The FDA approved the use of acesulfame potassium (ACE-k) in 1988, but since then the Center for Science in the Public Interest has requested more research to support its approval. While it is still approved by the FDA, current studies raise legitimate concerns regarding its long-term health effects. Researchers have discovered that ACE-k can alter the intestinal bacterial composition and metabolic profile of some people. In addition, it can contribute to weight gain over time.
Saccharin is one of the oldest artificial sweeteners on the market, dating back more than 100 years. This non-nutritive artificial sweetener is manufactured in the laboratory and, despite the fact that the FDA recognizes it as safe, many people are skeptical about its potential long-term effects. Outdated animal studies linked the use of saccharin to the prevalence of bladder cancer. However, subsequent studies did not support these findings and it was removed from the Report of the National Toxicology Program on Carcinogens.
Stevia is a natural, calorie-free sweetener that can help lower both blood pressure and blood sugar levels. Erythritol is another low-calorie sweetener that tastes a lot like sugar, although it may have a mild aftertaste. Keep in mind that erythritol is much less likely to cause digestive problems than other sugar alcohols such as xylitol. In addition, a study involving 264 young adults showed that higher levels of erythritol in the blood were associated with increased abdominal fat, which may be due to a genetic predisposition to convert sugar to erythritol.
Erythritol has recently come under criticism because of a new small study linking it to adverse cardiac events and thrombosis. The increase in the participants' blood erythritol levels lasted for days after ingestion. This study didn't necessarily show that erythritol causes heart disease and stroke, just that there's an association between the two. Many aspects of this study were conducted in vitro and in vivo laboratory studies, which do not necessarily translate into the same results in humans.
More research is needed to confirm that these potential side effects of erythritol are a valid concern. Monk fruit also contains antioxidant compounds known as mogrosides, which studies have shown can reduce markers of inflammation. In fact, consuming large amounts of natural sugars or sugar substitutes in the long term may increase cravings for sweets and contribute to problems such as weight gain and type 2 diabetes. For these people, especially those who are overweight or insulin resistant, large amounts of sugar can be especially harmful.
Some research on the long-term daily use of artificial sweeteners suggests a link to a higher risk of stroke, heart disease, and death in general. However, other things people do, or healthy habits that people don't do, may be the cause of the increased risk. Dates, honey, maple syrup, and coconut sugar are the best alternatives to sugar. The occasional use of stevia and monk fruit is also a good option.
The worst sweeteners include artificial sweeteners such as sucralose, saccharin and aspartame, high-fructose corn syrup, agave, and brown rice syrup. It's best to avoid these sweeteners if possible. We all have unique nutritional needs, and there are many valid reasons to include artificial sweeteners in a well-balanced diet. Artificial sweeteners can provide sweetness without sugar or calories, but their health effects are controversial.
Xylitol is another sugar alcohol that is technically an artificial sweetener and is among the best and worst artificial sweeteners. The use of low calorie sweeteners is associated with the perception of health risks, such as cancer, in part due to previous research and policy measures on the artificial sweeteners saccharin and aspartame. In general, many people report having headaches, stomachaches, and general malaise after consuming artificial sweeteners. Artificial sweeteners may be a short-term way to help some people reduce their sugar intake and lose or control their weight.
However, the FDA has reviewed more than 110 studies to determine the safety of artificial sweetener and identify possible toxic effects.