When it comes to managing diabetes or our weight, we want to satisfy our sweet tooth without sabotaging our health. But are artificial sweeteners, also referred to as non-nutritive sweeteners, the answer? For many years these no-calorie sugar substitutes have been deemed safe and even healthier than sugar. But new research suggests these artificial sweeteners are not as benign as we like to think. Let’s take a look at whether artificial sweeteners are helpful or harmful when it comes to managing diabetes and weight.
Diabetes and Artificial Sweeteners
Diabetes management is a complex task that requires paying attention to multiple dietary factors, especially sugar intake. Artificial sweeteners, commonly referred to as no-calorie or non-nutritive sweeteners, have gained popularity as sugar alternatives due to their minimal impact on blood glucose levels. As a nutrition professional specializing in diabetes management, people often ask me if artificial sweeteners are a good alternative to sugar. Let’s explore the benefits and cautions of using non-nutritive sweeteners for controlling diabetes.
Benefits of Non-Nutritive Sweeteners
1. Blood Sugar Control: Non-nutritive sweeteners do not raise blood glucose levels. This makes them suitable for people with diabetes who need to avoid spiking their blood sugar. They can help reduce the overall carbohydrate intake while maintaining the sweetness in foods and beverages.
2. Calorie Control: Artificial sweeteners are virtually calorie-free, which can be helpful for people with diabetes looking to manage weight. These sugar substitutes help satisfy the sweet craving without the calories.
3. Reduced Dental Impact: Non-nutritive sweeteners do not promote tooth decay, as they are not fermentable by oral bacteria. This feature helps improve oral health, which is crucial for individuals with diabetes since diabetes increases the risk for dental issues.
Cautions and Limitations
1. Changes in Taste Perception: Regular consumption of artificial sweeteners may affect taste perception and cause an increase preference for sweet foods. Some studies suggest that individuals who consume a lot of artificial sweeteners may develop a preference for overly sweetened foods, leading to overeating and potential weight gain. Extra body fat can negatively impact diabetes management.
2. Lack of Nutritional Value: Artificial sweeteners provide sweetness without any nutritional value. While they can be beneficial for blood glucose control, they do not offer essential vitamins, minerals, or other nutrients found in natural sweeteners. A balanced diet is crucial for overall health and relying solely on non-nutritive sweeteners may lead to nutritional deficiencies.
3. Changes in gut microflora. Artificial sweeteners cannot be used as food by bacteria in the gut. Our diet influences the type of bacteria that reside in our intestines. Good bacteria cannot survive on artificial sweeteners. Eating whole foods with plenty of dietary fiber and resistant starch provides the type of fuel our beneficial bacteria need to thrive.
Recommended Intake and Daily Limits
The Food and Drug Administration (FDA) has approved the use of six artificial sweeteners in our food supply. These include aspartame, acesulfame potassium, sucralose, neotame, advantame, and saccharin. Each of these are sold under various brand names and can be 200-20,000 times sweeter than sugar.
| Sweetener | Brand Name(s) | Sweetness |
| Aspartame | Equal, Nutrasweet | 200X sweeter than sugar |
| Acesulfame Potassium | Sweet One Sunnett | 200X sweeter than sugar |
| Sucralose | Splenda | 600X sweeter than sugar |
| Neotame | Newtame | 13,000X sweeter than sugar |
| Advantame | Advantame | 20,000X sweeter than sugar |
| Saccharin | Sweet N’Low, Sweet Twin | 300X sweeter than sugar |
Because too much of anything can be a bad thing, recommendations are listed to help us avoid overdoing sweeteners.
1. Sugar: The American Diabetes Association (ADA) recommends limiting added sugars to less than 10% of total daily caloric intake. For a typical 2,000-calorie diet, this equates to about 50 grams of added sugar per day.
2. Aspartame: The Acceptable Daily Intake (ADI) for aspartame is set at 50 mg/kg of body weight per day by the U.S. Food and Drug Administration (FDA).
3. Sucralose: The ADI for sucralose is set at 5 mg/kg of body weight per day by the FDA.
4. Saccharin: The ADI for saccharin is set at 5 mg/kg of body weight per day by the FDA.
The World Health Organization (WHO) released new guidelines in May 2023 stating they do not recommend the use of artificial sweeteners for weight management or to prevent noncommunicable diseases such as type 2 diabetes or cardiovascular disease. This includes the six artificial sweeteners listed as well as stevia, which is derived from the stevia plant. This recommendation does not apply to those who already have diabetes. These guidelines are conditional pending more research into the effects of these non-nutritive sweeteners.
Conclusion
Artificial sweeteners can be helpful tools for individuals with diabetes to manage their blood glucose levels, control calorie intake, and promote dental health. However, they should be consumed mindfully, as overuse may lead to potential taste perception disruptions and lack of nutritional benefits. When choosing non-nutritive sweeteners, individuals should be aware of the ADI limits set for each type and strive for a balanced diet that incorporates a variety of nutrient-dense foods.
As a nutrition professional, my recommendation is to use non-nutritive sweeteners sparingly just as we recommend limiting sugar. Keeping the emphasis on a well-rounded diet helps achieve optimal diabetes management. Always consult with a healthcare provider or registered dietitian to determine the most suitable approach for your individual diabetes management.
Want to learn more about how to balance your diet for better diabetes control with or without artificial sweeteners? Sign up for the next Better Diabetes Control program and learn how to include some sweetness in your diet while controlling your blood sugar. Click button below to learn more.
References:
- https://www.fda.gov/consumers/consumer-updates/how-sweet-it-all-about-sweeteners
- https://www.ewg.org/news-insights/news/2022/04/ewg-analysis-almost-all-new-food-chemicals-greenlighted-industry-not-fda
- https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline
