Is the 'healthiest' sugar substitute available? What should you know about artificial sweeteners?

Artificial sweeteners may appear to be a late-twentieth and early-twentieth-century fad, although they have been around for far longer.

In 1879, saccharin, the first artificial sweetener, was synthesised. It can be 300 to 500 times sweeter than table sugar and is used in toothpaste and diet soft drinks. Sugar substitutes like erythritol are included in everyday commodities including chewing gum, canned food, jellies, and dairy products, but they have a disputed history and position in research. 

The most nutritious sugar replacement

Sugar substitutes occur in a variety of forms: Aspartame, sucralose, and saccharin are examples of artificial sweeteners that are often made in a laboratory. To sweeten without adding many calories or carbs, synthetic sugar alcohols are utilised. Sugar alcohols aren't just artificial sweeteners; they can also be present in natural foods like fruits and vegetables. Natural or novel sweeteners are also popular; for example, monk fruit and stevia are plant-based. 

Jill Weisenberger, a registered dietitian nutritionist, suggests concentrating on the quantity rather than the type of substitute. As a result, the smallest amount of sugar substitute is the healthiest: Any sugar substitute in large quantities could be hazardous.

"The dose is what makes the poison," Weisenberger contends. 

Which sugar substitute should you use? It could be a matter of personal preference, or you could alternate between your favoured options on a regular basis.

"They all have such different chemical structures, so they will all behave differently in the body," Weisenberger said. "Adverse effects are always linked to a dose quantity... If you're worried about its safety, you may rotate between stevia, sucralose, and monk fruit."

Is sucrose better than artificial sweeteners?

Sugar isn't inherently dangerous; in fact, we need glucose to thrive, which our bodies make by breaking down carbohydrates, proteins, and lipids. While certain foods include naturally occurring sugars, the added sugars found in soft drinks, sweetened coffee, candies, and sweets can be harmful to our health.

Sugary drinks are the most common source of added sugar in American diets, according to the Centres for Disease Control and Prevention. According to the Centres for Disease Control and Prevention, one drink contains about the maximum amount of added sugar that should be consumed in a single day.

"I'd rather someone have a Diet Coke than a regular Coke," she explains, "but that doesn't mean I want them to have either."

A 12-ounce Coca-Cola Original contains 39 grammes of sugar, or slightly more than 9 teaspoons. A 12-ounce can of Diet Coke contains no added sugar and around 200 milligrames of aspartame. 

"Say someone uses one teaspoon of sweetener per day in tea or coffee; I don't think it matters; use whatever you like," says the author.

Weisenberger suggests the following if you have diabetes and want to limit your sugar intake: 

• Read food labels: Sugar can be found in foods that you might not associate with the term "sweet" such as bread, salad dressings or even canned beans.
  
• Pay attention to portion size: "If you don't look at the serving size on a nutrition facts panel, then you have no context for the numbers below it," Weisenberger says. 

• Watch how much sugar and sweetener you use at home: White sugar, brown sugar, honey, maple syrup, and other comparable sweeteners are included. The American Heart Association recommends no more than 24 grammes of sugar per day for adult women and 36 grammes for adult men, although Weisenberger suggests even less for prediabetic or diabetic people.

Is it safe to consume artificial sweeteners?

There has been minimal research into the long-term effects of sugar substitutes.

Artificial sweeteners are used in many sugar-free or diet food products because they are sweeter than table sugar and require less to get the same sweetness. Aspartame is 200 times sweeter than sucrose. 

The FDA has determined that the following sweeteners are safe for general consumption:

Aspartame

Acesulfame potassium (Ace-K)

Sucralose

Neotame

Advantame

Saccharin

The plant- and fruit-based sweeteners stevia, monk fruit, and thaumatin have also been approved by the FDA. Stevia leaf and crude stevia extracts, on the other hand, are deemed unsafe by the FDA due to "inadequate toxicological information," according to the FDA. Steviol glycoside (also known as "stevia") is a refined extract derived from stevia leaves. 

Popular sweeteners like aspartame are being studied for their potential health consequences. In 2022, a study published in the British Medical Journal identified a link between high artificial sweetener consumption and increased cardiovascular disease. According to World Health Organisation standards, sugar substitutes do not help weight loss goals in the long run, and a 2017 research paper revealed sweeteners may lead to weight gain.

Concerns about artificial sweeteners being carcinogenic stem from laboratory animal studies that discovered an increased risk of cancer in rats, although more recent research has put this into question. Some studies have looked into the link between obesity-related cancers and artificial sweeteners.

Aspartame is generally accepted as safe or nontoxic at "acceptable daily intake" levels, according to the FDA. The ADI threshold for aspartame, which is found in brand-name sweeteners such as Equal or Nutrosweet, is 75 packets per day.