Fake sugars sneak into foods, disrupt health
Many people are cutting back on their sugar intake for health reasons. But the food industry has found another way to give consumers their sweet fix.
It is quietly replacing the sugar in many packaged foods with sucralose, stevia, allulose, erythritol and a wide variety of other artificial sweeteners and sugar substitutes.
Low- and zero-calorie sweeteners have been used in diet soft drinks for decades. But now food companies are adding them to a growing number of packaged foods, including many that might surprise you.
These include bread, yogurt, oatmeal, muffins, canned soups, salad dressings, condiments and snack bars.
The number of food products containing lowor no-calorie sugar substitutes has surged in the past five years, according to an analysis by Mintel, the market research firm.
The food industry says sugar substitutes help people manage their weight and reduce intake of added sugars. But studies suggest that fake sugars can also have unexpected effects on your gut and metabolic health and even promote food cravings and insulin resistance, a precursor to Type 2 diabetes.
‘Ubiquitous’ additions
Table sugar, or sucrose, is still the dominant sweetener in the food supply, and eating a lot of ultraprocessed foods with added sugar has been linked to chronic illness and obesity. The number of new food products containing sucrose has fallen by 16 percent in the last five years. Use of high-fructose corn syrup and agave syrup also have declined.
“These low-calorie sweeteners are ubiquitous in the food supply, and so people often aren’t even aware that they’re consuming them,” said Allison Sylvetsky, an associate professor in the department of exercise and nutrition sciences at George Washington University.
Many sugar substitutes are known as high-intensity sweeteners because they’re often hundreds of times sweeter than table sugar. Some are synthetic, like sucralose, aspartame, and saccharin, while others, like allulose, stevia and monk fruit extract, are referred to as “natural” because they’re derived from plants.
Sugar substitutes can be found in ingredient lists on food packages, often with names that many consumers don’t recognize, like adventame, neotame and acesulfame potassium. Foods that claim “no artificial sweeteners” often are sweetened with stevia and other so-called “natural” sugar substitutes.
A variety of these sweeteners are turning up in cereals, juices and other packaged foods marketed to kids — even though public health groups have discouraged their use among children.
“When I started thirtysomething years ago I never saw low-calorie sweeteners in pediatric products,” said Julie Mennella, a developmental biopsychologist who studies children’s taste preferences at the Monell Chemical Senses Center in Philadelphia. “Now, they’re everywhere.”
Sucralose and acesulfame potassium are regularly used in Greek yogurts, tortilla wraps and other foods served in school meals. Schools in some states have experimented with serving chocolate milk sweetened with a blend of sugar and monk fruit extract.
Federal incentive
Under a proposal from the Food and Drug Administration, companies will no longer be able to label a food “healthy” unless it adheres to strict new limits on added sugars. One way companies can adhere to the proposed rules is to replace added sugars in foods with artificial sweeteners.
“When companies reformulate their foods to contain less sugar it leads them to use more non-nutritive sweeteners,” said Jotham Suez, an assistant professor at the Johns Hopkins Bloomberg School of Public Health who studies sugar substitutes.
The World Health Organization cautioned people to limit their intake of sugar substitutes because of their potential for “undesirable” long-term effects, including detrimental effects on gut and metabolic health.
Robert Rankin, the executive director of the Calorie Control Council, an industry group, pushed back against claims that sugar substitutes come with health risks. “Evidence shows that low- and no- calorie sweeteners are a safe and effective alternative to added sugars and can be used as part of a balanced diet to help consumers achieve dietary goals, whether it be managing weight or diabetes, reducing the consumption of added sugars, or reducing total caloric intake,” he said.
But one rigorous study led by Suez and carried out at the Weizmann Institute of Science in Israel last year looked at what happened when people were given aspartame, saccharin, stevia, or sucralose in amounts well below the FDA’s daily allowances.
The study found that these sweeteners caused changes in both the function and composition of the participants’ gut microbiomes, the communities of bacteria, viruses and fungi that live in the intestines.
Suez and his colleagues found that artificial sweeteners and sugar substitutes can alter your microbiome in ways that are detrimental to your metabolic health.
Other laboratory studies have shown that drinking beverages made with sucralose can promote insulin resistance, a precursor to diabetes.
Effects on the brain
Scientists have also uncovered surprising effects of artificial sweeteners on our brains and appetites.
Sweet taste receptors on your tongue tell your brain that you’re eating something sweet. This sends a signal to your brain and your body that an influx of calories is coming. But because these sweeteners are more potent than normal sugar with few or none of the calories, they can confuse your brain and your taste receptors.
One potential consequence of this, studies have found, is that you might develop stronger sugar cravings and end up eating more sugar and sweetened foods.
Scientists say it’s hard to fully understand the health effects of all these sugar substitutes. One reason is that there are so many of them. At least six artificial sweeteners have been approved by the FDA: Saccharin, sucralose, aspartame, acesulfame potassium, neotame and advantame. Companies are also allowed to use other non-nutritive sweeteners that the agency deems “generally recognized as safe,” which means they don’t have to undergo rigorous FDA safety reviews.
Observational studies suggest that people who consume a lot of low-calorie sweeteners have higher rates of obesity and weight gain. But that may be a case of reverse causality, since people who are at risk of obesity are more likely to choose diet foods and beverages. The most rigorous clinical trials show that when people replace sugary drinks with artificially sweetened beverages like Diet Coke and Diet Pepsi it helps them avoid gaining excess weight.
Detecting substitutes
The American Academy of Pediatrics says the FDA should require food companies to list the amounts of any non-nutritive sweeteners on the nutrition facts panel, alongside things like fat, carbohydrates and added sugar. Some consumer groups called for new labeling rules to make it easier to know when sugar substitutes are used in packaged foods.
One particularly vocal critic is the sugar industry. The Sugar Association, an industry trade and lobbying group, in 2020 submitted a lengthy petition to the FDA pointing out that packaged foods that carry label claims like “reduced sugar” and “no added sugars” are often sweetened with sugar substitutes.
The group argued that consumers are being “misled” because these products are frequently marketed as healthier, even though they’re often “higher in calories or contain alternative sweeteners that consumers are not familiar with.”