Artificial Sweeteners: An Update

Therese Martinez

When I was diagnosed with Type I Diabetes at 14 years old, I thought artificial sweeteners were God’s gift to diabetics. I couldn’t have much sugar anymore (or at least needed to cut way down or would end up “chasing” blood sugars”), yet there was this miraculous way to still have sweets without the calories or blood sugar ramifications.




As Diet Coke became my new best friend, I got to know sugar free Red Bull and skinny vanilla lattes pretty well too. Looking back, I am sad I wasn’t aware enough of my body to actually tie it together that those were actually making me feel pretty sick. Not to mention I became a vegetarian a few years later and had a whole host of other problems that followed. I remember this one New Years that I spent with a girlfriend of mine in Seattle when we were 22ish. We decided not to drink that New Years and instead just stayed hopped up on sugar-free energy drinks and the like. Pretty sure I had tofurkey meat slices and other sorts of sugar free candy, too. We woke up the next day honestly feeling just as hung over as if we had drank the night before. We went out to coffee and were just looking at each other, confused as to why we felt so crappy. It’s not like we thought sugar-free rockstar was GOOD for you, but surely it wasn’t comparable to alcohol, right? Oh, Therese. You silly, naïve, 22 year old. So much learn. Though I am not saying it IS the same/worse/better than alcohol, there is definitely a reason we felt the way we did after that night. So, I would like to take this opportunity to share with you some of the science behind artificial sweeteners in case you would like to make a more educated decision when picking up that can sugar free hazelnut creamer.


It is no mystery that people love the sweets. I am sure you have heard sugar is comparable to cocaine in how it affects the brain (5)? Sugar is VERY addictive. Let me be clear: I mean table sugar and high fructose corn syrup, not sugar in whole, natural foods, like fruit. The latter do not contain the dense amount of sugar that other packaged products do, and therefore are far less stimulating and addictive. Not to mention the other nutrients in the whole foods make them more satiating and help with hunger signaling. So, of course, it sounds great to have your diet soda without the problems sugar brings with it like excess calories, health problems, energy swings, etc.


But, is it really a better choice to grab the sugar-free option?


I want to say straight up that the research is a little slim on artificial sweeteners in human models, but that there is still some very compelling evidence that provides valid reasons to either stay away completely, or cut way back on your artificial sweetener intake.


What are artificial sweeteners?

Artificial sweeteners, also known as non-caloric or non-nutritive sweeteners, are compounds used to sweeten a variety of foods, medicines, gum, toothpaste, mouthwash, and other sneaky items.  These sweeteners are MANY times sweeter than table sugar and high-fructose corn syrup. I’m talking 600x’s (Splenda) more sweet. Dr. David Ludwig, an obesity and weight-loss specialist at Harvard-affiliated Boston Children’s Hospital (also partially behind the documentary “Fed Up”), points out “a miniscule amount produces a sweet taste comparable to that of sugar…Overstimulation of sugar receptors from frequent use of these hyper-intense sweeteners may limit tolerance for more complex tastes.” Meaning, you won’t find less sweet foods like fruit as tasty, and foods like vegetables will be downright unpalatable. Sound familiar? Your taste buds and your body are telling you the wrong thing, like eat that key lime pie flavored yogurt instead of the plain greek, because of how you train them with these overly-sweet foods (3).  You may recognize some:

  • Aspartame (Equal and NutraSweet)
  • Sucralose (Splenda)
  • Sacharin (Sweet ‘N Low, Sweet Twin, NectaSweet)
  • Acesulfame K (Sunett and Sweet One)
  • Neotame

There is some debate in the health world about how great one of the natural sweeteners, Stevia, is for you. While I think Stevia MAY be a better choice than the previous list, my thoughts on the matter are a little more complex. First, research is lacking a bit with Stevia, which always makes me a little more skeptical. Second, as discussed before, you are still choosing the SWEET option. You are still training your body to be stimulated in that unnatural way and leading to cravings in the future.


What else does the research say?

As I mentioned before, most of the research has been done on animal models, which makes concluding evidence hard to apply to humans. However, there have been a decent amount of studies done on both animals and humans that challenge the belief that artificial sweeteners are a better option over regular sugar.


Research notes:

  • No evidence that sweeteners like aspartame and sucralose help people manage their weight (2)
  • Sweetener consumption may sharpen your sweet tooth, prompting you to eat more sugary foods, or make you feel virtuous and overcompensate later (2)
  • The sweet taste paired with no calories may confuse the body and chage how it handles real sugar-shown in lab animals (2)
  • Sweeteners may alter the gut microbiome in ways that change metabolism for the worse (2)
  • Research participants who drank more than 21 diet drinks per week were twice as likely to become overweight r obese as people who didn’t drink diet soda (3)
  • Daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes (3)
  • Sweeteners can have significant negative effects on the host’s gut microbes (4)
  • Can lead to glucose intolerance (4)
  • Positive correlation between sweetener consumption and clinical parameters related to metabolic syndrome: weight, waist-to-hip ratio, fasting blood glucose, hemoglobin A1c, glucose tolerance test, and ALT (4)


With all of that said, there are definitely limitations to the studies, and more research needs to be done. Not to mention all of the research I did not touch on related to cancer, pregnancy, and other conditions. I like to err on the side of caution when consuming modern, industrial foods. As Chris Kresser has said before, the approach to these foods should be “guilty until proven innocent”. You are likely part of a population-wide experiment with these sugar substitutes right now, just like we were part of the experiment of the high omega-6 vegetable oils (4). We know that didn’t go over well, and if you’d like more information on that, check out:


I don’t think that having a diet or sugar-free drink here or there is going to kill you. I also don’t think having a regular sweet yogurt or soda will kill you. I am mostly concerned with how the intake affects your sweet cravings, and the effect on your gut microbiome. Those things can be the root of all evil when it comes to holding you back from reaching your optimal health. Please consider looking at all labels before choosing a product, if not to just create more awareness. After all, did you know sweeteners can hide in:

  1. Toothpaste and mouthwash
  2. Children’s chewable vitamins
  3. Cough syrup and liquid medicines
  4. Chewing gum
  5. No-calorie waters and drinks
  6. Alcoholic beverages
  7. Salad dressings
  8. Frozen yogurt and other frozen deserts
  9. Candies
  10. Baked goods
  11. Yogurt
  12. Breakfast cereals
  13. Processed snack foods
  14. “Lite” or diet fruit juices and beverages
  15. Prepared meats
  16. Nicotine gum


Yikes! Check the labels, people. If you really want the sweet stuff, go for the natural sweeteners like honey.


Therese Martinez, MS, RD, CPT





Therese Martinez, MS, RD, CPT