Sweeteners Part 2- Synthetic Sweeteners

July 22, 2020

Synthetic sweeteners have been approved for human consumption by regulatory agencies worldwide and found to be ‘safe’ for use. Although these sweeteners may have value in reducing the caloric content of the diet, their impact on health requires further investigation.

There is growing recognition that ‘safe’ and ‘healthy’ are different considerations. While safety considers disease (e.g. causative in cancer) and/or injury (e.g. toxicity), healthy implies a continued state of optimal physiological functioning (e.g. lack of insulin resistance) (1). 

Synthetic sweeteners include- Artificial sweeteners, modified sweeteners and sugar alcohols.

Artificial sweeteners

These are derived through chemical processing of plants and are also known as non-nutritive, high-intensity sweeteners, and non-caloric or low calories sweeteners (LCS). 

The Food Safety and Standards Authority of India (FSSAI) has approved six artificial sweeteners, namely

  • Saccharin
  • Aspartame
  • Acesulfame
  • Sucralose 
  • Neotame 

All of them have been widely advertised in the market as excellent ‘sugar substitutes’ because of their low or zero caloric content, ability to not raise blood sugar levels (as table sugar does) and not promoting tooth decay (2). These apparent benefits have caused a drastic increase in the use of these sweeteners and has also led to their extensive and exclusive use in the diet by replacing sugar entirely. This is a matter of concern because the use of artificial sweeteners has been controversial and is riddled with many safety concerns.

Researchers have linked an extensive use of these non-nutritive sweeteners (NNS) with increased risk of bladder cancers (3). They have also been accompanied with caution for usage among high-risk populations such as pregnant and lactating women, diabetics, migraine, and epilepsy patients, and children. Children are especially in focus because of their higher food and beverages consumption, of which these sweeteners are a part of (3).

Artificial sweeteners are  widely used every day in a variety of food, cosmetic, and dietary products and so, eliminating their daily use is virtually an uphill task if you continue to consume processed foods. 

Moreover, disruption in your gut bacteria, also called Dysbiosis, is now recognized as an active contributor towards the development of obesity and insulin resistance.

Mounting evidence suggests that regular, long term intake of these low dose, low calorie sweeteners (especially Sucralose, aspartame and saccharin) can disrupt the balance and diversity of your gut bacteria and can predispose people to insulin resistance (4).

Modified sweeteners

These are sugars produced by converting starch using enzymes and are often used in cooking or in processed foods. The main modified sugars include caramel, golden syrup, high fructose corn syrup, refined syrup and inverted sugar. 

Out of all the sweeteners, HFCS (short for high fructose corn syrup) is the most harmful and detrimental to your health. Corn is the primary starch which is used for the production of these sweeteners. HFCS is made by changing the sugar (glucose) in cornstarch to fructose and it is fructose which is the culprit.

The use of HFCS is pervasive in the food supply, with the products ranging from breakfast cereals, beverages, breads, sauces, spreads, salad dressings, canned fruits, snack foods, desserts, meat and fish products, condiments, dairy products, soups to frozen dinners and other products.

HFCS rich products have shown to drive inflammation which is the risk factor for a number of problems- obesity, diabetes, cancer and cardiovascular diseases (5).

Also, to add to the crisis, some HFCS is made using corn which is genetically modified, i.e., the GMO variety.

In his peer-reviewed study led by Dr. Michael Antoniou at King’s College London describes that polyamines found to be present in increased amounts in GMO NK603 corn include putrescine and cadaverine can enhance the effects of histamine, thus heightening allergic reactions and both have been implicated in the formation of carcinogenic substances called nitrosamines.

However, for those of you wondering about fructose from fruits, it would be incredibly difficult to consume excessive amounts of fructose by eating whole fruits.

Sugar alcohols

This category is the most talked about. Sugar alcohols are a hybrid between a sugar molecule and an alcohol molecule. However, they are neither a sugar nor an alcohol. They have been part of the human diet for thousands of years and are present in fruits such as pears, melons, and grapes as well as mushrooms and fermentation foods (wine, soy sauce and cheese). The most common sugar alcohols that are available in the market are:

  • Sorbitol
  • Mannitol
  • Xylitol
  • Erythritol
  • Isomalt
  • Lactitol
  • Maltitol

Hydrogenated starch hydrolysates (HSH)

Sugar alcohols are believed to be good sugar alternatives for people with diabetes plus they do not contribute to dental caries (cavities). Their caloric value is generally half that of the sugar which we usually use. Plus they have a very low glycemic index, which is great for controlling blood sugar levels. Also known as Polyols, they are usually used as food additives and are used primarily to sweeten sugar-free candies, cookies, and chewing gums. Others common use in the food industry as additives is to give color, to sweeten or to help in food preservation. 

In some people, however, they can cause bloating, diarrhea and a gassy situation. It is because sugar alcohols are incompletely absorbed in the small intestines and lead to fermentation, thereby causing flatulence and gastrointestinal distress. There can be an instant reaction seen in some people who are sensitive to these sweeteners. Excessive or over consumption has a laxative effect which results in abdominal discomfort (6).

In our opinion there seems to be no advantage in bringing artificial sweeteners especially of the first two categories into your diet. The risks outweigh the benefits. Sugar alcohols seem relatively safe, though they cause digestive discomfort in some people so tread with caution. 

We would recommend you pick natural sweeteners such as dates, raisins, honey in limited quantities if you need to satisfy a sweet tooth.


Ria Jain
Functional Nutritionist

Ria has a Master’s in Nutrition and Dietetics and is in a permanent research mode and keeps the rest of us at iThrive (Previously ThriveFNC) updated with her latest findings in the field of Nutrition. Her articles on iThrive's blog are an expression of her research findings. We really don’t know what we’d do without her support and her focus.

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