The Bittersweet Reality of Artificial Sweeteners

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Kameela Afifi

​Adverse health outcomes related to excessive sugar consumption have been established and seem ever-growing. From diabetes to obesity, tooth decay, and even adverse impacts on childhood cognition, overindulgence of refined sugars has been associated with chronic health issues common in the US. Sugar is omnipresent in the modern world and unrealistic to avoid completely, unless you are prepared to scrutinize ingredient lists for every item you choose to consume. For people looking to reduce sugar intake for health reasons, this may be burdensome and frustrating. Sugar substitutes offer a sweet promise: deliver a sweet taste without sugar or calories. Although they may seem like the solution, the reality is bittersweet.

Non-nutritive sweeteners, often referred to as artificial sweeteners, go by many names. Saccharin, aspartame, acesulfame potassium (Ace-K), sucralose, neotame, advantame, steviol glycosides, and Siraitia grosvenorii (monk fruit extract) are all high intensity, non-nutritive sweeteners currently approved for use in food, beverages, and medications by the FDA. These sweeteners are incredibly popular: 63% of youth and 49% of adults consumed artificially sweetened beverages daily between the years 2011 and 2014. Among those frequent consumers are potentially the 11.6% of US adults aged 20 and up who followed a weight-loss or diabetes diet from 2015-2018. Artificially sweetened products are often marketed with claims like “diet”, “skinny”, and “guilt-free” to capture the interest of those looking to lose weight. However, one study found that artificial sweetener consumption was associated with more weight gain over time, increasing the likelihood for an overweight or obese BMI (25.0-29.9 or ≥30 kg/m2, respectively) nearly twofold. Additionally, artificial sweetener consumption results in greater insulin resistance over time, which can contribute to the development of diabetes.  
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While they may fool our tastebuds, artificial sweeteners can’t fool our brains and bodies. One study in humans found that GLP-1, a hormone associated with satiety, was stimulated less by artificial sweeteners than real sugars – meaning artificial sweeteners may lead to eating more to feel the same level of satisfaction. In an animal model, this lack of satiety and calorie intake appeared to drive later compensation by eating more, negating any caloric reduction from skipping real sugars in favor of artificial sweeteners. These findings provide a possible explanation for why artificial sweeteners may fuel weight gain and obesity.

Another concern about artificial sweeteners is the effect they may have on the gut microbiome. In one small study of 31 adults consuming small amounts of aspartame and Ace-K sweeteners, bacterial diversity differed between artificial sweetener consumers and non-consumers. No change in bacterial abundance was observed. More large-scale, high-quality research is needed to understand the specificity of dose and length of use for artificial sweeteners and their impact to the human gut, but so far human research suggests minimal effects from moderate artificial sweetener consumption.

It’s important to recognize that research on artificial sweeteners is ongoing and we still have much to learn.  Though artificial sweetening compounds are categorized and used in similar ways, each is metabolized differently in the body and dosage plays a role in biological and physiological response, making it difficult to generalize the outcomes of artificial sweetener consumption as a whole. On top of this, research on the effects of artificial sweeteners in humans is lacking – there are more studies in mice than humans. It’s an individual decision to determine if the benefits of artificial sweeteners outweigh the potential risks and, as with many food decisions, moderation is likely key. 

About the Author:

Kameela joined CoRAL as a research assistant at Project Viva in August 2022. She received her BS in Cognitive Science from University of California, Santa Cruz in 2022. While there, she was also a Research Assistant for campus labs studying learning, memory, and psychopathology. In her free time, she enjoys exploring Boston by going to museums, trying new restaurants, and perusing record shops.