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The Low-Down on Sweeteners

This is probably one of the most common questions I get as a dietitian. “What’s the deal with low/no-calorie sweeteners?” “Do they cause cancer?” “Do they actually cause weight gain?” “Are they harmful in (fill in the blank) ways?” The list goes on and on, and I understand why; because there is SO much information out there, and all of it seems to be contradictory. 

Here is a summary of the information, based on education and experience I’ve had as well as research I’ve done. I’ve included some good references because I think the best way to find out these answers is to read the research and decide for yourself what you think is best for you. However, sometimes legitimate research can be hard to find and decipher from everything out there.  Much of what you read and hear is just personal thoughts and rants. Some stem from truth, some just outright lies. It’s difficult to tell the facts from the myths. So here’s what I have to say about it.  Hopefully you find this to be helpful! 

Alright, so obviously we know sugar adds calories.  The body breaks down sugar into the “sugar” you find in your blood - GLUCOSE. Because there are no vitamins or minerals in sugar it is called an “empty” calorie. That is one of the reasons why it is often the first food to be reduced or eliminated in weight loss . High sugar foods are usually high in calories and simple carbohydrates and can lead to weight gain and some chronic diseases such as diabetes . Therefore, many have turned to no-calorie sweeteners to get that sweet taste we crave without adding those empty calories. 

Thus, the debate ensues. So much research has been done on the safety and effects of these sweeteners and I honestly could write 50 pages worth of information on it; but unless you’re one of my old BYU Dietetics Professors (shout out to Nyland and Fullmer) you probably don’t want to read a research paper. So let’s sum it up as simply as we can, shall we? 

The Academy of Nutrition and Dietetics (AND), the world’s largest organization of food and nutrition professionals uses evidenced based, scientific research to support their guidelines. Their statement on sweeteners is this: 

**Note: NNS (nonnutrative sweeteners) are sweeteners with zero or very few calories (ie. splenda, stevia, aspartame, etc.) “It is the position of the Academy of Nutrition and Dietetics that consumers can safely enjoy a range of nutritive sweeteners and nonnutritive sweeteners (NNS) when consumed within an eating plan that is guided by current federal nutrition recommendations…as well as individual health goals and personal preference. A preference for sweet taste is innate and sweeteners can increase the pleasure of eating. Nutritive sweeteners contain carbohydrate and provide energy. They occur naturally in foods or may be added in food processing or by consumers before consumption. Higher intake of added sugars is associated with higher energy intake and lower diet quality, which can increase the risk for obesity, prediabetes, type 2 diabetes, and cardiovascular disease…NNS are those that sweeten with minimal or no carbohydrate or energy. They are regulated by the Food and Drug Administration as food additives or generally recognized as safe. The Food and Drug Administration approval process includes determination of probable intake, cumulative effect from all uses, and toxicology studies in animals…All NNS approved for use in the United States are determined to be safe.” (1)

When consumed in moderate (10-15 g/day – often listed on the nutrition label as “sugar alcohols”) amounts, sweeteners have not been found to be harmful. For many they are are a good way to cut calories and still stick to a healthy eating plan. 

“Is it true that sweeteners increase your risk of getting cancer?” The National Cancer Institute says this: “There is no clear evidence that the NNS (sweeteners) available commercially in the United States are associated with cancer risk in human beings.” (1)

They are a very credible source, and as such, base their recommendations on the findings of many studies and a great deal of research that has been conducted. “Do sweeteners cause other health issues?” The International Food Information Council made this statement:  “Low-calorie sweeteners are often inaccurately linked to adverse health effects, such as seizures, infertility, stomach ailments, and possible effects on kidney and liver function . However, the existing body of research does not support such effects. Health authorities around the world have verified that low-calorie sweeteners are safe. The following information…(see reference article for information on each specific sweetener)…on each low-calorie sweetener demonstrates that they do not cause or increase risk of these or other health conditions” (2)

“Do sweeteners help you lose weight, or do they actually promote weight gain?” The International Food Information Council states: “…Low-calorie sweeteners provide an alternative to caloric sweeteners and may facilitate weight loss or maintenance by limiting calorie intake. In addition, randomized controlled trials suggest that the use of low-calorie sweeteners may increase adherence to low-calorie diets and improve body weight and weight loss maintenance over time. Because they are not deprived of sweets, individuals consuming low-calorie sweeteners may feel more satisfied with their eating plan, helping them to lose weight and keep it off.” (2)

I’m sure you can tell by now, but thus far the research appears to show that no-calorie/low-calorie sweeteners can aid in weight loss and do not appear to have negative effects on health. However, that being said there are a couple things to consider… Consuming fairly large amounts of sweeteners (>30 g/day) can cause gastrointestinal (GI) issues. The reason sweeteners have no/low calories is because our bodies do not do a good job of digesting and absorbing them. Therefore, they end up in our stool (aka poop!) and we don’t end up absorbing the calories. But this also means increased consumption of sweeteners can lead to increased flatulence (passing gas), borborygmus (stomach gurgling/upset) and deification frequency and loose/water stools (diarrhea). (3) I know, lovely right? But as long as you stick with moderate amounts you should be okay. On that note, each person is different. Some people are allergic to certain sweeteners. Consuming a sweetener you’re allergic to can lead to many different problems from migraines to rashes and/or just general aches and feeling tired. So…pay attention to your body! From what I’ve found, aspartame seems to be the most common sweetener to be allergic to (just FYI). 

Another side note: Anyone with the rare condition PKU (Phenylketonuria) should avoid aspartame because it contains phenylalanine but don’t worry about this otherwise, and don’t worry about having it. If you had it, YOU WOULD KNOW. They check infants for PKU when they are born and these individuals have to follow a very strict diet for life. If you’d like to know more about this disease, just out of pure curiosity check out (4).

Lastly, as a dietitian I am always trying to promote food over supplements and artificial ingredients because I feel strongly that it’s the best way to go. Whole foods. Fresh fruits and veggies, lean meats and whole grains.  Those foods are where I feel the majority of our diet should come from, but I myself often use sweeteners when I’m making foods where I’m trying to cut down the calories and sugar. I find it helps me to satisfy my sweet tooth with foods that are “desserts” but lower-calorie and healthier versions (although it’s definitely okay to go all-out and eat the real-deal versions sometimes!). I try to substitute foods like applesauce instead of oil, pumpkin instead of butter, etc. when possible. However, sometimes I find sweeteners are the best option in making a food taste great, work well in what I’m baking and be lower in calories.   Overall, there is still more research to be done (there always will be) it’s never-ending, but that’s what makes this world what it is, right? We are always progressing and discovering new things. So for now, that’s what I have for you. Hope that helps! References (1) (2) (2013) (3) {Sorry, you can’t access this one unless you’re a registered user} (4)

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