When we reach for an artificial sweetener or a product containing one, it’s often because we want to make a health-conscious decision.
Artificial sweeteners tend to be included in products advertised as zero-sugar, low-calorie, low-carbohydrate and ketogenic (or keto). But what producers of these ingredients aren’t openly saying is that they come with health risks of their own.
Research backs concerns over the following sugar alternatives, so let’s get into what they are and the issues associated with them.
What it is: Xylitol is a type of sugar substitute known as a sugar alcohol. It’s found naturally in plants and some fruits and vegetables. It’s not uncommon to see it in sugar-free candies, baked goods, gum and everyday products like toothpaste.
What research shows: A study headed by researchers with the Cleveland Clinic’s Lerner Research Institute found that high levels of xylitol circulating in the body were associated with an increased risk of major cardiovascular events - like strokes and heart attacks - over a three-year period. Patients in the study who had the highest levels of xylitol in their blood were most likely to experience a cardiovascular event.
What it is: Erythritol is an artificial sweetener that’s about 70% as sweet as traditional sugar and is created by fermenting corn. It’s often recommended to people who have diabetes, metabolic syndrome or obesity - even though these populations have a higher risk of adverse cardiovascular events like heart attack and stroke.
What research shows: A study published in the scientific journal Nature Medicine found that erythritol may promote the formation of blood clots. The body also struggles to metabolize erythritol, so it enters the bloodstream and exits the body through urine.
What it is: Aspartame is a chemical sweetener made from a combination of aspartic acid and the methyl ester of phenylalanine, which are the foundation of proteins naturally found in milk, meats and some vegetables. But, aspartame can only be created by manually fusing the two chemicals together.
It can be found in thousands of foods and drinks, including diet sodas and low-calorie readymade meals. Aspartame is sold under brand names such as Nutrasweet, Equal and Sugar Twin.
What research shows: A 2022 study published in a British Medical Association journal, The BMJ, found a possible link between ingesting aspartame and a higher risk of cerebrovascular events (which affect blow flow to the brain). The World Health Organization also says it may be cancerous to humans, but research is limited.
What it is: Acesulfame potassium is also known as Ace-K, Acesulfame K and Acesulfame potassium?. It’s usually made as a blend of acesulfame potassium with other sweeteners like aspartame and sucralose. It’s more than 200 times sweeter than sugar and is sold under brand names such as Sunett and Sweet One.
What research shows: Also included in the 2022 BMJ study, acesulfame potassium is linked to a higher risk of developing coronary heart disease, which involves the heart’s arteries being unable to deliver enough oxygen-rich blood to the heart. Other research suggests it may interfere with appetite regulation, blood sugar control and body weight. The FDA suggests consuming no more than 15 mg per kilogram (mg/kg) of body weight per day.
What it is: Sucralose is made from sugar and a chemical process involving chlorine atoms. The sweetener is currently sold under the brand name Splenda.
What research shows: The 2022 BMJ study also links this artificial sweetener to a higher risk of coronary heart disease - the leading cause of death in the U.S., according to the National Heart, Lung, and Blood Institute. The study’s researchers note their findings suggest that - at the very least - using artificial sweeteners as a substitute for added sugar isn’t likely to provide any benefit for those hoping to lower their risk of cardiovascular disease.
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