Based upon some studies, artificial sweeteners have been a concern for the potential to cause various health problems including cancer. However, the U.S. Food and Drug Administration (FDA) has established an acceptable maximum daily intake considered safe to consume.  

Artificial sweeteners, such as Saccharin (Sweet’N Low), Aspartame (NutraSweet and Equal) and Sucralose (Splenda) are some of the most well-known sugar substitutes. The advantages of these is that they are zero-calorie, do not raise blood sugar levels, and do not contribute to tooth decay.

Sugar alcohols

Sugar alcohols such as xylitol, sorbitol and maltitol are not usually used in home cooking, but commonly found in processed foods to add sweetness. The biggest drawback of sugar alcohols is that they can cause bloating, intestinal gas and diarrhea, especially when eaten in large amounts. They also do contain calories, and can raise blood sugars, even if to a lesser degree than regular sugar.

Products claiming to be “sugar free” may contain these sweeteners. Please be mindful as these foods do still have calories and can contribute to weight gain and increased blood sugars. I always encourage my clients to read the food labels to determine the carbohydrate content.

New sweeteners

Newer sweeteners, such as stevia (Truvia,) have been approved as “generally recognized as safe” in the isolated chemical form. The FDA has not approved stevia leaves or "crude stevia extracts" for use as food additives.  These sweeteners do not raise blood sugars, but since they are relatively new products, it is advised to use them in moderation. Some studies have shown negative effects on the kidneys. I actually have a client that may have a kidney stone from using sugar substitutes like Stevia.

Potential risks

We know that artificial sweeteners are growing in the market, skepticism remains that these sweeteners are helping us achieve our health goals. New research is showing that consuming foods and drinks sweetened with low calorie sugar substitutes may actually be contributing to weight gain, cardiovascular disease, stroke, and hypertension.

Although artificial sweeteners do not cause the spike in blood sugar that real sugar does, it may actually be hijacking our taste buds, which then stimulates our appetites more and causing us to overeat.

Natural sugar alternatives

Using more natural sugar alternatives (in moderation) such as honey, maple syrup and agave nectar which are consider safe from a health perspective, but sugar spikes will occur similarly to sugar.

Sweetening baked goods naturally with applesauce, dates, prunes, and ripe fruits like bananas is an excellent option instead of sugar. These foods add beneficial nutrients and fiber that plain sugar lacks.  

Bottom line

There is no quick fix or magic bullet in sugar replacements. As I always encourage my clients to enjoy sugary foods once and awhile in moderation. The healthiest way is to cut back on sugar all together; artificial and “real” sugar alike. Following my “Fiber rule” of consuming whole foods, such as fruits, vegetables, whole grains and legumes, can rediscover your taste buds to enjoy the natural sweetness found in nature that can help you stay on a healthful track.

References:

1. Artificial sweeteners and Cancer. National Cancer Institute. 
2. Low-Calorie Sweeteners May Contribute to Weight Gain. Consumer Reports. 
3. High Intensity Sweeteners. US Food and Drug Administration.