Artificial sweeteners have been demonized in the media as terrible chemicals that cause cancer, diabetes, obesity, and alter gut microbiota to name a few. Should you be concerned about consuming artificial sweeteners? Let’s take a look at the research.
How Are Artificial Sweeteners Metabolized?
First let’s take a look at how the human body processes an artificial sweetener, specifically sucralose. The majority of an oral dose of sucralose is unabsorbed and excreted in the feces with the remainder excreted in the urine. Of the limited amount of sucralose that is absorbed, minor amounts undergo glucuronidation which is a common metabolic pathway in which foreign substances that the body does not recognize are excreted through the urine. The majority of sucralose that is excreted in the urine and feces is unchanged. Furthermore, there is no retention or build-up of sucralose in the body and there is also no catabolic (break-down) process meaning that sucralose is not a source of energy.
BOTTOM LINE: you pee and poop it out.
But Artificial Sweeteners Are Chemicals
Artificial sweeteners get a bad reputation because they’re a chemical. Let’s see if you recognize the following food found in every grocery store: Dihydrogen monoxide, glucose, fructose, sucrose, maltose, starch, fiber, glutamic acid, aspartic acid, histidine, leucine, lysine, phenylalanine, arginine, valine, alanine, serine, glycine, threonine, isoleucine, proline, tryptophan, cysteine, tyrosine, methionine, palmitic acid, linoleic acid, linolenic acid, oleic acid, palmitoleic acid, stearic acid, lauric acid, myristic acid, capric acid, ash, phytosterols, E515, oxalic acid, E300, E306, tocopherol, phylloquinone, thiamin, riboflavin, E160a, ethyl hexanoate, ethyl butanoate, 3-methylbut-1-YL ethanoate, pentyl acetate, E1510, ethene.
If you guessed a banana, you’re right!
BOTTOM LINE: everything is a chemical!
Do Artificial Sweeteners Cause Cancer?
Every now and then, a study claiming a link between sweeteners and cancer rears its ugly head. Here’s what typically happens with science in the news: 1) a research study is conducted and they find A is correlated with B, given C, assuming D, under E conditions 2) the University PR Office translates it into “scientists find potential link between A and B’’ and in fine print ‘‘under certain conditions’’ 3) News organizations pick this up and translate it into ‘‘A causes B, say scientists’’ 4) The internet gets wind and it becomes ‘‘scientists are out to kill us once again’’ and ‘‘A causes B all the time’’ 5) local news channels pick this up and report ‘‘Is there a killer among us? What you don’t know about A will kill you’’ 6) and now your mom and grandma are wearing tinfoil hats because the news told them it will ward off A.
I read the following articles: a review published in 2000 titled “Sucralose - an overview of the toxicity data” which reviewed 113 safety studies, a review published in 2016 titled “Sucralose Non-Carcinogenicity: A Review of the Scientific and Regulatory Rationale” which looked at 110 papers and articles, and a review published in 2017 titled “Critical review of the current literature on the safety of sucralose” which looked at an extensive database of studies related to sucralose. To quote the 2016 review, they found that “The chemical structure of sucralose predicts a low order of reactivity, no biotransformation potential, and no identified structural alerts for genotoxic or carcinogenic activity. Stability testing shows sucralose is remarkably resistant to both chemical and enzymatic degradation. The results of in vitro and in vivo assays of sucralose revealed no confirmed genotoxic activity, consistent with the chemical structure and metabolism of sucralose. Following ingestion, sucralose is not metabolized in the gut and approximately 85% of sucralose is excreted intact. The small amount absorbed is not metabolized to reactive intermediates and neither the parent molecule nor metabolites react with biological macromolecules (e.g., DNA). The small percentage of sucralose that undergoes metabolism is not catabolized (broken down), but is biotransformed to glucuronide conjugates that are toxicologically and biologically insignificant”.
BOTTOM LINE: artificial sweeteners do not cause cancer
Do Sweeteners Harm Your Gut Microbiota, Cause Obesity, or Diabetes?
In 2014 a study by Suez et al. hit headlines titled “Artificial sweeteners induce glucose intolerance by altering the gut microbiota”. The authors of this study tested saccharin, sucralose, and aspartame, and found saccharin to be the greatest offender of glucose tolerance in mice, so they further tested saccharin. Saccharin is found in the pink packets of Sweet’N Low and you’d have to consume 10 packets to reach the dose used in this study. Saccharin is not widely used to sweeten beverages; Coke, Pepsi, Dr. Pepper, Mountain Dew, Fresca, Barq’s, and Sprite do not contain saccharin. The fact that this study used artificially high doses of a sweetener that’s not primarily used by the food and beverage industry makes it a pretty irrelevant study. The 2017 review “Critical review of the current literature on the safety of sucralose” also looked at gut microflora studies and found no cause for concern. The review also critiques and criticizes the 2014 study by Suez et al. for jumping to the conclusion that ALL artificial sweeteners cause issues when really it was just saccharin in extremely high doses. A review titled “Non-Nutritive Sweeteners and their Role in the Gastrointestinal Tract” looked at 60 studies examining the effects of non-nutritive sweeteners on gastrointestinal physiology and hormone secretion, and to quote their conclusions: “To date, solid evidence for a clinically relevant role of non-nutritive sweeteners on gut hormones or glucose metabolism in humans remains to be established.”
All of these reviews I read also found no causal or correlational evidence between sweetener consumption and obesity or diabetes. In fact, most studies found sweetener consumption to be beneficial for weight loss management.
BOTTOM LINE: there is no cause for concern
The current research shows that there is no cause for concern regarding your health and consuming artificial sweeteners. That being said, not all sweeteners are created equal. You’re best to stick with aspartame and sucralose and steer clear of all the others. Don't sweat about consuming sweeteners to keep your calories down; you pee and poop most of it out anyways!