Artificial Sweeteners: Friend or Enemy?

I get a lot of questions about artificial sweeteners from both a medical perspective and also from a fitness and nutrition perspective. Thankfully the information is the same regarding both perspectives. If you are one of those people that is just simply scared of artificial sweeteners then you should read this post in its entirety because I’m about to drop some serious science on the subject. I will even touch on their safety in pregnancy.

There is no legitimate scientific study that shows that normal dietary consumption of artificial sweeteners is linked to any serious disease, cancer or medical problem. The Acceptable Daily Intake (ADI) is defined as an estimate of the amount of a food additive that can be ingested daily over a lifetime without appreciable health risk. For aspartame (the one everyone is scared of) this is 50 mg/kg/day which equates to over 20 12oz cans of diet coke a day (EVERY DAY FOR LIFE) for a 150 pound individual. For sucralose (Splenda) the ADI is 5 mg/kg/day, which is almost 30 packets of Splenda a day for a 150 pound person. For acesulfame potassium (commonly known as “Ace K”) it is 15 mg/kg/day. For stevioside (Stevia) it is 4 mg/kg/day. Keep in mind that these are just where the studies made it to in regards to volume. Many other studies have found no health problems with much higher doses.

That being said, there has been OBSERVATIONAL studies done that show increased body weight in those who consume artificial sweeteners. Observational studies have no control, no real evidence and are purely someone noticing a trend. That would be like me saying “I observe that people who play video games every day seem to be happier”. Without controlling the study and doing it right you can’t account for other variables, like the fact that we don’t know if these same individuals have a high calorie diet. The ONLY potential risk I have found in all my research over many years comes from Saccharin (Tab drinks from way back when). Studies have shown that this particular sweetener is linked to higher incidences of bladder cancer in those who were exposed in utero (the fetus has a higher chance of bladder cancer later in life from the mother drinking it while pregnant), but even this is still controversial as another study didn’t confirm this finding.

I drink diet pop (soda…whatever you call it). Being in the medical field I catch a lot of crap from people for doing so. I have challenged many coworkers to find a LEGITIMATE study that shows anything bad and no one has been able to do so. In fact, one person was so convinced that it caused osteoporosis (weak bones) she went to research and came back hours later proving just the opposite (a few studies have shown it may actually improve bone density/strength). The same scare tactics are being used to scare people away from artificial sweeteners as those trying to scare people away from vaccines. The problem is that people see someone famous (so they have to be smart right?) telling them that such and such causes cancer or is unhealthy and they forget that there are literally millions of scientist out there that have proved these insane theories wrong time and time again. So why don’t we hear about these studies? Because the scientists don’t have 12 million followers on social media…that’s why. There is also the “too good to be true” theory. People think that having a healthy alternative that happens to be low calorie (or calorie free in most cases) has to “have a catch”. There are also some conspiracy theorists out there that believe “big sugar” is responsible for all the chaos (which I believe true to a point). I also believe that “big sugar” turned the blame to fats regarding obesity and fueled the obesity epidemic.

The fact of the matter is that we have countless studies that are unable to give me a single reason to NOT consume most of these artificial sweeteners, but we have countless MORE studies that show that sugar is literally killing us slowly. I’m not talking about an acceptable amount of sugar every day, I am talking about those who are scared of artificial sweeteners and have way too much sugar in their diets as a result. That being said, just because something is “safe” doesn’t mean it is without potential side effects. For instance, Ace-K is associated with headaches, Stevia is associated with a slight drop in blood pressure in high doses, many of the “sugar alcohols” are associated with a lot of GI issues (abdominal pain/cramping, explosive diarrhea, etc). You have to see how you react to the artificial sweetener and use it in moderation still. That also reminds me that people can also be ALLERGIC to some of these artificial sweeteners, which can be deadly, but this is fairly rare. I am not talking about “intolerance”, I am talking about legitimate allergic reaction (hives, swelling, anaphalaxis, etc.)

On top of POTENTIAL side effects and POSSIBLE allergies, we also have to be vigilant as to what else is in these products that contain artificial sweeteners. For example; A Splenda packet contains maltodextrin and dextrose (in fact 95% of the powder in the packet is made up of these two). Both of these substances can illicit an insulin response as they are not zero on the glycemic index (maybe you remember the GI from my previous post?). This can cause hunger, thirst and other “symptoms” of an insulin spike. This is likely where the common misconception that artificial sweeteners cause weight gain likely stemmed from, when in reality it is the other “natural” contents of the packet that are the potential problem. Most of the artificial sweeteners in pre-packaged things (especially liquids like diet pop) are in their raw liquid form and don’t need fillers. Maltodextrin and dextrose are fillers because sucralose (Splenda) is actually up to 1,000 times sweeter than sugar, so that means that you would only need a few tiny granules to add to your coffee in order to sweeten it and that is not very good from a marketing standpoint and also very hard to measure out (plus those few granules would likely just get stuck in the packet). It is becoming much easier to find these sweeteners in liquid form without fillers, mostly due to the popularity of the ketogenic diet as insulin spikes and non-zero GI carb sources are the enemy on that diet. You also have to factor in your natural brain signals. When you consume something that your brain registers as “sweet” you body is going to tell you that you want more of it (just like real sugar). If you are aware of this and have a good enough mental fortitude you can easily negate this small downside of artificial sweeteners (but remember that real sugar shares this downside). You will need to establish some form of self control if you intend to get fit or lose weight anyway.

I can practically feel some of you out there rolling your eyes and saying “it’s just not natural”. Might I remind you that tobacco is natural…also proven to cause cancer and is extremely unhealthy. Just because something is natural doesn’t make it healthy and just because something is artificial doesn’t make it unhealthy. Did you know that Sucralose is actually just modified sugar? It IS sugar that has a very slight modification at the molecular level that makes it just pass gently through our digestive system without being absorbed (which is how it has zero calories = non-nutritive). Some of you may have read that a by-product of the breakdown of Sucralose is chlorine. This would be correct. But also still negligible. Did you know you likely have more naturally occurring chlorine in your fruits, veggies and other foods? Did you know that the water you may be sipping on while you read this post has an “acceptable level of chlorine in it” that is likely higher than what you would be getting from Sucralose? Did you know that you pump your body full of chlorine every time you have salt (also natural)? The amount of chlorine you get from the breakdown of Sucralose is negligible and safe, especially when compared to the amount of chlorine you are getting from all you “healthy foods and water”.

What about pregnancy? Well there is no surprise here that there has been numerous studies that show the most common artificial sweeteners (excluding Saccharin as mentioned above) DON’T have any harmful effect on the fetus or mother. In fact, a task force of the American Academy of Pediatrics’ Committee on Nutrition concluded that aspartame is safe for both the pregnant mother and developing baby. You want to hear the real kicker? Studies show that pregnant women should be advised to avoid or limit sugar-sweetened beverages for the health of both the mother and her child. That is REAL sugar, not artificial sweeteners. It is shown to be linked to childhood obesity and preterm deliveries (also gestational diabetes). So the take-home here is that it is very likely that the most common artificial sweeteners are MORE HEALTHY for a pregnant mother and fetus (in moderation) than real sugar. (mind blown). I am in no way saying that pregnant females should start guzzling diet pop like it’s going out of style, I am simply stating that the studies suggest it is actually healthier to drink diet pop instead of regular pop. In fact, the acidity of pop alone is enough to make acid reflux more of an issue (which is already a pain without pop later in the pregnancy). There are plenty of better options out there like flavored water (carbonated or not) that doesn’t even contain sweeteners (artificial or otherwise) and has no calories.

If you look deep enough into the bowels of Google you can find someone who is saying that something is causing cancer or MS or something (they tried to do so with bacon and eggs in the last few years). The point is that you should leave the research to those who know how to find it and interpret it and don’t trust everything you read on the web or see on TV (and for the love of baby Jesus….please quit listening to famous people…except Leo DiCaprio…that guy knows his stuff). In my personal opinion the most common artificial sweeteners have been so extensively studied over a sufficiently long period of time that we can safely trust the studies at this point. If you suffer from a medical condition (like diabetes) or are pregnant I would still advise you to speak to your personal physician/practitioner regarding artificial sweeteners. The unfortunate part is that even many educated and insanely smart people in the medical field have not spent time researching the subject or are still quite skeptical when it comes to artificial sweeteners and I think this stems from the “too good to be true” theory I mentioned above. I am in no way offering you medical advice in this post, I am simply providing you with the information to help guide your own decisions (hopefully in conjunction with your primary physician/practitioner). I know plenty of people that drink diet soda and utilize artificial sweeteners and they are healthy, happy and generally more fit than the “sugar die hards”. That being said, utilizing zero calorie (non-nutritive) artificial sweeteners is not a quick fix, but it can HELP you in your fitness journey when coupled with proper diet and exercise.

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