Sugar substitutes

When reducing added sugar intake and ditching dependence on the sweet stuff, there are various ways to go about it. 

Some go cold-turkey, cutting out added and free sugars entirely. Others wean off gradually, consuming less as time goes on.

Cravings are inevitable (especially in the early days), and ways to manage the desire including eating more whole food sources of protein and fibre, getting good sleep, and reshaping unhelpful eating habits into beneficial ones.

Another avenue some explore is swapping added, free sugars for sugar substitutes. 

Subbing out added sugars for these low or non-caloric sweeteners appears great in theory. You get all the sweetness, yet none of the energy provided by sugar that can lead to blood sugar highs and dips, weight gain, and myriad other health concerns associated with excess added sugar intake. 

But long-term, do sugar substitutes really serve us?

What are sugar substitutes?

Also known as non-sugar substitutes, non-nutritive sweeteners, and intense sweeteners, sugar substitutes are low or non-caloric food additives used to replace the sweetness of sugar. 

Under these umbrella terms fall artificial and naturally-derived sweeteners: synthetically derived chemicals and natural extracts that may or may not be chemically modified.

Examples include (but not limited to):

• acesulfame K
• aspartame
• advantame
• cyclamates
• neotame
• saccharin
• sucralose
• stevia and stevia derivatives

Sugar substitutes and health

Manufacturers created and marketed sugar substitutes as a weight loss tool. But evidence suggests this may work only some of the time, in the short-term, and in conjunction with energy (calorie) restriction. 

Thought to be inert, more and more evidence is emerging proving sugar substitutes do have a physiological impact. For example, a 2022 study found sucralose and saccharin impair the glycaemic response, leading to an increase blood sugar levels. 

Unfortunately, we are yet to fully understand the implications of long-term use of sugar substitutes.

Current health concerns for high intake of sugar substitutes include possible increased risk for type 2 diabetes, cardiovascular diseases, and all-cause mortality, as well as affecting the responses to food we eat by the microbes of the gut microbiome.

Sugar substitutes can also result in increased food intake, causing us to overeat in order to feel satisfied. Therefore, it may contribute to weight gain.

You cannot trick the body. When it desires sweetness, and you give it sucralose, stevia or another substitute, initially the craving is sated. But the body will seek out the energy it associates with sweet tastes! So, inadvertently, you may reach for more food – and possibly more sugar – in response.

There is also limited evidence for health benefits following long-term use, including weight loss (despite the hype). 

Ultimately, sugar substitutes have no nutritional benefit and only keep desire for intense sweet tastes alive.

Sugar-free does not automatically make a product healthy!

Increasingly, people want less added sugar in their lives. The food industry is responding by increasing use of sugar substitutes in packaged food and beverages yet ironically, our global packaged food supply is actually getting sweeter.

Sure, there are times when a sweetener is really helpful, such as making medications palatable.

But simply replacing added sugars with highly-procesed, lab-made sweeteners does not necessarily make it a nourishing food choice. 

Our position, which happens to be in line with recent recommendations in a draft guideline on non-sugar sweeteners from the World Health Organization, is that we should reduce intake of sugar AND sweeteners overall. 

The WHO states that replacing added, free sugars for sugar substitutes in packaged, ultra-processed foods does not make that product ‘healthy’.

Simply, ultra-processed foods do not serve health, despite any health claims plastered over the packaging.

Less sweeteners, more whole foods 

When assessing any packaged food or drink product, be wary of “sugar-free” health halos, clever marketing, and fancy packaging. Always flip the packet and read the ingredients list to understand what you are consuming.

Better yet, choose mostly real, whole foods over the ultra-processed, packaged stuff. It’s the whole foods we want more of in the diet for better health.

“Your body deserves better than laboratory-made sweetness.”

– Damon Gameau

Sugar substitutes are fine if weaning off a very high sugar diet for the short-term, but not something we recommend consuming regularly or long-term. As with added sugar intake, a little is okay – just ensure you do not go overboard. 

Bottom line: By reducing our intake of sugar and sweeteners overall, our sensitivity to the sweet taste from beneficial whole foods will eventually increase. 

Cut back on all intense sweet tastes over two weeks, choose whole food sugar swaps, and allow the palate to adjust. It will become easier to appreciate the subtle sweetness in whole foods, such as fruit, sweet potato, vanilla or cinnamon, and reduce the requirement for that intense sweet and sugary hit.

By Angela Johnson (BHSc Nut Med)