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Artificial sweetener : Friend or Foe?

Artificial sweetener: Friends or foe?

What is artificial sweetener?

Artificial sweeteners are increasingly popular as an alternative to sugar.

 Increased incidence of obesity, diabetes, and metabolic syndrome, and also increase awareness to zero calorie beverage among community has led to a steady paradigm shift toward the use of low-calorie artificial sweeteners.

Artificial sweetener, also called nonnutritive sweeteners (NNS)/low calorie sweeteners/intense sweeteners,  actually provide more intense sweetness and no or a few calories per gram and are used in beverages, dietary products, drugs, and even mouthwashes. They also will not affect blood sugar level.

Usage of artificial sweetener is increasing rapidly due to INCREASE awareness among people to lose weight and to avoid natural sugar that can contribute to calorie wise in their daily life.

Public: Hey Miss Dietitian, would like to ask it is healthy or not this artificial sweetener? Zero calorie or few calorie than natural right? Must be healthy because not affecting my calorie intake per day?

Dietitian: Hey! How are you? Yes true most of artificial sweetener is zero in calorie. Let me explain you in futher okey!

The United States Food and Drug Administration (US-FDA) authority has approved six artificial sweetener (saccharine, aspartame, sucralose, neotame, acesulfame-K, and stevia) for use in humans and has classified them under generally recognized as safe (GRAS) category.

Most NNSs are not metabolized in the body and so, are generally considered safe for consumption. However, there are prevailing concerns over toxicity of “nonmetabolized” compounds in preclinical models. For example, cyclamate one of the artificial sweetener was banned in 1970 due to suspicious over carcinogenicity. After further investigation, the only extensive artificial sweetener (>1680 mg/day) used leads to an increased risk of bladder cancer in humans.

Public: So all these artificial sweetener can be consumed?

Dietitian: Yes absolutely BUT!

For those who have diabetes, it is suitable for them to consume if sugars their favourite! Hehe. Because sweetness in the artificial sugar is not coming from carbohydrates but from organic component in it. It will not metabolized and digested as a glucose (breakdown of carbohydrates). However for diabetic patient who can control blood sugar level, it is recommended to consume natural sugar  limited to 1-2 tsp per day, not to entire depends to artificial sweetener because no proved artificial sweetener can cure diabetes But can only prevent  rises of blood glucose level.

For those who on diet or weight loss journey, you can consume this artificial sweetener because there is no calorie in the artificial sweetener however, the amount of artificial sweetener consumed should not be exceeded as recommended.

Public: Is there any side effects if I consumed?

From Malaysian Dietitian Association (MDA). Below is a summary report from the Center of Science in the Public Interest on the levels of safety of different artificial sweeteners.


Brand / Type that available in Malaysia



Equal, Pal Sweet

Caloric Value: 4 kcal/g
Status: Probably Safe.

- Some user reported of headaches after consuming. People with PKU (phenylketonuria) should avoid aspartame. It is used in many food items, especially beverages and snacks



Caloric Value: 0 kcal/g

Status: Inadequately tested.

FDA granted stevia a GRAS status in December 2008. However it is not approved in Canada.

The problem with stevia is there is not enough studies to conclude whether taking it in a large amount from food would be safe or not. Here’s what troubles the toxicologists:

Reproductive problems.

Stevioside “seems to affect the male reproductive organ system,” European scientists concluded last year. When male rats were fed high doses of stevioside for 22 months, sperm production was reduced, the weight of seminal vesicles (which produce seminal fluid) declined, and there was an increase in cell proliferation in their testicles, which could cause infertility or other problems.1 And when female hamsters were fed large amounts of a derivative of stevioside called steviol, they had fewer and smaller offspring.2 Would small amounts of stevia also cause reproductive problems? This has yet to be determined.


In the laboratory, steviol can be converted into a mutagenic compound, which may promote cancer by causing mutations in the cells’ genetic material (DNA). “We don’t know if the conversion of stevioside to steviol to a mutagen happens in humans,” says Huxtable. “It’s probably a minor issue, but it clearly needs to be resolved.”

Energy metabolism.

Very large amounts of stevioside can interfere with the absorption of carbohydrates in animals and disrupt the conversion of food into energy within cells. “This may be of particular concern for children,” says Huxtable.

The bottom line: If you use stevia sparingly (once or twice a day in a cup of tea, for example), it isn’t a great threat to you. But if stevia were marketed widely and used in diet sodas, it would be consumed by millions of people. And that might pose a public health threat.



Caloric Value: 0 kcal/g

Status: Safe

Sucralose has undergone many scientific studies and been deemed safe for use in lots of different food items. You can find sucralose in snacks, baked goods, ice cream, and even in pharmaceutical products.


According to the MNT for Diabetes Type 2 guidelines; the non-nutritive sweeteners are safe to be consumed within the acceptable daily intake levels among the Type 2 Diabetes adult. For example,The Acceptable Daily Intake (ADI) for diabetics who want to take the aspartame is 50mg/kg.


- Malaysian Dietitian's Association

- Clinical Practice Guideline, Type 2 Diabetes Mellitus.