Artificial sweeteners have been on the market for a long time, but there are still not enough long-term studies to determine safety and side effects of continued use. High-intensity sweeteners, also commonly referred to as artificial sweeteners, are substitutes or alternatives to sugar. They are many times sweeter than table sugar, so smaller amounts of these sugar alternatives are needed to reach the same sweetness level. They are used in a variety of foods to enhance and sweeten the flavor. These high-intensity sweeteners are popular with people for a variety of reasons, primarily because they contribute either minimal or no calories to the diet and have been traditionally thought to have no effect on blood glucose levels.
Frequently, concern is expressed over many "artificial" food additives, including sugar substitutes. The FDA regulates food additives like high-intensity sweeteners by first submitting them to a pre-market review, unless it has been has been determined to be Generally Recognized As Safe (GRAS). Some sweeteners have claimed to be GRAS to bypass the longer process where experts qualified by scientific training and experience use scientific procedures to conclude the safeness of the product based on available information. Some companies make independent GRAS determinations of foods without notifying the FDA. After reviewing the available scientific evidence, the FDA determines that "high-intensity sweeteners approved by FDA are safe for the general population under certain conditions of use."
The FDA's regulations require that products meet the Standards of Safety, showing with reasonable certainty of no harm under intended conditions of its use. This is the same for food additives or foods determined GRAS. The FDA has determined Acceptable Daily Intake (ADI) levels for the approved artificial sweeteners. ADI is the amount of the high-intensity sweetener that is considered safe to consume each day over the course of a person's lifetime. The FDA determined that the estimated daily intake even for people who really enjoy sugar alternatives would not exceed the ADI. The idea is that there are no safety concerns if the average daily intake less than the ADI.
Some of the most controversial sweeteners include the 4 following:
Acceptable Daily Intake (ADI) is in milligrams per kilogram body weight per day (mg/kg bw/d)
- Brand names Sunett® and Sweet One®
- ~200x sweeter than table sugar and is often combined with other sweeteners
- o ADI: is 15 (mg/kg bw/d), or about 165 packets
Flaws in the initial testing of acesuflame potassium been challenged by scientists in the Journal of the Environmental Health Perspectives, and they call for additional studies to be done to properly evaluate the safety of this this sweetener. A majority of the studies were poorly completed in the 1970s. One of the chemicals found in Ace-K is the carcinogen methylene chloride. There is evidence that long-term exposure to methylene chloride is linked to visual disturbances, headaches, depression, liver effects, nausea, mental confusion, kidney effects and cancers in humans.
However the FDA docket evaluating Ace-K use concluded the following:
"Methylene chloride, a carcinogenic chemical, is a potential impurity in ACK resulting from its use as a solvent in the initial manufacturing step of the sweetener. Data previously submitted in FAP 0A4212 show that methylene chloride could not be detected in the final product at a limit of detection (LOD) of 40 parts per billion (ppb) as discussed in the July 6, 1998. In the past, FDA has assumed that methylene chloride is present in ACK at the LOD of 40 ppb (worst-case scenario) and has evaluated its safety by performing a risk assessment for methylene chloride based on this level. No new information has been received to change FDA's previous risk assessment for methylene chloride. Moreover, FDA does not expect that methylene chloride will be present in ACK due to the following he multi-step purification process used in the manufacture of ACK and the volatility of methylene chloride."
- Brand names include Nutrasweet®, Equal®, and Sugar Twin®
- ~ 200x sweeter than table sugar
- ADI: is 50 (mg/kg bw/d), or about 165 packets per day
People who have a genetic disorder called Phenylketonuria (PKU) should avoid or restrict aspartame because they have problems metabolizing phenylalanine. Labels must include a statement to inform if a product contains phenylketonurics/phenylalanine. Aspartame has also had some negative side effects in people other than those suffering from PKU including many reports of headaches, dizziness, mood variations, vomiting and/or nausea, abdominal pain and cramping, changes in vision, diarrhea, memory loss, and fatigue. As with a lot of research, a lot of the studies indicating the safety of aspartame were funded by companies with a vested interest in the product being used and profitable.
- Brand name Newtame®
- ~ 7,000 to 13,000x sweeter than table sugar
- ADI: is .3 (mg/kg bw/d), or about 200 packets per day
This sweetener is chemically related to aspartame, but was modified to remove the negative issues associated with phenylalanine. Although there have been claims of over 100 scientifically based studies proving the safeness of I was unable to find more than a couple that were primarily rat/mouse/dog short-term studies looking into Neotame outcomes in very specific environments. Three studies done on humans found that participants suffered headaches, abdominal pains, diarrhea, and one had a back ache. But the participants were receiving doses above the FDA approved intake for Neotame.
- Brand names include Sweet and Low®, Sweet Twin®, Sweet'N Low®, and Necta Sweet®
- ~200-700x sweeter than table sugar
- ADI: is 15 (mg/kg bw/d), or about 250 packets per day
There has been some studies with rats that suffered from bladder cancer when consuming saccharin. Although this has not appeared in human studies, the concern is still there. If something causes cancer in rats, long-term effects on humans are a serious issue. Saccharin is also part of sulfonamides, which can cause allergic reactions in some individuals. Commonly reported reactions to saccharin use in some individuals include headaches, diarrhea, skin issues and headaches.
Whole Food Choices
As always, wholefood choices are the best. Choosing artificial sweeteners over plant-sourced sweeteners, like honey, has not actually been linked to long-term weight-loss and even in some cases there is more evidence that they are associated with increased weight gain. Sweeteners of any type should be always used in moderation, eating whole foods with lots of fiber, vitamins, minerals and phytonutrients will help you better manage blood glucose levels and weight management goals. Your body can adjust quickly to the excessively sweet flavors and make you carve more to satisfy, especially artificial sweeteners. When you eat artificial sweeteners, the 'sweetness' signals your brain to release insulin to take up the 'sugar' but there is no sugar to be found, so the insulin is unable to take glucose into the cells, causing a related signal to the brain for more 'sugar.' So continue to follow the research with artificial sweeteners and if you still continue to use them, make sure to keep your intake below the FDA safety limits.
Emily DeLacey MS, RD is a Registered Dietitian and currently working in Jamaica as a HIV/ AIDS Prevention Specialist. She attended Central Washington University for her Bachelor's Degree in Science and Dietetics and continued on after her internship to Kent State University for her Master's Degree in Science and Nutrition, with a focus on public health and advocacy. She served as a U.S. Peace Corps Volunteer in Malawi 2012-2014 working as a Community Health Advisor in a rural village, immersing in the joys of life without electricity or running water. She has been to 20+ countries and 47 of the 50 states in the US. Traveling, adventuring and experiencing new cultures has made her a passionate advocate for the equality of nutrition and wellness for all people.