Are Artificial Sweeteners and Sugar Substitutes Safe?


Today’s “Ask the Nutrition Consultant” question comes from Kait!

Q: In your recent blog post “Avoiding Weight Gain During the Holidays” you recommend limiting liquid calories. I really enjoy having a few special holiday lattes or a creamy hot cocoa during the season. Would it be better to get the non-caloric or sugar free flavored syrups and sweeteners? 

A: Great question, Kait! I recommend staying away from sugar alcohols and artificial sweeteners/sugar substitutes. Here’s why:

Sugar alcohols are produced industrially by adding hydrogen to sweet substances such as glucose and sucrose. They are not completely digested by our GI tract and can cause nausea, gas, bloating, and diarrhea. Sugar alcohols can usually be identified by the -ol at the end of their name: erythritol, xylitol, lacitol, malitol, mannitol, polyglycitol, sorbitol. 

Most sugar substitutes or artificial sweeteners are just that, artificial, and made from chemicals. Common artificial sweeteners found in the US include: saccharin, aspartame (NutraSweet™ or Equal™), sucralose (Splenda™), neotame, acesulfeme potassium (Sunett™ and SweetOne™). Saccharin was first discovered in 1879 and is a derivative of coal tar. Splenda is a chlorinated sugar that is in the same chemical class as perchlorethylene (a carcinogenic dry cleaning fluid), and the banned insecticides DDT and chlordane (Dessy, 2017). 

Both animal and human studies have shown that artificial sweeteners change the gut microbiome, lead to decreased satiety, alter glucose homeostasis, and are associated with increased caloric consumption and weight gain (Pearlman, Obert, & Casey, 2017). Artificial sweeteners have also been shown to have various adverse health effects such as cancer of the bladder, uterus, ovaries, skin, and blood. The Ramazzini Institute in Italy found an increase in lymphomas, leukemias, and breast cancer in rats fed aspartame (Landrigan, & Strait, 2021). As a result of this study the Center for Science in the Public Interest (CSPI) has downgraded its aspartame rating to “everyone should avoid” from the previous “use caution” rating (CSPI, 2021).  

I feel it’s important to note that animal studies, particularly in mice and rats, are a well respected way to identify potential hazards with foods, medications, and other substances due to the fact that humans share approximately 99% of our genes with mice. There has been a lot of flip-flop between acceptance and non-acceptance of these studies done in rats/mice, and it seems to be driven more by manufacturer preference and  lobbying and not out of compliance with safety and efficacy standards. 

So what sweetener could be a healthier alternative to sugar alcohols and artificial sweeteners? Small amounts of Stevia are OK on occasion. Stevia is a sweet herb from South America that has up to three hundred times the sweetness of white sugar and does not cause a rise in blood sugar. It also has zero calories. Be sure to read the labels and look for pure stevia extract or stevia rebaundiana. Products like Truvia and PureVia are created chemically from an isolated extract of the stevia leaf called rebiana, and mixed with erythritol, a sugar alcohol. 

Stay tuned for an upcoming post where I will share my favorite healthier homemade hot cacao recipe that I like to indulge in as a special treat! I will also be sharing how you can get access to my Healthful Sweet Alternatives list! 


Center for Science in the Public Interest (CSPI) (Aug 2021). Aspartame and cancer: what is the evidence? Retrieved from:…/aspartame%20fact%20sheet%209…

Debras, C., Chazelas, E., Srour, B., Druesne-Pecollo, N., Esseddik, Y., Szabo de Edelenyi, F., Agaësse, C., De Sa, A., Lutchia, R., Gigandet, S., Huybrechts, I., Julia, C., Kesse-Guyot, E., Allès, B., Andreeva, V. A., Galan, P., Hercberg, S., Deschasaux-Tanguy, M., & Touvier, M. (2022). Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study. PLoS medicine, 19(3), e1003950.

Dessy, M. (2017). Trick or treat? Understanding Sugars. The pantry principle (pp55-65). Willlis, TX: Versadia Press.

Landrigan, P. J., & Straif, K. (2021). Aspartame and cancer – new evidence for causation. Environmental health : a global access science source, 20(1), 42.

Pearlman, M., Obert, J., & Casey, L. (2017). The Association Between Artificial Sweeteners and Obesity. Current gastroenterology reports, 19(12), 64.

* indicates required