firsthand how a lack of proper nutrition can lead to chronic disease. During her year at the VA, her interest in using food as prevention grew. Marissa's true passion lies in incorporating healthy foods earlier on as a means of avoiding certain diseases.

Her food philosophy is simple and inclusive.

Instead of categorizing foods as “good” or “bad” and spending time talking about foods we shouldn’t eat, she works with clients to help them eat more real, whole foods that fit their preferences. She avoids “miracle foods”, and emphasizes eating more real foods that are nourishing and enjoyable. "After all, life is complicated, but food does not have to be."

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