Artificially Sweetened Beverages

    Researchedby:
    Megan Michaux

    Fact-checked

    by:

    Nick Milazzo
    Last Updated: September 12, 2023

    Artificially sweetened beverages (ASBs), most commonly diet sodas, are drinks that use nonnutritive sweeteners (NNS) like aspartame, sucralose, or acesulfame K instead of sugar. They are sometimes recommended in place of sugar-sweetened beverages for people who are trying to lose weight, or for those with diabetes.

    What are artificially sweetened beverages?

    Artificially sweetened beverages (ASB) are drinks, such as soda, carbonated water and juices, that have been sweetened with nonnutritive sweeteners (NNS) instead of (or in addition to) sugar. These NNS include aspartame, sucralose, and acesulfame potassium (or acesulfame K). They produce a sweet taste using the same taste receptors as sugar, but are not similar enough to sugar for the body to process as energy.[3] ASB consumption is on the rise globally, with many people choosing to replace sugar-sweetened beverages with ASBs. While controversy exists around the safety of ASB, they are often recommended to people who are trying to lose weight and to diabetics.[4]

    What are the main benefits of artificially sweetened beverages?

    ASBs are often used by people who are trying to lose weight. Since they taste sweet, they can be substituted in place of higher-calorie sugar-sweetened beverages, helping to lower calorie intake while still providing a similar taste. This is also beneficial since fluids are generally less satiating than solid foods, so drinking ASBs helps limit the calories in drinks, leaving more room in a weight loss plan for food.[5][6][7] In some studies, a high intake of ASBs is associated with higher BMI, but this is not necessarily because they cause weight gain: it’s commonly thought that people who have a higher BMI are more likely to drink ASBs, possibly in support of attempts to lose weight. In fact, some research shows that replacing sugar-sweetened beverages with ASBs may help not only with losing weight, but also with maintaining weight loss.[8][9][10] In people with diabetes, replacing sugar-sweetened beverages with ASBs may not only help improve disease control, but may even lower medication requirements in some cases. Of course, ASBs should be used in conjunction with other appropriate lifestyle modifications.[5][11]

    Maintaining a healthy weight with the help of ASBs in place of sugar-sweetened beverages may lower the risk of cardiovascular disease and of certain cancers associated with overweight or obesity. Obesity-related cancers include gastric cancer, esophageal cancer, pancreatic cancer, and breast cancer. However, the study also noted a possible association between ASB and CVD in some subgroups; this needs to be investigated further, but in the meantime, the study authors note that it is worth considering replacing SSBs with water rather than ASB where possible.[12]

    What are the main drawbacks of artificially sweetened beverages?

    While the majority of the evidence seems to support the safety of ASBs at moderate intake levels, there may be some negative aspects to their consumption. Infants born to mothers who consumed ASBs throughout pregnancy had an increased risk of being overweight according to BMI at 1 year of age. With childhood obesity on the rise, this is a concerning association, although this link is not necessarily causative.[13]

    It is theorized that ASBs may impact the gut microbiome, causing changes in appetite regulation and weight, but this is not yet supported by research. In fact, some studies found that sugar-sweetened beverages can have more impact on the gut than ASBs. More research is needed to understand the effect of ASB intake on the gut microbiome.[14]

    While some research has found an association between the intake of artificial sweeteners and cardiovascular disease, this could be related to lifestyle choices and confounding factors; there is no clear evidence that ASBs cause cardiovascular disease.[15][8][16]

    Do artificially sweetened beverages cause cancer?

    Do artificially sweetened beverages cause insulin spikes?

    What are other names for Artificially Sweetened Beverages

    Note that Artificially Sweetened Beverages is also known as:
    • Diet Soda
    • Sugar-free soft drinks
    • Low-calorie drinks

    Dosage information

    The FDA recommendation for aspartame is to consume less than 50 mg per kilogram of body weight per day (mg/kg/day). In Europe, the recommended limit is slightly lower, at less than 40 mg/kg/day. One can of diet soda would amount to about 5 mg/kg for a 40-60 kg person, or 200–300 mg in total. It’s worth noting that ASBs are not the only source of NNS, and other food products must also be considered when estimating total NNS intake.[1] Other NNS safe dosage recommendations include:[2]

    • Acesulfame K: 15 mg/kg/d
    • Sucralose: 5 mg/kg/d
    • Saccharine: 15 mg/kg/d
    • Steviol glycosides (e.g., rebaudioside A): 4 mg/kg/d

    ASBs often use combinations of these ingredients, so adding up the amounts can be confusing. For example, Diet Coke uses only aspartame, but Coke Zero combines aspartame and acesulfame K.

    Frequently asked questions

    What are artificially sweetened beverages?

    Artificially sweetened beverages (ASB) are drinks, such as soda, carbonated water and juices, that have been sweetened with nonnutritive sweeteners (NNS) instead of (or in addition to) sugar. These NNS include aspartame, sucralose, and acesulfame potassium (or acesulfame K). They produce a sweet taste using the same taste receptors as sugar, but are not similar enough to sugar for the body to process as energy.[3] ASB consumption is on the rise globally, with many people choosing to replace sugar-sweetened beverages with ASBs. While controversy exists around the safety of ASB, they are often recommended to people who are trying to lose weight and to diabetics.[4]

    What are the main benefits of artificially sweetened beverages?

    ASBs are often used by people who are trying to lose weight. Since they taste sweet, they can be substituted in place of higher-calorie sugar-sweetened beverages, helping to lower calorie intake while still providing a similar taste. This is also beneficial since fluids are generally less satiating than solid foods, so drinking ASBs helps limit the calories in drinks, leaving more room in a weight loss plan for food.[5][6][7] In some studies, a high intake of ASBs is associated with higher BMI, but this is not necessarily because they cause weight gain: it’s commonly thought that people who have a higher BMI are more likely to drink ASBs, possibly in support of attempts to lose weight. In fact, some research shows that replacing sugar-sweetened beverages with ASBs may help not only with losing weight, but also with maintaining weight loss.[8][9][10] In people with diabetes, replacing sugar-sweetened beverages with ASBs may not only help improve disease control, but may even lower medication requirements in some cases. Of course, ASBs should be used in conjunction with other appropriate lifestyle modifications.[5][11]

    Maintaining a healthy weight with the help of ASBs in place of sugar-sweetened beverages may lower the risk of cardiovascular disease and of certain cancers associated with overweight or obesity. Obesity-related cancers include gastric cancer, esophageal cancer, pancreatic cancer, and breast cancer. However, the study also noted a possible association between ASB and CVD in some subgroups; this needs to be investigated further, but in the meantime, the study authors note that it is worth considering replacing SSBs with water rather than ASB where possible.[12]

    What are the main drawbacks of artificially sweetened beverages?

    While the majority of the evidence seems to support the safety of ASBs at moderate intake levels, there may be some negative aspects to their consumption. Infants born to mothers who consumed ASBs throughout pregnancy had an increased risk of being overweight according to BMI at 1 year of age. With childhood obesity on the rise, this is a concerning association, although this link is not necessarily causative.[13]

    It is theorized that ASBs may impact the gut microbiome, causing changes in appetite regulation and weight, but this is not yet supported by research. In fact, some studies found that sugar-sweetened beverages can have more impact on the gut than ASBs. More research is needed to understand the effect of ASB intake on the gut microbiome.[14]

    While some research has found an association between the intake of artificial sweeteners and cardiovascular disease, this could be related to lifestyle choices and confounding factors; there is no clear evidence that ASBs cause cardiovascular disease.[15][8][16]

    Do artificially sweetened beverages cause cancer?

    Hypotheses about the possible carcinogenic effects of ASBs in humans come from carcinogenicity observed in rodent studies. However, carcinogenic effects like those seen in rodents have not been seen in humans. 4-methylimidazole (4-MEI), which is what gives cola its brown color, was associated with cancer in extremely large doses in rodents but does not appear to be carcinogenic in humans at the moderate doses found in ASBs.[17]

    A tenuous association has been found between leukemia and ASB intake. However, there is not yet a lot of evidence to support this association; the evidence to date is from small studies that are not conclusive.[1][18]

    Obesity-related cancers are not associated with ASB intake.[19][20][21][22]

    Do artificially sweetened beverages cause insulin spikes?

    ASBs, and NNS in general, do not cause insulin to increase in the bloodstream. Hypotheses suggesting that ASBs and NNS could initiate an insulin response, by either a central or a hormonal mechanism, have not been supported by research. Multiple studies have been done showing that artificial sweeteners do not impact blood sugar or insulin levels, whether taken alone or with a meal.[23][24][25][23][26]

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