Hopefully by now you are convinced that excess sugar consumption is a major cause for disease, ranging from childhood and adult obesity to diabetes, heart disease, cancer, fatty liver disease, and even Alzheimer’s disease.  So for those of us with a sweet tooth, artificial sweeteners touted to be low glycemic (lower glucose spike) seem to be a perfect replacement, right?  The answer is a big NO.

Not only are artificial sweeteners not healthier than sugar, they appear to be even more toxic.  The word “artificial” should already be a tip off to the recurring truth that man made efforts at reproducing natural foods usually results in epic failure.

So before you keep tearing off those tiny yellow, blue or pink packets to dump into your coffee or tea, or before you keep consuming those “low carb” energy bars, diet sodas, breakfast cereals, protein shakes or other “sugar-free” foods, thinking you’re preventing diabetes and weight gain, you need to keep reading because you’re likely doing more harm than good.

Diabetes and Heart Disease Risk

Diet sodas are one one way to assess the health risks of consuming artificial sweeteners.  The Northern Manhattan Study followed diet soda drinkers for ten years and noted a 43 percent increase in the risk of strokes and heart attacks.

The MESA study, which examines an ethnically diverse study population found that at least daily consumption of diet soda was associated with a 36% greater relative risk of metabolic syndrome and a 67% greater relative risk of type 2 diabetes compared to those who don’t drink diet soda. Metabolic syndrome is the most common cause of global heart disease and like diabetes is linked to insulin resistance.  Read about metabolic syndrome in this post if you’re not familiar with it.

Weight Gain

A compelling study done in mice made a very strong case for the association between artificial sweeteners and obesity, in addition to explaining the underlying mechanism.  There is a growing amount of literature now linking obesity and chronic disease to the types of bacteria that lurk inside our gut.  “Good bacteria” like Bacteroidetes promote leaner physiques and lower disease risk while “bad bacteria” like Firmicutes do the exact opposite.

It’s the balance of these 2 bacteria that can tip us in one direction or the other.  More Bacteroidetes and less Firmicutes favor lower body weight while more Firmicutes and less Bacteroidetes favor greater body fat storage.

Mice fed artificial sweeteners like aspartame, sucralose, or saccharin had higher blood sugars due to insulin resistance and gained a gut bacterial profile that promoted obesity.  When these mice were treated with antibiotics to kill all their gut bacteria, their glucose and body weight normalized.

Now don’t use this controlled experiment to think antibiotics lower body weight and glucose.  In fact, antibiotics can completely throw off the normal balance of bacteria in our gut, increasing the risk of various health conditions.

Read this Scientific American review for a nice summary of these experiments and how our gut microbes are influenced by artificial sweeteners.


One of the primary drivers for my food selection process is to choose nutrients that keep me satiated so I don’t overeat.  Interestingly, the low calorie sweeteners in sodas and sugar-free foods are less satiating than natural sugar and drive cravings for more.

This article is a nice review of studies looking at MRI images of the brain and noting that artificial sweeteners only partially activate our brain’s reward centers compared to sucrose (table sugar). When our brain is partially satisfied, our body aggressively seeks out more sweetened food to fulfill our cravings.  Paradoxically, these sugar-free diet foods cause us to overeat.

Big Food Loves “Sugar-Free”

The food industry is profiting greatly from artificial sweeteners.  As the public is rightfully looking to cut down sugar consumption, they are looking for low carb, sugar-free diet foods that still taste sweet. Artificial sweeteners give manufacturers the perfect vehicle to label foods “sugar-free” while making them highly addictive.  If consumers become diabetic and obese (artificial sweeteners being one of several culprits), then they will even more aggressively seek out these same “sugar-free” alternatives, feeding the vicious cycle of insulin resistance and obesity.  No wonder there are over 6,000 new artificially sweetened foods on the market.

What Sweetener Should You Use?

If I’m stuck in a hotel lobby or an airport with limited options to sweeten my coffee or tea, I’ll use natural sugar or no sugar at all.  If I’m home and want my beverage or food to taste a little sweeter, I might use a more natural, lower glycemic alternative like coconut sugar (my favorite) or just a touch of raw honey.

I’ve recently been using the more expensive manuka honey which has antibacterial properties (see this study) and a very rich nutrient density profile that make it worth the extra cost.  You can read more about manuka honey here.  Keep in mind that excessive honey use will still lead to spikes in your blood glucose, so do use in moderation.

Cinnamon and fresh mint are other ways I sweeten desserts, smoothies and herbal tea.  These natural herbs have anti-inflammatory and anti-diabetic properties.  Stevia is also a natural sweetener derived from a plant and studies do not show the same adverse effects as artificial sweeteners.  Prerna Uppal, the dietitian who works with me, actually grows her own stevia plants and crushes the leaves into desserts which is another alternative.

Now don’t be fooled by agave nectar which is often treated as a lower glycemic, natural sweetener. Agave is actually 80 percent fructose and fructose is a toxin that not only raises blood glucose and diabetes risk, but is also directly metabolized by the liver to produce fatty liver and cholesterol disorders.  Just because it’s natural doesn’t mean it’s good for you.

The above narrative should sound familiar.  Remember the low fat movement which is still going strong by the way. Reducing the fat content of foods and replacing them with excess carbohydrates, sugar, fructose and addictive artificial ingredients simply increased obesity, diabetes and heart disease risk.  Now food manufacturers are repeating the cycle by using artificial sweeteners to spur the sugar-free, low carb movement.  Don’t fall victim to yet another ploy to replace a specific unhealthy nutrient with addictive ingredients that may be even more toxic.