Sugar Substitutes and Artificial Sweeteners

Sugar substitutes (sometimes called low-calorie or artificial sweeteners) are ingredients that do not contain sugar used to sweeten foods and beverages. There are a variety of foods on the market that contain sugar substitutes. Some food companies that utilize sugar substitutes will advertise it clearly on the label. This could look like a claim on a product stating  it is “sugar free”. But it is not always clear which type of sweetener is being used in a product, so you may need to look closely at the ingredient list to find out if a food contains a sugar substitute. Common products that contain sugar substitutes are diet or zero calorie soda, light juice, flavored zero-calorie water, sugar-free syrup, gum, low-fat or sugar-free ice cream, fruit cups, yogurt, and pudding. If a food or drink tastes sweet but is very low in calories or has “no added sugars”, chances are it contains sugar substitutes. There are different kinds of sugar substitutes including artificial sweeteners (such as Splenda®, Sweet n’ Low®, Equal® etc.), plant-derived sweeteners (such as stevia and monk fruit), and sugar alcohols (such as erythritol, sorbitol and mannitol). There can be benefits and possible downsides to using all types of sugar substitutes.

Potential benefits of sugar substitutes:

• Have few or no calories
• May cause a slower rise in blood sugar compared to a quick spike caused by natural sugars, though this data is a bit controversial
• Do not cause tooth decay or cavities

 Potential downsides of sugar substitutes:

• Little to no nutritional value- no fiber, vitamins or minerals
• May alter taste buds to make naturally sweet foods (like fruit) less appealing
• May cause upset stomach (cramps, diarrhea etc.)
• Some studies have shown that long-term consumption of sugar substitutes may actually have a negative impact on the way our bodies regulate blood sugar over time, possibly leading to insulin resistance

What are artificial sweeteners?

Artificial sweeteners are chemicals that are sweeter than sugar, so a much smaller amount is needed to have the same sweetness as sugar. Some artificial sweeteners are up to 700 times sweeter than sugar! Artificial sweeteners provide zero to very few calories and contain no nutrients.

Examples of artificial sweeteners include:

• Saccharin (Sweet’N Low®, SugarTwin®)
• Acesulfame K (Sunett®, Sweet One®)
• Sucralose (Splenda®)
• Aspartame (NutraSweet®, Equal®)

Products containing aspartame have a warning label on their package because they are NOT safe for use by people that have the hereditary disease Phenylketonuria (PKU). Pregnant women may be advised by their health care provider to avoid saccharin due to the unknown long-term effects. The long-term effects of high consumption of foods/drinks with artificial sweeteners in young people is also largely unknown. Like mentioned above, some studies are showing that since these sugar substitutes taste sweet, they may still stimulate our pancreas to release insulin as if true sugar was present. Overtime, insulin being released when no real sugar is present may lead to insulin resistance

What is stevia?

Stevia is the common name for sweeteners such as PureVia® and Truvia® that are found naturally in the stevia rebaudiana plant. Unlike other sugar substitutes, stevia originates from a plant rather than being a man-made chemical, however, chemicals are still used in the processing of stevia. Stevia sweeteners provide no calories and can be found in packets at coffee shops and in a variety of drinks and foods. If you are trying to avoid sugar substitutes, it is important to note that stevia sweetened products may say “naturally sweetened” so it’s always a good idea to check out the ingredient list too!

What is monk fruit extract?

Monk fruit extract, or norbu, is the main ingredient in the sweeteners of PureLo®, Monk Fruit in the Raw®, and Nectresse®. It can be found in foods such as Artic Zero® frozen desserts and Capri Sun® beverages. Monk fruit extract is made from the monk fruit, a fruit regional to Southeast Asia. The liquid from the seeds and the pulp of the monk fruit plant are squeezed out to obtain the juice. The juices of this fruit are extremely sweet, so can be used in very small quantities to sweeten foods and beverages. Monk fruit extract contains no calories. Just like stevia, products that say “naturally sweetened” may contain monk fruit extract so be sure to check the ingredient list.

What are sugar alcohols?

Sugar alcohols are carbohydrates found in plant products. In order to use sugar alcohols as a sweetener, they are altered in a laboratory environment to make them usable in sugar-free and reduced-sugar foods. Sugar alcohols are typically slightly less sweet than sugar and provide less calories per gram than sugar. Sugar alcohols can be tough on the stomach and can cause irritation such as gas and diarrhea because they are not completely digested by the body. Foods that contain sugar alcohols often include the label “excess consumption may have a laxative effect” on the packaging. It is also important to note that sugar alcohols are carbohydrates so still have an impact on blood sugar levels. Sugar alcohols are used in sugar-free candy and gum, low-calorie baked goods, ice cream and soft drinks.

Examples of sugar alcohols include:

• Sorbitol
• Mannitol
• Zylitol
• Isomalt
• Lactitol
• Maltitol
• Erythritol

Are sugar substitutes safe?

There are eight sugar substitutes that are considered safe (GRAS or “generally recognized as safe”) by the U.S. Food and Drug Administration (FDA): saccharin, aspartame, acesulfame-K, sucralose, neotame, advantame, stevoil glycosides (stevia), and luo han guo fruit extracts (monk fruit). The FDA has also set an “acceptable daily intake” (ADI) for each sweetener, which is an amount they feel is safe to have each day, and is backed by scientific research. ADIs are calculated per kg of body weight. Like most foods and nutrients, each individual person has unique nutrition needs based on their body weight. Calculating the ADIs for yourself is not important but you may want to stick to having less than 5 packets per day of any artificial sweetener

Sugar substitutes have not been shown to increase the risk of chronic diseases. Even though these substitutes are generally recognized as safe, they do not provide any nutritional benefits. The most nutritious foods and drinks (such as fruits, vegetables, milk and water) do not contain sugar substitutes.

Are there any other sugar-free ways to make my food taste sweet (without adding sugar substitutes)?

Yes! There are plenty of other sugar-free ways to make your foods more flavorful without adding sugar substitutes. Experiment with adding spices such as nutmeg and cinnamon to yogurt, cooked cereals, cookies, or coffee. You can also consider adding flavors such as vanilla extract and unsweetened cocoa powder to puddings and baked goods.

There are also many options for natural sweeteners that you may want to give a try. These include things like maple syrup, honey, agave, coconut sugar and beet sugar. All of these sweeteners will still turn into sugar in the body so if you are told to limit sugar for certain medical conditions, these should be limited as well.

The majority of foods that you eat daily should come from nutrient-dense foods and drinks like fruits, vegetables, whole grains, lean protein, dairy, and water. Eating foods from a variety of food groups in a balanced way, similar to MyPlate, will ensure your body is getting the nutrition it needs.

Our health guides are developed through a systematic, rigorous process to ensure accuracy, reliability, and trustworthiness. Written and reviewed by experienced healthcare clinicians from Boston Children's Hospital, a Harvard Medical School teaching hospital and consistently ranked as a top hospital by Newsweek and U.S. News & World Report, these guides combine clinical expertise, specialized knowledge, and evidence-based medicine. We also incorporate research and best practices from authoritative sources such as the CDC, NIH, PubMed, top medical journals, and UpToDate.com. Clinical specialists and subject matter experts review and edit each guide, reinforcing our commitment to high-quality, factual, scientifically accurate health information for young people.