This Is Your Body And Brain On Artificial Sweeteners
Consumers of sugar-free sweets were shocked when a study began circulating last month noting that the use of erythritol – a popular sweetener used in everything from cereal to sugar-free sodas – is linked to an increased risk of heart problems. This can lead people to reevaluate many kitchen items, from coffee sweeteners to granola bars to baking sugar substitutes.
This isn’t the first study to link artificial sweeteners to health problems — research has highlighted many possible side effects. So is it time to ditch them altogether?
As with anything related to food, there are factors to consider (how often you consume artificial sweeteners, for example). We spoke to experts about what you need to know about the new study and previous research, and got their advice on alternative ways to sweeten your food if you want to make a change.
The latest erythritol study analyzed the amount of sugar alcohol in the blood of about 4,000 people, mostly over the age of 60. Those with high levels were said to be at a higher risk of having a heart attack or stroke.
The research also showed that higher levels of erythritol in the body were likely to make it more prone to blood clots. Some study participants had pre-existing heart problems, which experts say may have affected the results. But the risk of clotting was enough for Leah Groppo, a clinical dietitian at Stanford Health Care.
Groppo noted that sugar alcohols like erythritol have a better flavor profile than pure monk fruit and stevia, which are also used as sweeteners. This means that in addition to being added to foods on their own, erythritol is commonly found in mixtures of monk fruit and stevia.
Additional research has linked other artificial sweeteners, including aspartame, acesulfame potassium and sucralose, to increased risk of cardiovascular disease as well.
The risk of cancer
There is debate as to whether consuming artificial sweeteners causes cancer, but some studies suggest there may be a link.
The biggest indicator comes from a large cohort study of 102,865 French adults. The research found that those who consumed the highest amounts of aspartame had a 1.15 times greater risk of developing cancer overall compared to those who did not. Those who consumed higher amounts of the sweetener acesulfame-K had a 1.13 times greater risk of cancer.
That said, other studies have shown that there is no consistent link between artificial sweeteners and cancer, according to the National Cancer Institute.
There may be some evidence that artificial sweeteners may have an effect on the brain over time. A 2017 study found that artificially sweetened beverages were associated with a higher risk of strokes and dementia. Additional research has linked aspartame to mood disorders, depression and mental stress. Sweeteners have also been linked to headaches and dizziness.
Some research has suggested that certain artificial sweeteners can alter the gut microbiome in both mice and humans who eat foods containing them. Studies also show that non-nutritive sweeteners can impair glucose tolerance. And some sugar alcohols can cause digestive upset.
“While we don’t know the long-term effects of consuming non-nutritive sweeteners, we do know that some sugar alcohols like sorbitol and xylitol can cause digestive upsets like diarrhea and bloating,” explained Melissa Hooper, a registered dietitian and founder. of Bite-Size Nutrition.
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Studies have been murky on the dangers of sugar substitutes, but some research shows that overuse can have negative effects.
So what should we use to sweeten things up?
Groppo said that while some of these studies may cause panic, the key is everything in moderation. She noted that research suggesting that artificial sweeteners can alter the gut microbiome is confusing to navigate.
“The hard part about this is that we don’t have strong indicators to say, ‘these ratios of gut bacteria in your gut biome lead to this health.’ So we give people a lot of artificial sweeteners. And then we change their gut biome. We’re assuming it’s changing to a negative, but we don’t know if that change means it’s necessarily bad,” she said.
Ultimately, Groppo recommended consuming artificial sweeteners on occasion if they’re in something you like. If you’re using a coffee bag now and then, that’s probably OK, she said. But if you find yourself regularly eating artificially sweetened foods, it may be time to make some changes.
Groppo recommended giving preference to occasional use of pure monk fruit and stevia, or blends that do not contain sugar alcohols such as erythritol. Coconut and date sugar can have a slightly lower glycemic index than sugar and can be a good alternative, she said. And honey, maple syrup, and agave will raise your blood sugar, but they’re more natural than some of the artificial sweeteners we know less about.
It’s also worth remembering that if a product seems too good to be true, it just might be. “When we look at these new artificial sweeteners, they’re coming to market quickly and there’s probably not very good in-depth research about what they can potentially do inside our bodies,” Groppo explained. She advocated getting as close to Mother Nature as possible when looking for something to sweeten your food.
“At this point, I think in general, when it comes to artificial sweeteners, less is better,” added Hannah Wolf, a registered dietitian at the Frances Stern Nutrition Center at Tufts Medical Center.
If you have a pre-existing condition like cardiovascular disease, you may want to cut back on artificial sweeteners more than the average person, Wolf added. She also advocated reading the labels of the foods you’re eating to take inventory of how much artificial sweeteners you might be getting in a day.
“Products marketed as keto, low-carb, sugar-free friendly diets … all likely contain artificial sweeteners,” she said. “Almost anything that says it’s sugar-free but still tastes sweet will contain them.”
Another issue with artificial sweeteners is that they can be anywhere from a hundred to a thousand times sweeter than regular table sugar, Wolf said. “So my concern comes down to where people’s taste buds are desensitized to sugar, but they feel they need that taste,” she said. That, and the fact that sugar seems to be in everything these days—from chips to ketchup and beyond—can make us crave more sugar than normal.
Groppo said to try to reduce the sugar in your coffee, eventually bringing it closer to black. “You can add a little honey or coconut sugar, or even just a splash of vanilla almond milk,” she said. Use frozen berries to sweeten smoothies and oatmeal. And try replacing sugar with applesauce, mashed bananas or dates in baked goods.
“A small amount of real sugar or fructose in fresh or frozen fruit is much higher than processed or artificially sweetened beverages or foods,” said Dr. Denise Sorrentino, a cardiologist at MercyOne Medical Center in Des Moines, Iowa.
Spices like cinnamon, nutmeg and vanilla extract are another great way to give foods more of a natural sweetness. You can use these ingredients in baking, over oatmeal, in coffee, or even blend them into smoothies.
“My strong recommendation would be to just look at all the things we’re adding sugar to and think about how we can reduce those foods,” Wolf said. This includes artificial sweeteners.