Artificial sweeteners are sugar substitutes that provide a sweet taste but with very few to no calories thanks to their high sweetening power. They are commonly found in various processed foods such as diet drinks, sugar-free yogurts and sports products (e.g. protein bars, shakes and powders). Foods and beverages containing artificial sweeteners are sometimes labelled as “sugar-free” or “diet” on the packaging.
There are six artificial sweeteners approved as food additives in Canada and the United States: aspartame (Equal, Sugar Twin), acesulfame-K, saccharin, sucralose (Splenda), neotame and advantame. There are also sugar alcohols (also called polyols), which contain fewer calories than sugar. They are added to various supplements, medications, throat lozenges, chewing gums, and prepackaged foods. They include sorbitol, xylitol, lactitol, mannitol, erythritol, maltitol, and isomalt.
Finally, some sweeteners are called “natural” because they come from a plant, such as steviol glycosides (e.g. stevia and truvia) or from a fruit, such as monk fruit and allulose. For more information about sugar substitutes, read this article.
The World Health Organization (WHO) published guidelines on sugar consumption in 2015, recommending that adults and children reduce their daily intake of added sugars to less than 10% of their total energy intake. As a result of this recommendation, interest in artificial sweeteners has increased. Artificial sweeteners are commonly used in products for ketogenic and low-carbohydrate dieters, people with diabetes, and in supplements for athletes. Although they are approved by regulatory authorities such as Health Canada, the Food and Drug Administration (FDA) in the United States and the European Food Safety Authority (EFSA), their long-term health effects remain controversial.
A recent report from the WHO (May 2023) advises against the use of artificial sweeteners, even natural ones such as stevia. This recommendation is based on the results of a systematic review of 283 studies, including two randomised controlled trials as well as many observational studies. The results suggest that the use of artificial sweeteners is not beneficial for weight loss or for reducing calorie intake. Studies have also found a small increase in the risk of type 2 diabetes, high blood pressure, stroke, heart disease, cancer and premature death with the use of artificial sweeteners. The WHO recommends considering other ways to reduce your intake of added sugars, such as eating foods with natural sugars like fruit or gradually reducing the amount of sugar added to foods and beverages to get used to a less sweet taste.