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Topic summary contributed by volunteer(s): Sharon and Dawn

Artificial sweeteners are man-made substitutes for table sugar in food and beverages.

Popular artificial sweeteners include: acesulfame K (Sweet One®), aspartame (Equal, NutraSweet®), cyclamate (Sugar Twin®), erythritol ( Zsweet®), saccharin (Sweet’N Low®), stevia (Truvía®, Pure Via®),  sucralose (Splenda®), xylitol (XyloSweet®) and sorbitol.

Acesulfame K has been associated with various cancers in studies.  Cyclamate has been banned in the United States since 1970 because of studies indicating an association with bladder cancer.  Saccharin has also been associated with bladder cancer.  Sucralose may be a migraine trigger and negatively affect gut microbiome.


Around 92% of independent studies report adverse health effects associated with aspartame. During digestion, aspartame is converted to methanol (wood alcohol) and then formaldehyde (a known carcinogen) in the large intestine. Adverse health effects reported include:  pre-term births, fibromyalgia, hypertension, brain disorders, blood platelet disorders, migraine headaches and bowel disorders.

Sugar Alcohol Sweeteners

Erythritol, xylitol and sorbitol are sugar alcohols.  Xylitol and sorbitol are used in consumer products like gum, sugar-free candies and toothpaste.  Studies show these two sweeteners may draw fluid into the colon in digestion and have a laxative effect.  Erythritol may not have the same laxative effect as it is absorbed in the small intestine. Erythritol also behaves like an antioxidant to act against free radicals.


Stevia is extracted from the leaves of the Stevia Rebaudiana plant and heavily processed. The resulting steviocides in the consumer product are converted into steviol in the gut, which may be toxic and cause mutagenic DNA damage in great enough quantities.  The World Health Organization has defined safe daily consumption at up to 1.8 milligrams per pound of body weight.

Artificial Sweeteners and the Microbiome

Studies have shown an association between consumption of three artificial sweeteners (sucralose, acesulfame K, aspartame) and an increase in inflammatory bowel disorders like ulcerative colitis and Crohn’s disease. This is thought to be caused by a negative impact in the large intestinal flora, the microbiome. However, healthy microbiome can be restored a few weeks after cessation of consumption of these substances. Consumption of maltodextrin, a polysaccharide in sucralose and aspartame, may also worsen Crohn’s disease.

Artificial Sweeteners and Weight Gain

Studies show a direct relationship between consumption of foods containing artificial sweeteners and weight gain. The reasons for this are: 1) “reverse causation”, i.e., the more weight people gain, the more they consume artificial sweeteners to try to offset the weight gain, 2) overcompensation for expected calorie reduction (e.g., having a diet cola with a double cheeseburger) and 3) the appetite-promoting effect of sweet substances on the tongue versus the appetite suppression effect of actual calories in the gut.

Other studies have shown artificial sweeteners may contribute to obesity, metabolic syndrome and type 2 diabetes.



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