Sugar Substitutes: the current truth

When it comes to sugar substitutes, can you really have your sugar and eat it too? What affects do they have on our health? Do they cause cancer, lead to diabetes or simply make no difference at all? Let’s take a look!

Sugar substitutes (AKA artificial sweeteners) are generally considered any form of sweetener you use instead of table sugar (sucrose). These are often found in “diet” or “sugar-free” products such as fizzy drinks, yoghurt, chewing gum and some baked goods. How do they work? These types of sweetener are super sweet; we are talking many, many times sweeter than sugar (Stevia is 300 times sweeter than sugar). Because of this, you need a lot less of them. The result? The same amount of sweetness with far less kilojoules. Win-win right?

Now if you’re anything like me, you’re probably thinking that this sounds a little too good to be true. Sugar substitutes have been a hot topic of discussion – so many rumours and catchy headlines about cancer, weight gain and other scary sounding health problems. But what does the science say? And by this we mean all of the science that relates to human health on this topic, not just the one or two extreme or scary articles.

Firstly, what impact do sugar substitutes have on body weight and food consumption? In short – it’s a pretty mixed bag of results. On the positive side, just over two thirds of studies showed that consuming sugar substitutes instead of table sugar had a helpful effect on weight or food consumption (i.e. participants tended to lose weight and eat less)^1-8. On the not-so-positive side, around one fifth of studies reported an increase in weight and body mass index (BMI) of people who ate/drank sugar substituted products^2,9-14. Many also showed that consuming sugar substituted products had no effect on weight and appetite^13,15-22. Talk about mixed messages! Although the jury is definitely not out on this one, what we can say is that most of the evidence indicates that sugar substitutes do not have a negative effect on appetite and weight gain.

Now, lets take a look at type 2 diabetes and blood sugar levels. This one is a little more clear-cut, where most studies showed that sugar substitutes have no effect on blood sugar, insulin levels and the presence of bad fats (think triglycerides and cholesterol)^6,23-40. Hurrah! Unfortunately, it’s not all kittens and roses. Some evidence suggests that consuming sugar substitutes can increase the risk of developing type II diabetes^41-43. Like anything, it’s important to take some sugar science with a grain of salt, as many of these studies were not representative or had very few participants.

What about sugar substitutes and cancer? As there are so many different types of cancer, which are caused by a mix of genetics, our environment and other unknown factors, this one is a little tricky! The majority of studies acknowledge this, reporting that it was difficult to show any link between the two given that they did not take factors such as pollutants into consideration²³. Those that did (as well as is possible) showed no relationship between sugar substitutes and risk of developing cancer. One study does report a link between particular cancers (non-Hodgkin lymphomas and multiple myelomas) and the consumption of sugar substitutes⁴⁴. However, the researchers who carried out this study noted that this was only observed in males and that they did not take into consideration other cancer causing substances, such as pollutants. Lifetime consumption of sugar substitutes and increased risk of cancer has been reported in rats, however only at reasonably high doses relative to the recommended dietary intake (RDI) in humans⁴⁵. Remember, even water can be toxic at high concentrations!

Last of all, do sugar substitutes cause any harm to our brains? Three-quarters of studies showed no effect on things such as reaction time, headaches, hunger and sedation^46-49. Some negative effects were seen with the consumption of sugar substitutes in patients who suffered migraines, however the methodology in these studies was limited^23,50-53. For the most part, it seems that sugar substitutes don’t cause too much of a headache!

All in all, the evidence for adverse health effects from sugar substitutes is fairly limited. In most cases, sugar substitutes have little or no effect on food consumption, body weight, blood glucose levels and cancer. Although we are yet to fully understand their affect on human health. Remember – sometimes we don’t know what we don’t know, and there is still a lot to learn about these wee molecules!

Our overall message is that we recommend drinking water or water with natural flavours added like mint, real lemon, lime, orange or frozen berries. Sometimes artificial sweeteners can help as a transition from a high sugar diet but ultimately we think there are just too many unknowns and we strongly encourage ‘stepping away from everything needing to be sweet’ so your palate can adjust and you can enjoy the subtle and wonderful favours of real foods. It will happen if you give it time. Respect your body, eat and drink real foods as often as you can.

Check out some real food snacks and drinks in our new recipe ebook here or visit our recipe pages here.

(A huge thanks to Elyse Dunn PhD for her help with this article)

References

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