For dietitians and holistic health nutritionists, the party line has long been to steer clear of artificial sweeteners.
Ironically, they could make you fat, studies suggested, destroy the healthy microbes in your gut, or they could cause cancer. Diet Coke was the devil in a soda can, as toxic in the health-minded communities as high-fructose corn syrup. The results were inconclusive, but we reasoned: natural good, artificial, bad.
Now, a large review of studies, including observational studies as well as clinical trials, settles the score. Researchers found artificial sweeteners offered no health benefits, but they don't cause any harm either. The New York Times reported:
"They found no convincing evidence that nonsugar sweeteners had any effect in adults on eating behavior, cancer, cardiovascular disease, kidney disease, mood, behavior or cognition. The study, in BMJ, did find a slight benefit in promoting weight loss and improving fasting blood glucose levels, but only in small studies and over short periods of time."
Hold up before you install a Diet Coke fountain in your kitchen, though. The review's lead author, Dr. Joerg J. Meerpohl, of the University of Freiburg, said the goal of the work was to summarize the evidence, rather than make practical recommendations. Though they found no evidence of harm, he said, they could not rule out the possibility, either.
"There's no need to have them in your food," he said. "There are cheaper and widely available alternatives to artificially sweetened foods. You can always have water instead of Diet Coke."
That said, there are six low-calorie sweeteners included on the Generally Recognized as Safe (GRAS) list by the U.S. Food and Drug Administration. People with a rare hereditary disease known as phenylketonuria (PKU) have difficulty breaking down phenylalanine, a component of aspartame, and should limit their intake of phenylalanine from all sources, including aspartame. Some of the most common ones include:
Used in Equal, NutraSweet, and Sugar Twin, aspartame is 200 times sweeter than sugar. Products with aspartame include chewable multivitamins, light yogurt, and most diet sodas.
Used in Sweet 'n' Low, Sweet Twin, and Necta Sweet, saccharine is 200-700 times sweeter than sugar. Saccharin was banned in 1981 when it was found to cause bladder tumors in rats. At that time, many diet drink manufacturers switched to aspartame as a sweetener. Today, saccharin is no longer banned and can be found in baked goods, jams, jelly, chewing gum, canned fruit, candy, dessert toppings, and salad dressings, as well as toothpaste, mouthwash, and some medicines.
Used in Splenda and sweetening Coke Zero, sucralose is 600 times sweeter than sugar. Products with sucralose include Thomas' 100% Whole Grain English Muffins, Orville Redenbacher's Kettle Corn, and reduced sugar ketchup.
Stevia and monk fruit, commonly perceived as more "natural" low-calorie sweeteners, are still awaiting GRAS status by the FDA until further research is available.
Looks like Shakespeare, to paraphrase the Bard, was right again: sugar by any other low-calorie name tastes just as sweet. (Actually, way sweeter.)