What are the different types of artificial sweeteners?

Artificial Sweeteners: Types, Safety, and Health Implications

Artificial sweeteners are generally safe for consumption within established limits, but should be used as an intermediate step to reduce sugar-sweetened beverage intake rather than as a permanent solution due to potential long-term health concerns. 1

Types of FDA-Approved Artificial Sweeteners

High-Intensity Synthetic Sweeteners

• Saccharin (Sweet'N Low, Sugar Twin)

  • 200-700 times sweeter than sucrose
  • 0 calories
  • No known contraindications 1

• Aspartame (NutraSweet, Equal)

  • 180 times sweeter than sucrose
  • 4 calories per gram (but used in such small amounts that caloric impact is negligible)
  • Contraindicated in phenylketonuria (PKU) due to phenylalanine content
  • Safe when consumed within FDA-established acceptable daily intake (ADI) of 50 mg/kg body weight per day 1, 2

• Acesulfame Potassium (Sunett, Sweet One)

  • 300 times sweeter than sucrose
  • 0 calories
  • No known contraindications in humans 1

• Sucralose (Splenda)

  • 600 times sweeter than sucrose
  • 0 calories
  • No known contraindications 1

• Neotame (Newtame)

  • 7,000-13,000 times sweeter than sucrose
  • 0 calories
  • Contains phenylalanine and aspartate; contraindicated in phenylketonuria 1

• Advantame

  • 20,000 times sweeter than sucrose
  • 3.85 calories per gram (but used in extremely small amounts)
  • Determined safe for use in children 1

Natural High-Intensity Sweeteners (GRAS Status)

• Stevia (Truvia, Pure Via)

  • 200-400 times sweeter than sucrose
  • 0 calories
  • Heat stable
  • No known contraindications 1

• Monk Fruit Extract (Luo Han Guo)

  • 600 times sweeter than sucrose
  • Caloric content unknown but negligible
  • No known contraindications 1

Health Implications of Artificial Sweeteners

Potential Benefits

• Reduction in caloric intake when substituted for sugar
• May help with weight management in the short term
• Useful for diabetes management by avoiding blood glucose spikes 1
• Substituting low-calorie sweetened beverages for sugar-sweetened beverages is associated with 0.47 kg less weight gain over a 4-year period 1

Potential Concerns

• Metabolic Effects: May impact glucose-insulin homeostasis, metabolic hormones, and gut microbiome 1
• Cognitive Effects: May alter taste perception and reward pathways, potentially reducing attraction to naturally sweet, healthful foods (particularly concerning in children) 1
• Observational Associations: Some studies show associations with:
  • Obesity (pooled relative risk: 1.59,95% CI: 1.22,2.08) 1
  • Hypertension (pooled relative risk: 1.14,95% CI: 1.10,1.18) 1
  • Type 2 diabetes (25% increased risk before adjustment for adiposity, 8% after adjustment) 1
  • However, these associations may reflect reverse causation or residual confounding 1

Special Populations

Children and Adolescents

• The American Academy of Pediatrics states that "stimulant-containing energy drinks have no place in the diets of children and adolescents" 1
• Concern exists about how intense sweetness may affect developing taste preferences 1

Individuals with Phenylketonuria (PKU)

• Must avoid aspartame and neotame due to phenylalanine content 1, 2

Pregnant Women

• Should consider moderating aspartame consumption as a precautionary measure, though FDA maintains consumption within limits is safe 2

Practical Recommendations

1. Transitional Use: Artificial sweeteners are best used as an intermediate step to reduce sugar-sweetened beverage intake (e.g., switching from regular soda to diet soda), but should subsequently be reduced (e.g., switching from diet soda to seltzer water) 1

2. Moderation: All artificial sweeteners should be consumed in moderation, even when within established safety limits 2

3. Alternative Options: Consider natural sweeteners like stevia or monk fruit extract which have GRAS status and no documented contraindications 1, 2

4. Context of Overall Diet: Focus on reducing overall sweetener consumption (both artificial and natural) as part of a healthy dietary pattern 1

Common Pitfalls

• Assuming "Natural" Means Safe: Even natural sweeteners should be consumed in moderation
• Compensation Effect: Some individuals may compensate for "saved" calories by consuming more food elsewhere
• Ignoring Individual Variation: Some people may be more sensitive to certain sweeteners' effects on hunger, satiety, or gut microbiome
• Overlooking Total Diet Quality: Focus should remain on overall dietary pattern rather than single ingredients

While artificial sweeteners can help reduce caloric intake in the short term, the current evidence suggests they should be viewed as a transitional tool rather than a permanent solution for reducing sugar consumption 1.