Sugar substitutes, are they really better for you?

There has been scientific debate for a number years concerning "sugar substitutes".

Most studies have shown that these substitutes are just as bad and sometimes worse than regular sugar.

Recently released data on one particular substance, erythritol, shows an increased risk of developing blood clots. You can follow the link, https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events to read more.

Low-calorie sweeteners and sugar substitutes (also known as artificial sweeteners) are often considered healthier alternatives to sugar, and some are promoted to lower blood sugar and blood pressure, as well as lose weight, but some of these claims are weak, and many of these sugar substitutes can cause side effects.

The World Health Organization (WHO) suggests that non-sugar sweeteners should not be used by the general population to achieve weight control or to reduce the risk of chronic diseases (e.g, cardiovascular disease, cancer, etc.) because of clinical studies showing no long-term weight loss and observational studies linking the use of non-sugar sweeteners with increased risk of new-onset obesity (+76%), type 2 diabetes (+23% to 34%), cardiovascular disease (+32%), mortality (+12%), and preterm labor (+25%) (WHO Guideline, 2023). A subsequent study of over 200,000 people in the UK over nearly 10-years found those who consumed more than 2 liters/week of beverages containing artificial sweeteners had a 20% increased risk of experiencing atrial fibrillation compared to non-consumers. Those who consumed more than 2 liters/week of sugar sweetened beverages had a 10% increased risk of atrial fibrillation, while those who consumed 1 liter/week or less of pure fruit juice had an 8% lower risk of atrial fibrillation (Sun, Circ Arrhythm Electrophysiol 2024). Bear in mind, however, that all of these associations do not prove that using non-sugar sweeteners cause these conditions, and the recommendation to avoid these sweeteners does not apply to people with diabetes (see below for details). The "non-sugar sweeteners" of concern are the high-intensity sweeteners such as acesulfame K, aspartame, saccharin, sucralose, stevia, and monk fruit, but exclude sugar alcohols and other low-calorie sugars (such as xylitol, sorbitol, allulose, inulin, tagatose, etc.), as well as alternative sugars (such as coconut, date, and other syrups).

The sweeteners fall mainly into three categories: High-intensity sweeteners that have no calories, such as stevia and monk fruit, as well as acesulfame K (Ace-K), aspartame, saccharin, and sucralose (be aware that since such small amounts of high-intensity sweeteners are needed, these are often combined with other, bulkier, sweeteners); Low-calorie sweeteners such as erythritol and xylitol as well as allulose, glycine, inulin, kabocha extract, lucuma, polydextrose, sorbitol, and tagatos. Better options include sugar alternatives such as agave syrup, coconut sugar, date syrup, glycerol, honey, maple syrup, trehalose, and yacon syrup.