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People with a sweet tooth may think that it’s fine to use artificial sweeteners instead of regular sugar, but research proves otherwise.
In a study published in the journal BMJ, researchers from the Sorbonne Paris Nord University warned that artificial sweeteners are linked to an increased risk of heart disease and they “should not be considered a healthy and safe alternative to sugar.”
Earlier research has confirmed the harmful effects of sugar and its link to various chronic diseases. This is why food companies switched to artificial sweeteners for a variety of food and drinks consumed daily by millions of people worldwide.
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While the use of artificial sweeteners has come under increased scrutiny in previous years, studies about their link to various diseases often reported conflicting results.
For example, the role of artificial sweeteners in cardiovascular disease has previously been suggested in experimental studies. Yet data from human studies was limited and previous observational studies only focused on artificially sweetened drinks used as a proxy.
Artificial sweeteners and heart disease risk
Artificial sweeteners are chemicals added to foods and beverages to make them taste sweet.
People often call artificial sweeteners “intense sweeteners” because they provide a taste similar to table sugar but up to several thousand times sweeter.
Here are some common artificial sweeteners allowed for use.
- Aspartame is sold under the brand names Equal, NutraSweet, or Sugar Twin. It is 200 times sweeter than table sugar.
- Acesulfame potassium, also called acesulfame K, is sold under the brand names Sunnet or Sweet One. It is also 200 times sweeter than table sugar. Acesulfame potassium is often used for cooking and baking.
- Sucralose, which is sold under the brand name Splenda, is a whopping 600 times sweeter than table sugar. It is often used for cooking, baking and mixing with acidic foods.
The findings from the BMJ large-scale prospective cohort study point to a direct link between high artificial sweetener consumption and an increased risk of cardiovascular disease.
For the study, researchers analyzed data from 103,000 French adults. The volunteers had an average age of 42, and four in five were adult women. Their sweetener intake from dietary sources like drinks, tabletop sweeteners and dairy products was tracked using diet records.
The researchers found that at least 37 percent of the volunteers used artificial sweeteners and that higher usage was associated with a greater risk of cardiovascular, cerebrovascular and coronary heart diseases. (Related: Not so sweet: Study links artificial sweeteners to liver damage.)
Artificial sweetener consumption was linked to an 18 percent higher risk of cerebrovascular disease, or conditions that affect blood flow to the brain.
Aspartame, in particular, was linked to a 17 percent increased risk of cerebrovascular events. Meanwhile, acesulfame potassium and sucralose were linked to an increased risk of coronary heart disease.
Because the study was observational, it can’t establish cause or rule out the possibility that other unknown factors may have altered the results.
However, the study’s findings clearly indicate that “artificial sweeteners might represent a modifiable risk factor for cardiovascular disease prevention.”
Healthy alternatives to artificial sweeteners
If you have a sweet tooth but wish to avoid artificial sweeteners, try these natural sugar substitutes:
Dates
Dates are the dried fruits of the date palm tree. Sweet and chewy, dates are an excellent alternative to refined sugar and offer several health benefits.
Unlike refined sugar and other sweeteners, dates contain nutrients like fiber, magnesium, manganese, potassium and vitamin B6, along with carotenoid and polyphenol antioxidants.
Dates can be used instead of sugar or artificial sweeteners when making cakes, cookies or energy bars. You can also blend dates to give homemade nut milks and smoothies a natural and delicious flavor boost.
Alternatively, you can use dates to make a thick paste that can be used as a 1-to-1 replacement for refined sugar.
While dates are high in calories and natural sugars, studies show that they don’t significantly affect blood sugar levels. But like all other sweeteners, it’s best to consume dates moderately to avoid any potential adverse effects.
Honey
Honey contains trace amounts of vitamins and minerals, as well as many beneficial plant compounds that provide anti-inflammatory and antioxidant benefits.
Honey compounds, like honey polyphenols, help modulate inflammation in the body. Honey also has a slightly lower glycemic index (GI) compared to table sugar.
These qualities make honey a healthy alternative to artificial sweeteners and refined sugar. Use honey in moderation because it is still full of sugar and calories.
Monk fruit sweetener
Monk fruit extract comes from the Siraitia grosvenorii plant.
While monk fruit is at least 300 times sweeter than table sugar, it doesn’t contain any calories. Its sweetness comes from compounds called mogrosides, mainly mogroside V.
Since monk fruit doesn’t have any calories, it can help promote weight loss and improve blood sugar levels when used instead of regular sugar. Note that monk fruit extract is often mixed with other sweeteners, so always check the label before buying monk fruit products.
Stevia
Stevia is a natural sweetener that comes from Stevia rebaudiana leaves. Two glycoside compounds can be extracted from this plant: stevioside and rebaudioside A. These compounds don’t contain any calories and are at least 450 times sweeter than sugar. However, they may taste slightly different from table sugar.
According to human and animal studies, replacing sugar with stevia can help prevent weight gain and reduce blood sugar levels. However, some studies suggest that stevia may harm the gut microbiome.
Sugar alcohols
Sugar alcohols, or polyols, are a type of carbohydrate naturally found in fruits and vegetables. Popular sugar alcohols used as sugar alternatives include erythritol, maltitol and xylitol.
The bacteria in your mouth don’t ferment sugar alcohols, so they don’t damage your teeth like regular sugar does. Polyols also contain substantially fewer calories and don’t significantly affect blood sugar levels, making them a healthier alternative if you have diabetes.
Erythritol contains only 0.2 calories per gram and xylitol provides 2.4 calories per gram. Meanwhile, sucrose or table sugar contains as much as four calories per gram.
While sugar alcohols are considered generally safe, some may cause digestive problems when consumed in large amounts.
For example, sorbitol may trigger laxative effects in doses of 20 to 50 grams. If you eat over 455 mg per pound of body weight of erythritol, you may experience an upset stomach.
Xylitol, meanwhile, is highly toxic to dogs. If you have a pet dog at home, you may want to store xylitol in a safe place or opt for another sugar substitute.
