When we try to express the beauty of life we say that "life is sweet", and when we try to celebrate a happy event we make desserts and different kinds of sweets. Moreover, when we try to give presents to those we love we give them candy, chocolate and sweetened food.

The taste of "sweetness" has become associated with joy, happiness and love and this is fine sometimes however, eating food that is rich in sugar all the time is considered some sort of an addiction in and of itself because our bodies are susceptible to becoming addicted to all-things-sweet. This may lead to many health problems like diabetes, teeth cavities, gaining weight around the waist, hyperactivity disorder and many other problems.

If you wish to know more about sugar and how it affects the human body, please press here.

Given the facts that our taste buds will not stop loving the taste of sweets, our social habits are not going to be altered, and the sweets will not disappear from our celebrations' tables overnight, we should start thinking about healthy alternatives to the processed white sugar that we consume daily.

Pharmaceutical companies have come up with many innovations to substitute sugar. But the question remains: are these "diet" sugar and artificial sweeteners healthy alternatives to the real thing?

There has been so many claims that questioned whether these artificial sugar substitutes can sweeten our food and at the same time keep diabetes, cavities and obesity away.

Whatever our verdict may be, it has become very difficult to avoid using these substitutes. The production process of an estimated 6000 products between the years 1999 and 2004 DOES include these sugars as a component.Those products have a very wide industrial variety such as toothpastes, beverages, sweets, gum, jam, food supplements, vitamins, drugs and cosmetics.

If you are one of those people who are really into watching you weight and striving for a better health, then you may want to continue reading this article as it has everything you need to know about those artificial sugars, the most famous products in the market and the known side effects of consuming them.

There are 5 types of sugar alternatives which are also known as non-nutritive sweeteners or very low calories sweeteners that are approved by the FDA.

1- Saccharin:

Saccharin is one of the most common artificial sweeteners. It is a calories free substance that was discovered in the USA by mere coincidence in 1879, and it is 300 to 400 times sweeter than regular sugar. It has a bitter and metal undertone to it. It's most known product is Sweet 'N Low.

Saccharin doesn't get digested and broken down to molecules in the body. Instead, it gets absorbed slowly in the digestive system and then secreted as is through the kidneys.

Maximum dosage allowed per day: 5 mg for each 1 kg of the total body weight.

2- Aspartame:

It is a low calories sweetener. It contains only 4 calories per gram. It was discovered in 1964 and it is 160 to 220 times sweeter than regular sugar.

It has an edge over saccharin as it does not have a bitter taste to it. It breaks into phenylalonine, aspartic acid and methanol which get absorbed into the blood.

FDA approved dosage per day is: 40 mg for each 1 kg of the total body weight.

3- Acesulfame K:

It is one of the zero-calories alternatives. It is 200 times sweeter than sugar. It doesn't break inside the body. Instead it get absorbed then thrown out of the body as it is.

Acesulfame K is approved by the USA and the EU, however studies concerned with its long term effect on human health is still in process.

Maximum dosage allowed per day: 15 mg for each 1 kg of the total body weight.

4- Sucralose:

It is a relatively new zero-calories sweetener that was approved by the FDA in 1998 but was not widely used until 1999. Now, sucralose is part of the production process of nearly 4500 products. It is commercially known by Splenda and it is 650 times sweeter than regular sugar.

Sucralose is chemically derived from sucrose in which the hydroxy group is substituted by three chlorine atoms to produce what is known as chlorinated sugar. Due to the fact that it is a very sweet substance, it is often mixed with another low calories sweetener like dextrose to make it less sweet.

As for digestion, only 8-20% of sucralose get absobed by the blood and the rest goes directly to the kidneys that throws it out of the body.

Maximum dosage allowed per day: 5 mg for each 1 kg of the total body weight.

5- Neotame:

Commercially known as "Newtame". It was approved by the FDA in 2002 as a new derivation of aspartame as it is similar to in chemistry but does not contain the phenylalanine group. People who are unable to break phenylalanine are at risk of having Phenyleketoneurea disease (PKU). Neotame os 7000 to 13000 times sweeter than regular sugar.

All studies have shown that Neotame is safe for people from all ages as long with pregnant and nursing women, however none of these studies have investigated its long term effects.

Maximum dosage allowed per day: 0.3 mg for each 1 kg of the total body weight.


Are there benefits to the sugar alternatives?

Scientists and nutritionists have worked hard to provide us with sugar alternatives that gives the sweet taste without adding calories to our bodies. These calories are the cornerstone of obesity.

Many of us prevent themselves from having their favorite drinks or desserts because if all the sugar intake that will result from it. Luckily, with sugar substitutes you can have desserts to your hearts content and gain only 4 to zero calories.

They are also chemically different to real sugar which drives you away from risks imposed by sugar like obesity, diabetes, and cavities.

Artificial sweeteners are better for your teeth and gums health:

When you eat white sugar, mouth bacteria is produced heavily in the mouth producing, in turn, many acids that eat away the tooth enamel. On the other hand, artificial sweeteners do not encourage the production of this bacteria which preserves teeth from cavity and decay.

Artificial sweeteners are good for combating diabetes:

Artificial sweeteners are a true blessing for those who have diabetes. Diabetes can be hard to control, and having too many sweet food can lead to extreme fluctuation of sugar levels in the body to an alarming rate. People with diabetes can now, thanks to these products, tend to their sweet tooth while watching for their sugar levels.

They are perfect for people who are seeking to lose some pounds!

Those artificial sweeteners have low to zero calories which is great for people who want to stay in shape or lose weight. They can enjoy their favorite food without gaining calories. They should, however, be smart about it and not get fooled by the label "Sugar-free" as sugar free does not necessarily mean "calories-free". A cake for example can be made with artificial sweeteners but still has a lot of calories in it. These calories are in the other cake ingredients.

Rumors around potential risks of artificial sweeteners and the studies conducted to prove they are safe:

In 1977, a study conducted on lab rats has lead scientists to believe that a relation exists between saccharin and bladder cancer. As a result both American and Canadian FDAs have warned against using saccharin in food products. They put a label the products that has it  that says "This a product that contains saccharin and it may endanger your health". A lot of research has been made since then to debunk this theory. It was said later that saccharin cause bladder cancer only to male rats in a mechanism that does not apply to humans. what typically happens is that, when used in high quantities, saccharin leaves urine depositions in the bladder that eats away its inside tissues. When these tissues grow again they grow cancerous tumors.

According to IARC, SCF, Center for the science in public interest-CSPI, and in cooperation with National toxicology program- NT, saccharin is not considered a cancerous substance for humans although it was proven than, in different circumstances, it causes cancer to rats and it was taken off the list of cancer-causing substances.

Many researches and reports from 1996 have indicated that using Aspartame for a long time as a sugar substitute may lead to Lymphoma and brain cancer. These studies, however, were not very accurate. The American National Institute of Cancer has conducted an research on around 1 million people who consume drinks with regular sugar and others who consume drinks with aspartame and the number of people who developed cancer did not rise among the group that consumed aspartame. The result of this research proves that cancer does not increase susceptibility to cancer.

A research has recently suggested the existence of a link between artificial sweeteners and obesity. The research claims that the reason behind this suggestion is the fact that these sweeteners serve as appetizers. These studies are not scientifically strong, though and their claims are still under investigation.

Are there people who should NOT use artificial sweeteners?

Given the fact that saccharin belongs to the family of sulfonamides, people who are allergic to the sulfo group, and the cosmetics and medications that contain its elements may suffer headache, difficulty in breathing, rash and diarrhea. Due to that, saccharin should not be consumed by children, pregnant women, or whoever that may develop an allergic reaction towards products that has a member of the sulfo group.

As for aspartame, we particularly discourage people who suffer from phenylketoneurea (PKU) from using it. PKU is a hereditary diseases that results from a genetic defect in metabolism that leads to the accumulation of the amino acid "phenylalinine" in the tissues. Phenylalinine levels rise in the blood causing damage in the brain cells that causes, in turn, severe mental disability. This happens due to a genetic defect in the enzyme that breaks phenylalinine.

In conclusion: 

The FDA has stated that consuming artificial sugar substitutes should be safe, and that it constitutes no threat to our health as long as it is used moderately. And as we always say: moderation in all things and all things in moderation.


Wagdan Foura
Wagdan Zeyada Foura, B Pharm is currently residing in Gaza. She graduated in 2016 with a bachelor degree in pharmacy from AlAzhar University in Gaza. She became a licensed pharmacist on the 27th of January, 2017 after a training period that lasted for 6 months in governmental and private pharmacies. She participated in a workshop about safe injecting and she currently is a private sector pharmacist. Wagdan is interested in the medical field, the safe handling of medicine and everything things related to health and nutrition.