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How Sweet It Is
For: Food Additives: What You Need to Know, June 2002

What used to be called artificial sweeteners are now usually called sugar substitutes or low-calorie or noncalorie sweeteners, largely because the word "artificial" makes many people nervous. (In addition, the line between artificial and natural is often impossible to draw.) Ever since safety issues about saccharin arose three decades ago, people have worried about these substances—and lately scary rumors about some of them have been spreading wildly. Only four sugar substitutes are used in the U.S. today (several others are awaiting FDA approval). There's also stevia, an herbal extract, plus a group of reduced-calorie sugar alcohols, such as sorbitol (see below).

Here's what we know about these sugar substitutes:

Aspartame (brand name NutraSweet or Equal). Approved by the FDA in the early 1980s, aspartame is made from two amino acids (the building blocks of proteins) and has almost no calories. It's used in countless foods and beverages, but can't be used in most baked goods. Lately there have been rumors—widely spread on the Internet—that aspartame causes everything from multiple sclerosis, lupus, Alzheimer's and Parkinson's disease to diabetes, Gulf War syndrome, and brain tumors. Reputable health organizations have denounced the rumors. Aspartame has been more intensively studied than almost any other food additive. Leading authorities, including the FDA, AMA, and the World Health Organization, have concluded that it is safe. Aspartame's only proven danger is for people with phenylketonuria, an uncommon genetic disorder—the labels warn about this.

Acesulfame-K, or acesulfame potassium (brand name Sunette or Sweet One), was approved by the FDA in 1989 and is used in soft drinks (sometimes combined with aspartame), candy, baked goods, and other foods. More than 90 studies have given it a clean bill of health, though some consumer groups still worry about it. Acesulfame-K passes through the body unchanged and is thus noncaloric. It contains only a small amount of potassium per serving. It doesn't break down when heated and can be used in baked goods and other cooked foods. Many recipes need some sugar for proper volume, texture, and browning, however, so when baking with acesulfame-K you should replace only half the sugar, or less, with it.

Saccharin. The oldest approved sugar substitute, saccharin has been under a cloud since the 1970s, when studies found that it caused cancer in rats and the FDA proposed a ban on it (this was overruled by Congress). In May 2000 the U.S. government, citing accumulating evidence from animal and human studies, removed saccharin from its official list of potential cancer-causing agents. Used in sugar-free soft drinks, jams, salad dressings, mouthwash, and toothpastes, saccharin may have a slight aftertaste.

Sucralose. Related to sugar (sucrose), but 600 times sweeter, sucralose has no calories since it isn't digested. It tastes like sugar and can be used in just about anything, though so far it is approved for only 15 foods and beverages.

Stevia. This herbal extract is widely used as a calorie-free sweetener in South America and Japan. Until 1995 the FDA banned its import, on the basis of its unproven safety as a food additive. But under the Dietary Supplement Act of 1994, stevia, like other herbal products, can be sold as a "dietary supplement" in health-food stores, on the Internet, and by mail order. It can't be labeled a "sweetener," which is a food additive, or used in any commercial food or beverages in this country, Canada, or the European Union because of long-term safety questions. It is 200 to 300 times as sweet as sugar, has a licorice-like aftertaste, and can be used for cooking. Its marketers make a variety of health claims for stevia, but none have been substantiated.

Sugar alcohols (xylitol, sorbitol, mannitol, maltitol, etc.). These have about half the calories of sugar and are absorbed more slowly, which is a plus for diabetics. They promote little or no tooth decay and are used mostly in "sugar-free" or "dietetic" candies, chewing gums, and cookies. But they can cause gas, bloating, and diarrhea in some people.

Last words: Sugar substitutes don't cause tooth decay, and since they don't affect blood sugar, they're a boon to diabetics. We would be more positive about sugar substitutes, new and old, if there was evidence that they keep people from gaining weight or help them lose it. On the contrary, as Americans have consumed more and more sugar substitutes during the past 30 years, they've grown heavier and heavier. There's nothing wrong with consuming sugar substitutes in moderation. But artificially sweetened foods and beverages tend not to be nutritious. There's also nothing wrong with eating sugar in moderation.

UC Berkeley Wellness Letter, September 2000