Alice Sugar Substitutes

Sugar Substitutes – Some Karma Sense at the End of the Rabbit Hole [REFERENCE]

Executive Summary

I’m going to come right out and say it. Sugar substitutes are gross. They taste nasty. They undermine your appreciation for good food. They’re made in factories that could just as well be making dog food or bear mace.

Obviously, I’m biased against sugar substitutes. I base that bias on little more than personal preference. However, Some of you seem to like them. You need your diet soft drinks or you look at low calories sweets as a bridge towards better health. That view is no less legitimate than mine.

If you’re in that group, I encourage you to read on. It will help you come to peace with a decision to continue to consume fake sugar or to start tapering off.

If you’re like me and  avoid eating things that taste like gym socks, please continue reading. You’ll learn important stuff like how your microbiome is exactly like a dog, even the drooling part. You can also smugly throw the wisdom of your choice to your Diet Rite Cola addicted friends (Diet Rite brand is their drug of choice, right?).

This post is the second in a three-part series focused on sugar substitutes. Truth be told, the three-part series is part of a larger compendium concerning the 2015 Dietary Guidelines for Americans. For the first time in its thirty year history, the guidelines had something to say about sugar substitutes.

Part one of this series discussed the specific recommendations in the guidelines and described my discovery that any attempt to give advice regarding sugar substitutes is a rabbit hole akin to the convoluted and confusing route Alice took during her Adventures in Wonderland.

In this part, we focus upon what lies at the end of the rabbit hole. By the time you finish reading, you’ll get the answer to the questions, do fake sugars:

  • Help you lose weight?
  • Make you sick in the process?

The short answer is, they likely help you lose weight and they likely don’t make you sick. That may be a less-than satisfying answer, but such is life in the rabbit hole.

This Post’s Structure

I deliver part two of the Sugar Substitute series in the spirit of the “Food Lists” appendix of The Karma Sense Eating Plan. That section was chockablock full (which I believe is a nautical term for “crapload”) of useful info to help guide more nutritious food choices. In fact, there is a subset of readers who commented that the appendix is the best part of the book. I could take this any number of ways, such as:

  1. The narrative portions of the book are so poorly written and factually bankrupt that tables containing nothing but facts and totally devoid of superhero references rise to the top. Or…
  2. I have mad skills when it comes to analyzing, summarizing and organizing worthwhile information that you can’t find from one single source.

I’m going to assume it’s the latter.

Before presenting that lovely set of tables, we review what the research says on some of the claims about sugar substitutes. SPOILER ALERT: When I hedged earlier and said, “they likely help you lose weight and they likely don’t make you sick,” it’s because, in most cases, the science isn’t very strong for either position.

What follows is a reference for you to use when pondering some of life’s deeper questions, such as, “What is more disgusting, sugar-free Ho-Hos or Diet Chocolate-Covered-Bacon-and-Ranch-Flavored-Cheese-Puffs?

You may want to consider finding a way to save this reference offline because I’m considering pulling it off the website in the future and packaging it as an eBook for sale. It is that valuable and a guy has to make a living somehow. Other reasons to pull it are the cease-and-desist letters I expect to get from Celanese and Monsanto but we’ll worry about those as they happen.

Sugar Substitutes – The Research

This section of the post examines the common questions about sugar substitutes and what the research says regarding three important aspects, do they make you sick in the short term, do the may you sick in the long term, and do they even work?

Do Sugar Substitutes Make You Sick in the Short Term?

Many claim that sugar substitutes cause bellyaches and headaches. Do they?

Sugar Substitutes and Bellyaches

Bellyaches, indigestion and undesirable anal emissions of both the gaseous and solid form. These are all symptoms some people experience when they consume sugar substitutes. The real culprit causing this problem is your microbiome or your gut flora (gut). Your digestive tract is teeming with bacteria that can help or hinder the process of absorbing nutrients and excreting toxins.

These little fellers get a lot of play in the media these days but the fact is we really don’t know that much about them. This is confirmed in a recent meta-analysis (the kind of research that makes a food-geek swoon). But there does appear to be some evidence that sugar substitutes change the current gut population to something else. That change may just as well be beneficial as harmful.

It is my opinion that they are most likely neutral or slightly harmful to your gut. You see, them fellers in your gut are a lot like dogs. Their main purpose in life is to drool. The only difference is your gut drools in your intestines. Your dog drools all over that rug that really pulled your room together. Despite this, you’d miss both kinds of fellers terribly if they weren’t around, but they’re not exactly what I would call “smart.” For example, both will happily eat things that aren’t really food and that rarely ends up well. In both cases the damage will eventually “pass” if you take good care of them and feed ’em canned pumpkin.

But keep in mind, one fake sugar in particular, Xylitol, is deadly poisonous to dogs. This is another reason to keep your Trident sugarless gum away from Phydeaux. Four out of five veterinarians agree. The fifth one is an a-hole.

Regardless, many people anecdotally report stomach upset after consuming certain substitutes. Caveat emptor.

Gut Issues? For some.

NOTE: There are links to poor gut health and several chronic (long-term) conditions including cancer and diabetes. In addition, the microbiome is linked to a long list of behavioral  and mood disorders. As stated, the science on this is immature and not conclusive.

Sugar Substitutes and Headaches

Aspartame is the usual suspect for this claim.

There are several studies (here’s one) that say the frequency of headaches for people who consume aspartame is no different from those who consume a placebo. But other studies (such as this one and this one) conclude some people are more susceptible to headaches than others.

This is an issue that is clearly in people’s head (see what I did there?). As someone who feels he’s susceptible to aspartame-induced headaches, I know it’s true. But I can’t help but believe it’s at least partially psychosomatic since simply thinking about the migraines I used to get from during my Diet Pepsi drinking days is giving me that queasy migraine feeling right now (⇐not a joke).

Headaches? Irrelevant. If you get them does it matter whether it’s psychosomatic or not?

Do Sugar Substitutes Make you Sick in the Long Term?

“Experts blame sugar substitutes for diabetes, cancer, depression and other chronic diseases. What is the evidence for these claims?

Sugar Substitutes and Diabetes

Again, the studies go either way (linked or not). In the case of diabetes, there are only observational studies which mean they don’t prove that sugar substitutes cause diabetes. People who acquired Type 2 Diabetes in those studies could have gained this dubious achievement due to any number of reasons and it just so happens that they also guzzle Diet Coke.

The studies that show no link are much stronger. They’re randomized control trials (RCTs) that prove that the intake of sugar substitutes do not elicit any of the mechanisms that are symptomatic of or precursors to Type 2 Diabetes.

We can safely assume there is no link. Any evidence to the contrary implies that there may be other behavioral or genetic links.

Diabetes? Very weak link. More research needed for specific populations.

Sugar Substitutes and Cancer

The research that demonstrates a link between sugar substitutes and cancer only seem to apply if you are a rat or if you spent your entire life drinking Tab at the same rate that the coeds in my neighboring dorm in college did (study).

Most recently, study after study after study demonstrate no link and this is why the FDA considers they’re safe.

The only exception to the “not banned due to cancer” rule is the sweetener cyclamates. Those of us who have geeked out on Dr. Atkins Diet Revolution as a child, (I know there are others of you out there) are familiar with the long sad tale concerning cyclamates. It was banned due to a link found in one of those rat studies in which they’re overfed the stuff and eventually get tumors the size of rats. Many of those studies are now discredited but to this day, one of the least objectionable tasting artificial sweeteners remains banned in the US.

Cancer? Nope.

Sugar Substitutes and Depression

There isn’t a lot to go on with this claim but one study found that people who already have mood disorders may be subject to exacerbated symptoms when eating or drinking food that contains aspartame.

Depression is a serious disorder that depends on many physiological and mental processes. It makes sense that individual substances, whether natural or artificial, could have this effect. Depression also is reversible using both natural and artificial (e.g., drugs) means.

If you’re suffering from depression, avoid aspartame. It probably won’t eliminate your symptoms but it makes treatment easier and less dependent on artificial means.

Depression? Be mindful if you’re prone to mood disorders.

Do Sugar Substitutes Work?

For sugar substitutes to work, they should help people lose or maintain their weight. The most obvious way they can help people lose weight is to reduce cravings and therefore calorie intake.

Sugar Substitutes and Cravings

There is plenty of speculation regarding mechanisms that link the use of sugar substitutes to the desire to eat more real sugar (here’s two⇒1, 2). But I find a lot more studies that show the opposite effect (here is a small sample of four⇒1, 2, 3, 4)

Many mechanisms drive hunger. Your hormones and nervous system contribute a bunch. But the absolute biggest reason you get hungry is because you decide you’re hungry. None of this research tested for that. What the research shows is that different people respond in different ways. Trust your gut.

Effect cravings? Mostly it’s in your head.

NOTE: When I say in your head, I don’t deny that physiological drivers for hunger are there. However, with proper training, you can overcome this. Ask me how (Don’t stop scrolling at this form. There is more awesome info below!).

Sugar Substitutes and Weight

Regardless of whether sugar substitutes affect your appetite, do they help you lose weight?

By now you should recognize that the dirty little secret of most nutrition research is that it is easy to find studies that support a specific point of view. I can find research that says sugar substitutes increase weight (here and here). I can find studies showing the opposite (here and here).

We’re back to the advice in the above discussion on hunger. Individual results will vary.

Weight Effect? For most people, they help you lose weight.

Sugar Substitute Survey

In the previous post on this subject, I introduced a taxonomy of artificial sweeteners. That’s because while most normal people haphazardly apply the term “artificial sweeteners” to a broad class of substances, pedantic nutrition geeks have many different terms with nuanced meanings that are important only to them. This is similar to the way my mother, a normal person, referred to the “old comic book” she threw out and I, pedant that I am, sternly corrected her that it was not an “old comic book” it was “Uncanny X-Men #1.” and it currently sells for $3500 in today’s money. Normally my speaking back to her that way would not end well for me but when I put it in terms of lost money, she immediately felt my pain.

Anyway, to normalize between these two models, I introduced a taxonomy that works roughly like this:

  • Artificial Sweeteners – chemicals that don’t occur in nature and happen to taste sweet.
  • Sugar Alcohols – chemicals of a specific molecular configuration (alcohols) that occur in nature and happen to taste sweet. Also, they can make you poop a lot.
  • Natural (or real) Sugar Substitutes – chemical of a specific molecular configuration (glycosides) that occur in nature and happen to taste sweet.

Artificial Sweeteners

Most artificial sweeteners share these features:

  • No calories.
  • Made in factories.
  • Strong concerns about safety but weak evidence.
  • There is no end to Big Food’s ingenuity when it comes to making us crave disgusting food with no redeeming value. New artificial sweeteners are invented all the time and it takes a while for them to actually infiltrate our food supply.
  • Taste gross.
  • So sickeningly sweet that they undermine your appreciation for real and delicious food.
Artificial Sweeteners
Name Used In? Comment
Aspartame Nutrasweet, Equal, Sugar Twin, Canderel
  • Can’t be metabolized by people with phenylketonuria (PKU). If you don’t know what PKU is, you probably don’t have to worry.
  • Some people experience headaches.
  • People with mood disorders may be susceptible to depression.
  • Promotes certain bad bacteria. These happen to be the same ones starved by Xylitol (discussed below).
ACE-K (E950) Sunnet, Sweet One
  • Full name is Acesulfame potassium.
  •  Not yet in general use.
  • Occurs in nature but not in quantities that can fill demand. Thus, it’s always made in a factory and therefore artificial.
Aspartame-acesulfame salt  Twinsweet
  •  Banned in US.
Neotame Newtame
  • Not approved in US.
Saccharin Sweet’N Low, Sweet Twin, Equal, Necta Sweet
  • Some people are allergic and may experience typical allergy symptoms.
  • Promotes certain bad bacteria. These happen to be the same ones starved by Xylitol (still discussed below).
Sucralose Splenda
Tagatose  Allsweet, Naturelose
  • Occurs in nature but not in quantities that can fill demand. Thus, it’s always made in a factory and therefore artificial.
  • A potential carrier for good gut bacteria strains so hits two Big Food marketing hot buttons of low calorie and probiotic. Coming from your neighborhood girl scout soon, New Diet Probiotic Tagatose Tagalongs.

Sugar Alcohols

Most sugar alcohols share these features

  • Occur in nature but usually made in labs to increase yield.
  • Cause bellyaches and upset gut bacteria.
  • Less sweet than sugar.
  • Have calories but fewer than real sugar.
  • Usually used in combination with other sugar substitutes to add bulk to their packaging and to help disguise the fact that the other substitutes taste gross. Most artificial sweeteners are so sweet that it takes an infinitesimally small amount to satisfy a sweet tooth. Big Food adds bulking agents like sugar alcohols to “fill out” those little paper packets and to help mask the gym sock taste.
Sugar Alcohols
Name Used In? Comments
Erythirol Truvia, Zerose, Nectresse, MonkSweet+
  • Has about 6% the calories of regular sugar while most other sugar alcohols have 40-90%.
  • Least objectionable taste.
  • Not usually associated with that explosive diarrhea affect most common with other sugar alcohols.
  • Full name Hydrogenated Starch Hydrolysates. Don’t worry about the word “hydrogenated” here. HSH is not gross like partially hydrogenated oils. It has it’s own unique reason to be gross (gym socks)
Isomalt  Palitinit
  • Promotes good dental hygiene by starving bad bacteria in mouth.
  • Appears to fight other common infections as well.
  • Aspartame and saccharin feed the very same mouth bacteria starved by Xylitol.
  • Poisonous to dogs.

Natural Sugar Substitutes

Most natural sugar substitutes share these common features:

  • Yield from natural means is not likely to keep up with demand. Big Food is lobbying the FDA to allow them to call factory-made versions “natural.”
  • Often blended with “unnatural” artificial sweeteners or sugar alcohols.
Natural Sugar Substitutes
Name Used In? Comments
Stevia EverSweet, Purevia, Truvia, Stevia in the Raw, MonkSweet+, STEVE-IA (for Breaking Bad fans)
  • Less expensive than monk fruit as it’s made from leaves. Leaves are usually more plentiful in plants than the fruit. I know, I have a strong handle on the obvious.
Monkfruit Nectresse, MonkSweet +, Monkfruit In The Raw
  • Most people find Monkfruit to have the least funky (not gross) flavor of all the sugar substitutes.

If you followed all of this, thank you. Also, if you followed all this, you may just be a food geek. Food geek or not, I’ve taken enough of your time for one post. The next and final post in this series offers my advice for how to negotiate your relationship with artificial sweeteners. But so as not to leave you hanging, I repeat my summary advice from the previous Rabbit Hole post, only without the jokes, because frankly, they weren’t that funny the first time.

Artificial Sweeteners – WWDHD (What Would Davey H Do?)

  1. Your best bet is to avoid artificial sweeteners just like you should avoid added sugar. “Avoid” doesn’t mean eliminate. But if you do remove them from your diet, good for you!
  2. Artificial sweeteners can be part of a healthy lifestyle. Don’t panic if you can’t avoid them.
  3. Evidence that artificial sweeteners cause chronic diseases or make you gain weight is weak and depends on consuming more than one ever could in a lifetime.
  4. Still, specific types of artificial sweeteners can cause specific issues for people under specific conditions. Most common is the stomach upset associated with eating the so-called low-calorie sugar alcohols.
  5. It’s best to research the effects of the different kinds.
  6. If you don’t want to worry about it, see #1.


In researching this post, I learned there isn’t a single source for the provided information. This is a win-win. I got to do what I love best, geek out over food. Meanwhile, you get to have all that handy info in one place. I know for a fact there is a significant niche market for what I collected here. Therefore, I’ll likely remove this series of posts in the future and offer it for sale as an eBook. If you’re reading this from the Karma Sense Wellness blog and want the benefit of this research for future reference, you may want to consider saving a copy to access offline.


  1. Authority Nutrition (a usually reliable source of nutrition information)
  2. Nutrition Diva (a Karma Sensible Revolutionary)
  3. The Sweetener Book (an excellent reference on the subject)
  4. Wikipedia (if you don’t know what it is, look it up on Wikipedia)
  5. Calorie Control Council (a lobbyist for Big Food)
  6. The Sugar Association (the Calorie Control Council’s evil nemesis who attempts to rationalize that Sugar is better by saying “not only do the artificial sweeteners packaged for sale to consumers have calories, these products do not have the same clean sweet taste of pure, natural sugar.” They’re nicer than I am the could have said “these products do not taste like gym socks.)

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