I often am asked if people should use regular sugar or artificial sweeteners. The questioner is trying to get on the road to healthy eating, and they have heard in the media about the evils of artificial sweeteners. There are many different artificial sweeteners on the market. Some of the more common ones are saccharin (Sweet 'n Low,) Aspartame (Equal,) and Sucralose (Splenda.) We have all seen and many of us have tasted these zero-calorie sweet packets. Calorie-free sweeteners are often used by people with diabetes or people who are trying to lose weight.
But are they safe? Over the years, there were studies that linked these studies to cancers, but these studies were often poorly designed, in rats (not humans,) and the quantities fed were very large. The FDA approved artificial sweeteners if they are eaten in moderation. This means that 1-2 packets in your coffee 2-3 times per day is considered safe by these standards.
There has been a lot of more recent research on this topic. Some studies link these sweeteners to adverse metabolic effects—that is weight gain, higher blood sugars, and heart problems. There have even been proposed mechanisms to these metabolic effects. Yet, a conclusive answer in this area is not known yet.
Practically, when I am advising a patient, the answer will be customized. Is the patient newly diagnosed with diabetes and currently drinks 1-2 cans of regular soda per day? If the patient is ready and willing to drink 1-2 cans of diet soda per day instead of the regular soda, this might be a good swap. For this patient, the risks of regular soda are likely greater than the potential risks of diet soda. What if the patient has never been much of a sweet drink-drinker and is asking if it is okay to start drinking diet soda? I would likely recommend that this patient choose other beverages, such as water, seltzer, or fruit-infused water. This risks of adding diet soda with potential adverse health outcomes is definitely greater than the “risks” of fewer beverage choices.
In short, it is important to take all health news and information in context of a specific person's needs. Every person’s health is different, and what might be an obvious choice for one person might be the wrong choice for another person.
Fascinating read!