Nutrition | POSTED February 28, 2024

The Sweet Truth About Non-Sugar Sweeteners

Thanks to years of research, we know that excessive consumption of sugar may lead to a variety of negative health outcomes. Increases in body fat,1 cardiovascular disease risk,2 cancer risk,3 and Type-2 diabetes have all been linked to excessive intake of added sugars.4 A reduction in sugar consumption is therefore generally recommended to mitigate these health effects. Enter Non-Sugar Sweeteners (NSS).

Non-Sugar Sweeteners are an increasingly popular alternative that may help to reduce sugar intake. They contain no/low calories and can be either artificial (e.g. aspartame) or naturally occurring (e.g. stevia). They are generally used to sweeten a variety of pre-packaged foods and beverages, or as a direct substitute for table sugar.

Seems like a pretty sweet deal, right? However, there are some common questions and concerns that we need to address before giving a final recommendation. Let’s take a closer at a couple of them.

Are Non-Sugar Sweeteners Safe?

The main concern that people have regarding NSS is whether or not they are harmful to health. A no-strings attached substitute for sugar, a substance that we know has negative health effects? Surely there must be a catch? Fortunately, we have lots of research to help us find the answers.

Reported side-effects of NSS often include headaches and allergic reactions. Evidence shows that these are no more likely to be caused by NSS than by placebo.5 Claims that NSS cause an increase in blood sugar are similarly not supported by reliable data.6 For health conditions such as cancer, cardiovascular disease and Type-2 diabetes, data from controlled experiments shows no significant relationship with NSS intake.7

Long-term safety data is less conclusive, with some small positive associations between NSS intake and markers of disease and mortality. However, the nature of long-term research means that it’s a lot harder to determine causation. Other variables that often go hand-in-hand with NSS consumption are the likely cause of the negative health outcomes that we’re seeing here. For example, people who replace sugar with NSS often do so because they want to reduce an already elevated risk of disease (due to overweight/obesity, lifestyle, diet, etc). Rather than long-term NSS consumption leading to poor health outcomes, the poor health outcomes are what lead people to consume more NSS.8

Overall, does this mean that NSS are safe? The body of evidence that we currently have seems to indicate that they aren’t inherently harmful on their own.

Are Non-Sugar Sweeteners Useful?

Non-sugar sweeteners are usually recommended as a great weight loss tool. Logically, replacing high-calorie, sugar-sweetened food and drink with low/zero calorie alternatives would make sense, right? Let’s see what the evidence has to say.

In short-term controlled studies, using NSS lead to a small reduction in body weight and BMI.9 This effect was greatest when NSS intake were either compared to a diet containing sugar, or when replacing sugar completely. In these scenarios, it appears to be a reduction in energy intake that drives the weight loss.

Long-term evidence associates increased NSS intake with increased body weight.10 However, it’s important to note that most of these long-term studies do not actually replace sugar with NSS, but just look at diets high in NSS. We know that the average adult diet is not particularly health-promoting.11 We also now know that NSS have the greatest effect on body composition when replacing added sugar. If NSS are being added to the average diet without changing anything else, it’s likely that other factors are driving this long-term weight increase, not the NSS.

What does this mean for the utility of NSS? Overall, they do not seem to be beneficial on their own. Adding NSS without addressing other aspects of a poor quality diet does not seem to have any uniquely positive effects. The main scenario in which they are useful seems to be when they replace added sugar, both for weight management and disease prevention.

Our Recommendations

Based on the evidence we’ve discussed here, here are our thoughts on non-sugar sweeteners:

  • NSS don’t seem to be inherently unsafe to consume.
  • NSS don’t seem to be inherently beneficial for health.
  • Adding NSS to your diet won’t lead to better outcomes if that diet isn’t also health-promoting.
  • Replacing sugar with NSS seems to be beneficial for managing disease risk and body weight.
  • We especially recommend replacing sugar-sweetened beverages with non-sugar options, as our bodies do not seem to account for liquid calories particularly well.12

Would you like to know more about non-sugar sweeteners or nutrition in general? Get in touch with one of our dual-certified trainers and nutritionists to see how we can help you improve your diet, training, and lifestyle!

References:

  1. The Dose Makes the Poison: Sugar and Obesity in the United States – a Review ↩︎
  2. Relation of Total Sugars, Sucrose, Fructose, and Added Sugars With the Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-analysis of Prospective Cohort Studies ↩︎
  3. Consumption of Sugars, Sugary Foods, and Sugary Beverages in Relation to Cancer Risk: A Systematic Review of Longitudinal Studies ↩︎
  4. Role of diet in type 2 diabetes incidence: umbrella review of meta-analyses of prospective observational studies ↩︎
  5. Aspartame and susceptibility to headache; Aspartame is no more likely than placebo to cause urticaria/angioedema: results of a multicenter, randomized, double-blind, placebo-controlled, crossover study ↩︎
  6. Glycemic impact of non-nutritive sweeteners: a systematic review and meta-analysis of randomized controlled trials ↩︎
  7. Health effects of the use of non-sugar sweeteners: A systematic review and meta-analysis ↩︎
  8. Health effects of the use of non-sugar sweeteners: A systematic review and meta-analysis ↩︎
  9. Health effects of the use of non-sugar sweeteners: A systematic review and meta-analysis ↩︎
  10. Health effects of the use of non-sugar sweeteners: A systematic review and meta-analysis ↩︎
  11. https://www.csiro.au/en/news/all/news/2023/september/total-wellbeing-diet-1 ↩︎
  12. Effects of carbohydrates on satiety: differences between liquid and solid food ↩︎