The Potential Risks of Artificial Sweeteners

Sweetener Packets

Most everyone likes to have a sweet treat on occasion. It’s also nice if you don’t have to feel guilt over indulging. Unfortunately, sugar has been tied to a number of health concerns, including diabetes and heart disease (DiNicolantonia 2016, Livesey 2019). The sugar industry itself has been downplaying the heart health risks of sugar since the 1960s, even quietly sponsoring research focused on blaming fat and cholesterol instead (Kearns 2016). 

As a calorie-free alternative, a number of artificial sweeteners have been introduced. These include Equal (aspartame), Splenda (sucralose), Sunnett (acesulfame potassium) and Sweet ’N Low (saccharin). Generally, they are marketed and sold as diet products to reduce calories and assist with weight loss. They are often seen as “guilt-free” options, as a way to avoid the calories found in sugar.

Artificial Sweeteners, Blood Sugar and Obesity

While the idea of non-caloric sweeteners seems to make sense, it’s worth exploring the research to find out if artificial sweeteners really do help people lose weight. Unfortunately, from what we know, it appears that they don’t. In fact, the research appears to show the exact opposite. Artificial sweeteners contribute to obesity and other health problems. 

A recent review found that artificial sweeteners likely contribute to blood sugar problems and increased obesity. Artificial sweeteners appear to induce detrimental changes in healthy bacteria or gut flora throughout the gastrointestinal tract. When individuals consume artificial sweeteners, they stimulate appetite and cause increased food consumption (Pearlman 2017). The data is strong enough that I’ve often joked that it may be possible to sue manufacturers of diet products containing artificial sweeteners for false advertising.  

However, you can find research that claims the findings for weight gain aren’t significant (Lohner 2017). Yet studies show that industry-sponsored research is likely biasing some publications in their favor (Mandrioli 2016).

Artificially Sweetened Beverages and Health Risks

A Diet Soda Can

Unfortunately, the potential health concerns over artificial sweeteners doesn’t stop there. A large, well-done analysis of data from the Women’s Health Initiative found that higher consumption of artificially sweetened beverages increased risks for heart disease and stroke. In addition, they even found a small but significant increased risk in “all-cause mortality” (death from any cause) with artificially-sweetened beverage consumption (Mossavar-Rahmani 2019). 

There also appear to be potentially concerning risks for other aspects of brain health. Research has found correlations between artificially sweetened beverage consumption and dementia risk (Wersching 2017). However, these risks may be tied to blood sugar problems and diabetes in people drinking artificially sweetened beverages and not from artificial sweeteners directly. 

Artificial Sweeteners and Cancer 

Probably one of the most publicized concerns for artificial sweeteners is around their risk for contributing to cancer. Unfortunately, the quality of the research on cancer and artificial sweeteners is poor. A review from 2015 assessed the research and found increased risks for throat and urinary tract cancers. In men, there also appeared to be increased risks for lymphoma, myeloma and leukemia. Interestingly, evidence in total suggested that breast and ovarian cancers might be reduced with artificial sweetener use, although I would never recommend them as part of a preventative strategy (Mishra 2015). 

Overall, more research is needed to fully understand the risks from these products, especially newer varieties, like sucralose. The fact that they appear to increase risks for obesity, blood sugar problems and stroke should be enough to spur interest in whether or not they should be approved for human consumption in the first place. It doesn’t make sense that a product marketed directly for weight loss has the opposite of its intended effects. 


Artificial sweeteners have long been controversial. The latest research only adds to concerns about the use of these products on a regular basis and adverse health outcomes. In patients looking for healthier sweeteners I often recommend natural, low-calorie alternatives which I’ll cover in next week’s article.   

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