Thinking about swapping sugar for a substitute? Here’s what you should know.

The next time you get a coffee at your favorite diner, you might not want to reach for the sugar. It’s possible that your doctor suggested avoiding it to help you lose a little weight. Or maybe they offered it as a way to help cut your chance of developing type 2 diabetes.

It could have nothing to do with your doctor: Maybe you just want to eat less sugar and live a healthier life.

Here’s some good news: You have quite a few artificial sweeteners to choose from. There are 6 approved by the U.S. Food and Drug Administration (FDA). But it’s not always clear if they are better for your health than regular sugar. First, let’s look at what artificial sweeteners are. Then, we can get to know some of the myths and realities about them.

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What are artificial sweeteners?

Scientists create artificial sweeteners by synthesizing chemical substances. They’re then used instead of table sugar (sucrose) to sweeten foods and beverages.

The 6 artificial sweeteners approved by the FDA are:

• Acesulfame potassium
• Advantame
• Aspartame
• Neotame
• Saccharin
• Sucralose

Artificial sweeteners are a lot sweeter than real sugar. So, it takes smaller amounts of them to sweeten a food or drink.

Now that you have a better idea of the artificial sweeteners out there and how they’re made, let’s take a closer look at some of the biggest myths (and facts) about them.

Myth: Artificial sweeteners can help you lose weight.

There’s no good research that confirms whether artificial sweeteners can help you lose weight, says Kimberly Battistoni. She’s a Smilow Cancer Hospital dietitian at Saint Francis Hospital in Hartford, Connecticut.

There is some evidence that artificial sweeteners may help with short-term weight loss, especially if you’re overweight or obese. That is, if you tend to drink a lot of sugary beverages, says Battistoni. But there’s no evidence that artificial sweeteners provide benefits over a long period of time, she emphasizes.

In fact, artificial sweeteners have also been linked to weight gain and increased appetite. “It’s thought that high intake of artificial sweeteners may increase your preference for sweet foods, which leads you to crave more and overall take in more empty calories,” explains Battistoni. (If a food has empty calories, that means it has no nutrients.)

They may also affect the bacteria in your gut, which can change the way your brain tells you you’re hungry. That can also influence your body weight.

Truth: Artificial sweeteners can protect you against cavities.

Sugar-free gum — meaning gum that’s sweetened with an artificial sweetener such as aspartame or saccharine — may help cut your chance of developing cavities, according to the American Dental Association.

Some research suggests that if you chew sugar-free gum for 20 minutes after each meal, you may have a lower chance of developing cavities. One reason is that it increases saliva in your mouth, to help wash bad bacteria away. But sugar-free gum isn’t a substitute for an at-home dental routine, so you’ll want to continue brushing your teeth at least twice a day and flossing at least once a day.

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Myth: Artificial sweeteners can cause cancer.

There was a lot of buzz around aspartame in July 2023, when the International Agency for Research on Cancer labeled it as “possibly carcinogenic to humans.” But this is based on limited evidence, and it doesn’t mean aspartame itself causes cancer, notes Battistoni. The FDA still considers aspartame safe.

Also, before the 6 artificial sweeteners were approved by the FDA, the agency reviewed many different studies done on each sweetener to make sure they were safe. There’s no evidence that these sweeteners cause cancer or other health issues in people, according to the National Cancer Institute. Studies that have shown a link have been done in animals, in very high doses.

Case in point: The acceptable daily intake of aspartame, set by the FDA, is equal to about 9 to 14 cans of diet soda daily, says Battistoni. “But just because you can safely consume this amount, doesn’t mean you should!” she adds.

Myth: Artificial sweeteners protect against developing type 2 diabetes.

It’s true that artificial sweeteners don’t have calories, and they don’t raise blood sugar levels. But just because a food is sugar-free, that doesn’t mean it’s calorie-free.

Artificial sweeteners can still cause weight gain that increases your chance of developing diabetes. That’s especially true of artificial sweeteners, since they’re often added to ultra-processed foods (such as ice cream or breakfast cereals) or refined carbohydrates (such as pizza dough and pasta), points out Carlos Fragoso, M.S. He’s a registered dietitian and nutritionist based in New York City.

“We know those 2 things can cause weight gain when they are consumed in excess,” says Fragoso.

Truth: You can use other things to sweeten your foods and drinks besides artificial sweeteners.

It’s important to remember that there’s no black and white when it comes to artificial sweeteners. “They’re not necessarily healthier than sugar, or vice versa — either in excess isn’t a good thing,” Battistoni emphasizes.

Overall, she recommends eating foods with less added sugar and sweeteners — including artificial sweeteners. Plus, you can sweeten your foods and beverages with things other than artificial sweeteners, she notes. These include:

• Agave
• Honey
• Maple syrup
• Monk fruit
• Stevia (a type of plant-based sweetener)

Just remember that while these are all different forms of natural sugar, “they are still sugar and should be used in moderation,” cautions Battistoni. Better yet? Use fresh fruit in your oatmeal, cereal or plain yogurt, or to add flavor to water.

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This article contains information that is not compiled by UnitedHealthcare or any of its subsidiaries. UnitedHealthcare does not represent all the information provided are statements of fact. Please consult directly with your primary care physician if you need medical advice.

Sources:

1. American Dental Association: “Chewing gum.” May 4, 2023. Retrieved from https://www.ada.org/en/resources/research/science-and-research-institute/oral-health-topics/chewing-gum
2. American Diabetes Association. “Nutrition for life: sugar substitutes.” Retrieved from https://jenkinsmedicalcenter.com/wp-content/uploads/2023/12/2.3.10-Sugar_substitutes.pdf Accessed October 3, 2023.
3. National Cancer Institute. “Artificial sweeteners and cancer.” August 29, 2023. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet
4. Journal of the American Heart Association. “Effects of sugar-sweetened, artificially sweetened, and unsweetened beverages on cardiometabolic risk Factors, body composition, and sweet taste preference: a randomized controlled trial.” August 2020. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32696704/
5. U.S. Food and Drug Administration. “Aspartame and other sweeteners in food.” July 14, 2023. Retrieved from https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food

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