Are artificial sweeteners bad for you? A nutritionist explains

Few foods are as controversial as sugar. We’ve all heard that sweet treats are bad for our health and should be avoided. Instead, there are plenty of healthy sugar alternatives out there that claim to provide the same sweetness without the added carbs and calories. That said, there are differing guidelines regarding the long-term consumption of artificial sweeteners, which have been linked to an increased risk of type 2 diabetes, cardiovascular disease, and even overall mortality in adults.

So what’s the real story with artificial sweeteners? Should the public be worried? Artificial sweeteners are generally recognized as safe by the U.S. Food and Drug Administration, so the risk of serious health problems is fairly low, says Stephanie Wells, MS, RD, registered dietitian and founder of Time to Go Vegan Nutrition Services. For example, cancer studies have shown that you’d have to ingest a huge amount of aspartame to be at risk. According to The New York Times, a 150-pound person could drink dozens of cans of diet soda without any harm.

To find out more about the pros and cons of artificial sweeteners, PS spoke with a registered dietitian to learn more about the health risks, whether artificial sweeteners are actually bad for you, and what you really need to do to protect your health.

Experts featured in this article:

Stephanie Wells, MS, RD, is a registered dietitian and founder of Thyme to Go Vegan Nutrition Services.

Jen Bathwick, RD, is a registered dietitian and founder of The Intuitive Nutritionist.

First of all, what are artificial sweeteners?

“Artificial sweeteners are sugar substitutes used to add sweetness to foods and beverages with few or no calories,” says Jenn Baswick, a registered dietitian and founder of The Intuitive Nutritionist. “Artificial sweeteners are usually quite sweet, so a small amount of artificial sweetener can replace a large amount of sugar.”

You’ve probably seen artificial sweetener packets at restaurants and coffee shops, but these sugar substitutes are more common than you might think. “Artificial sweeteners are commonly found in diet sodas and foods that claim to have ‘no added sugar’ or are ‘ketogenic,'” Wells says. Artificial sweeteners are also often found in baked goods, frostings, puddings, chewing gum, ice cream, yogurt, bottled fruit juices, breads, and condiments like nonfat salad dressings and ketchup, she adds.

Artificial Sweeteners: Side Effects and Health Risks

Side effects from consuming artificial sweeteners are not common, but some people are sensitive to the ingredients and may experience headaches or nausea after consuming aspartame in particular, Wells says. Some people also report digestive issues like gas, constipation and bloating after consuming foods that contain certain artificial sweeteners, but Bathwick adds that it’s unclear whether these side effects are actually caused by the artificial sweeteners themselves.

As for potential health risks, the findings are preliminary and more research is needed. Some studies have suggested links between certain artificial sweeteners and conditions such as metabolic disorders, cancer risk, and changes in gut microbiome, says Bathwick. Specifically, consumption of saccharin and sucralose has been linked to increased glycemic responses and altered gut microbiome function in adults, she explains.

Another study found that high intake of artificial sweeteners was generally associated with an increased risk of cancer, although the study didn’t clearly show causation, Bathwick explains. “Currently, the overall research base lacks conclusive evidence that moderate intake of artificial sweeteners poses significant health risks,” she says. The WHO report also noted that aspartame intake was much higher than average.

A 2021 study found that there may also be a link between artificial sweeteners and intestinal inflammation. This also needs further study, but if true, artificial sweeteners could worsen symptoms of digestive disorders like Crohn’s disease and inflammatory bowel disease, Wells explains.

Ultimately, more analysis is needed before any definitive claims can be made about the impact of artificial sweeteners on long-term health risks. “It’s very difficult to be absolutely certain about nutritional findings in a study, and these findings don’t necessarily indicate causation,” Bathwick says.

(Things to consider: If you’re pregnant or have a medical condition, like phenylketonuria, it’s a good idea to talk to your doctor about which artificial sweeteners are safe for you.)

Artificial sweeteners and sugar

The main differences between artificial sweeteners and sugar are their ingredients, calorie content, and level of sweetness, explains Bathwick. “Artificial sweeteners are low- or no-calorie chemically modified compounds that serve as a sweetener substitute,” she explains. That means artificial sweeteners are made in a lab, whereas sugar is found naturally in plants like sugar cane, corn, and beets, says Wells.

It’s also important to remember that sugar is not evil or inherently bad. “Sugar contains calories and contributes to an individual’s total energy intake,” says Bathwick. “While artificial sweeteners may seem appealing to many as offering a way to reduce calorie intake, it’s important to remember that sugar does provide a source of energy and can be part of a balanced diet.”

So is sugar better than artificial sweeteners? The answer is tricky. “Having small amounts of sugar and artificial sweeteners in an overall balanced diet is probably fine. But relying too heavily on these ultra-processed foods can eliminate nutritious foods known to reduce the risk of chronic disease,” says Wells. In a WHO study on avoiding artificial sweeteners for weight loss, the agency clarified that “the evidence base for the new recommendations is weak, so the true impact of artificial sweeteners on health remains to be seen.”

The most common artificial sweeteners

If you want to be wary of artificial sweeteners in your food, Bathwick and Wells say the most common ones are:

So, are artificial sweeteners bad for you?

There are no clear answers and it’s hard to say something is absolutely “bad for you”, says Bathwick, but we need to be mindful of everything we ingest, including artificial sweeteners. “I would say food isn’t something to be feared and sugar is not evil and can be consumed as part of a healthy, balanced diet,” Bathwick told PS.

“Artificial sweeteners can be very helpful for people with a sweet tooth who are trying to reduce their sugar intake, or for people with active type 2 diabetes who are trying to manage their blood sugar levels,” says Bathwick. “My main learning is that if you’re eating a balanced diet that’s full of minimally processed fruits, vegetables, whole grains, nuts, and legumes, the small amounts of artificial sweeteners and sugar in your diet are unlikely to cause health problems.” That said, if you’re concerned about consuming artificial sweeteners, it’s best to talk to your doctor about your personal risks.

Andy Brightwich A Chicago-based freelance writer and graduate of Emory University and Northwestern University’s Medill School of Journalism, her work has appeared in PS, Women’s Health, Cosmopolitan, and more.

Mirel Zaman Wellness Director at PS. With nearly 15 years of experience in the health and wellness field, she writes and edits articles on fitness, general health, mental health, relationships and sex, food and nutrition, astrology, spirituality, family and parenting, culture, and news.