Should you use artificial sweeteners?

With a low to no calorie sugar count, artificial sweeteners may seem  like a treat for people with diabetes. But recent research indicates  that artificial sweeteners may actually be counterintuitive, especially  if you’re looking to manage or prevent diabetes.

In fact, the increased consumption of these sugar substitutes may correlate to the increase of obesity and diabetes cases.

The good news is that there are sugar alternatives you can choose from, including:

stevia or stevia products such as Truvia

tagatose

monk fruit extract

coconut palm sugar

date sugar

sugar alcohols, such as erythritol or xylitol

You’ll still want to watch your intake for glucose management, but these options are far better than the products marketed as“sugar-free.”

What is stevia?

Stevia is a low-calorie sweetener that has antioxidant and antidiabetic properties. It’s been approved by the U.S. Food and Drug Administration (FDA).

Unlike artificial sweeteners and sugar, stevia can suppress your  plasma glucose levels and significantly increase glucose tolerance. It’s also not an artificial sweetener, technically speaking. That’s because it’s made from the leaves of the steviaplant.

Stevia alsohas the ability to:

increase insulin production

increase insulin’s effect on cell membranes

stabilize blood sugar levels

counter the mechanics of type 2 diabetes and its complications

You can find steviaunder brand names such as:

Pure Via

Sun Crystals

SweetLeaf

Truvia

While steviais natural, these brands are usually highly processed and  may contain other ingredients. For example, Truvia goes through 40  processing steps before it’s ready to be sold. It also contains the sugar alcohol erythritol.

Future research may shed more light on the impact of consuming these processed stevia sweeteners.

The best way to consume stevia is to grow the plant yourself and use the whole leaves to sweeten foods.

What is tagatose?

Tagatose is another naturally occurring sugar that researchers are studying. Preliminary studies show that tagatose:

may be a potential antidiabetic and antiobesity medication

can lower your blood sugar and insulin response

interferes with the absorption of carbohydrates

A 2018 review of studies concluded tagatose is“promising as a sweetener without major adverse effects observed.”

But tagatose needs more studies for more definitive answers. Talk to  your doctor before trying newer sweeteners such as tagatose.

What are some other sweet options?

Monk fruit extract and coconut palm sugar are other alternatives that  are gaining popularity. But no processed sweetener can beat using fresh  whole fruit to sweeten foods.

Another excellent option is date sugar, made of whole dates that are dried and ground. It doesn’t provide fewer calories, but date sugar is made of the whole fruit with the fiber still intact.

You can also subtract fiber from total grams of carbohydrates, if you  count carbs for meal planning. This will give you net carbs consumed.  The more fibrous a food, the lower impact it will have on your blood  sugar.

Why are artificial sweeteners bad for people with diabetes?

Some artificial sweeteners say“sugar-free”or“diabetic-friendly,”but research suggests these sugars actually have the opposite of effect.

Your body responds to artificial sweeteners differently than it does  regular sugar. Artificial sugar can interfere with your body’s learned taste. This can confuse your brain, which will send signals telling you to eat more, especially more sweet foods.

Artificial sweeteners can still raise your glucose levels

One 2016 study saw normal-weight individuals who ate more artificial  sweeteners were more likely to have diabetes than people who were  overweight or obese.

Another 2014 study found that these sugars, such as saccharin, can  change your gut bacteria composition. This change can cause glucose  intolerance, which is the first step towards metabolic syndrome and  diabetes in adults.

For people who don’t  develop a glucose intolerance, artificial sweeteners may help with  weight-loss or diabetes control. But switching to this sugar replacement  still requires long-term management and controlled intake.

if you’re thinking of replacing sugar regularly, talk to your doctor and dietitian about your concerns.

Artificial sweeteners may also contribute to weight gain

Obesity and being overweight is one of the top predictors for  diabetes. While artificial sweeteners are FDA-approvedTrusted Source, it  doesn’t mean they’re healthy.

Marketing for food products can lead you to think non-caloric  artificial sweeteners help with weight loss, but studies show the  opposite.

That’s because artificial sweeteners:

may lead to cravings, overeating and weight gain

alter gut bacteria which is important for weight management

For people with diabetes looking to manage their weight or sugar intake, artificial sweeteners may not be a good substitute.

Being overweight or obese can also increase your risk factors for  several other health issues such as high blood pressure, body pain, and  stroke.

Safety rating for artificial sweeteners

The Center for Science in the Public Interest currently deems artificial sweeteners a product to“avoid.”Avoid means the product is unsafe or poorly tested and not worth any risk.

What about sugar alcohols?

Sugar alcohols are naturally found in plants and berries. The types  most often used in the food industry are synthetically created. You can  find them in food products that are labeled as“sugar-free”or“no sugar added.”

Labels such as this are misleading because sugar alcohols are still  carbohydrates. They can still raise your blood sugar, but not as much as  regular sugar.

Common FDA-approved sugar alcohols are:

erythritol

xylitol

sorbitol

lactitol

isomalt

maltitol

Swerve is a newer consumer brand that contains erythritol. It’s available in many grocery stores. The brand Ideal contains both sucralose and xylitol.

Different from artificial sweeteners

Sugar alcohols are often synthetic, similar to artificial sweeteners.  But these two classifications of sugar alternatives aren’t the same. Sugar alcohols are different because they:

can be metabolized without insulin

are less sweet than artificial sweeteners and sugar

can be partially digested in the intestine

don’t have the aftertaste of artificial sweeteners

Research suggests that sugar alcohols can be a sufficient replacement for sugar. But reports also say that it won’t play a significant role in weight loss. You should treat sugar alcohols the same as sugar and limit your intake.

Sugar alcohols are also known to produce side effects such as gas,  bloating, and abdominal discomfort. However, erythritol is usually  better tolerated, if you’re concerned about these side effects.

What’s the takeaway?

Recent studies indicate that artificial sweeteners are no longer the  healthy alternatives to sugar. In fact, they may increase a person’s risk for diabetes, glucose intolerance, and weight gain.

If you’re  looking for a healthier alternative, try stevia. Based on research to  date, this alternative sweetener is one of your better options. It’s known for its antidiabetic properties and ability to stabilize blood sugar levels.

You can get stevia in raw form, grow the plant yourself, or buy it under brand names such as Sweet Leaf and Truvia.

However, you should still limit your total added sugar intake rather than switching to sugar substitutes.

The more you consume any kind of added sweeteners, the more your  palate is exposed to sweet tastes. Palate research shows that the food  you prefer and crave is the food that you eat most often.

You’ll see the most benefit for managing your sugar cravings and diabetes when you reduce all forms of added sugar.

Medically reviewed by Natalie Olsen, RD, LD, ACSM EP-C—Written by the Healthline Editorial Team—Updated on April 13, 2020