Sugar-free or “zero” labels on foods and drinks are largely made possible by low- and no-calorie sweeteners (LNCS). Using a much smaller amount of these compounds to deliver a sugar-like taste (often with few or no calories) has become increasingly common. As their use grows, researchers focus on exposure (how much and how frequently) and patterns of use (true substitution vs. addition) when evaluating potential effects, as well as on individual differences.

Do sweeteners affect insulin responses? Do they alter the gut microbiome? Do they increase appetite? Is there any cancer risk? Are all sweeteners the same, and does a “sweetened but sugar-free” product automatically make a healthier choice?

In this article, we outline the main sweetener types, summarize their evidence-based pros and cons, and explain which sweeteners may have which effects. We’ll also assess when replacing sugar with LNCS is sensible (and when it may not be) so you can make informed, confident decisions.

Highlights

• Weight & calories: Replacing sugar-sweetened drinks with low- or no-calorie options is linked to minor, meaningful improvements in body weight and cardiometabolic risk (which can help prevent weight gain), often in a direction similar to switching to water. These benefits are largely due to reduced energy intake.
• Glycemia: Most controlled trials show neutral short-term effects on glucose and insulin; however, responses can be individual and microbiome-dependent.
• Gut microbiome: Human trials report mixed findings, some show little to no change, others note composition/function shifts that vary by sweetener, dose, and baseline diet.
• Safety signals: Erythritol has been associated (not proven causally) with major adverse cardiovascular events in observational analyses with a small pilot exposure arm; caution may be reasonable for high-risk individuals.
• Cancer debate: Aspartame received a 2023 hazard label (IARC Group 2B, “possibly carcinogenic”), while food-safety bodies maintained the acceptable daily intake (ADI) as a reminder that hazard ≠ real-world risk under typical exposure.

What Counts as a “Sweetener” or Artificial Sweetener?

A sweetener is any substance added to food or beverages to provide a sweet taste.
Sweeteners can be classified as nutritive and nonnutritive sweeteners: nutritive sweeteners, like sugar alcohols, provide calories, while nonnutritive sweeteners, such as high-intensity sweeteners, provide little or no calories. A sugar substitute is any ingredient used to replace sugar in foods and beverages.

Sweeteners are widely used in foods and drinks ranging from desserts and yogurts to diet sodas and protein powders. Some add calories (like sugar or honey), while others contribute little to none (like aspartame or stevia).

Artificial Sweeteners

• Definition: Chemically synthesized, non-nutritive compounds that provide an intense sweet taste without significant calories.
• Common Examples: Aspartame, Sucralose, Saccharin, Acesulfame-K, Neotame, Advantame.
• Key Characteristics:
  Up to hundreds or thousands of times sweeter than table sugar (sucrose).
  Provide sweetness without contributing energy or carbohydrates.
  Typically heat-stable (except aspartame), making them useful in baking and beverages.
• Uses: Common in “diet,” “zero,” or “sugar-free” products; often used by people managing diabetes or aiming to reduce calorie intake.

Natural Sweeteners

• Definition: Sweeteners obtained from natural sources such as plants, fruits, or sap.
• Common Examples: Honey, Maple Syrup, Agave Nectar, Stevia (Steviol Glycosides), Monk Fruit (Mogrosides).
• Key Characteristics:
  Some (like stevia and monk fruit) are low- or zero-calorie; others (like honey or agave) contain calories and sugars.
  May also provide trace nutrients or antioxidants (especially unprocessed forms).
  Stevia and monk fruit are often used as natural low-calorie alternatives to artificial sweeteners.
• Uses: Found in “naturally sweetened” beverages, baked goods, and health-focused products as alternatives to refined sugar.

Sugar Alcohols (Polyols)

• Definition: Carbohydrate-derived compounds that taste sweet but provide fewer calories than sugar.
• Common Examples: Erythritol, Xylitol, Sorbitol, Maltitol.
• Key Characteristics:
  Provides about half the calories of sugar.
  Do not cause sharp spikes in blood sugar levels.
  May cause gastrointestinal discomfort (bloating or gas) at high intakes.
• Uses: Common in sugar-free gum, mints, chocolates, and “keto” products.

How they work: Sweeteners fit the tongue’s T1R2/T1R3 sweet taste receptor, producing sweetness with little or no metabolizable energy. Some are heat-stable for baking; others are best in cold products.

Food Sources of Sweeteners

Sugar substitutes, including plant-based options like stevia and monk fruit, are increasingly used to sweeten foods and beverages without adding as many calories. You’ll find these low-calorie sweeteners in sugar-free candies, diet soft drinks, and a variety of processed foods marketed as “sugar-free” or “reduced sugar.”

Food Additives and Regulation

Food additives, including a wide variety of sweeteners, are carefully regulated to ensure they are safe for consumption. The Food and Drug Administration (FDA) reviews scientific evidence for each food additive, including sugar substitutes and sugar alcohols, before approving them for use in foods and beverages. The FDA sets an acceptable daily intake (ADI) for each approved sweetener, such as aspartame, sucralose, and acesulfame potassium, to help consumers stay within safe limits over a person’s lifetime.

Some sugar alcohols, like xylitol and sorbitol, as well as natural sweeteners like stevia and monk fruit, are classified as “generally recognized as safe” (GRAS) when used as food additives. This means they have a long history of safe use or are supported by scientific studies. The FDA’s ongoing oversight ensures that both artificial and natural sweeteners in your food and drinks (from fruit-flavored yogurts to sugar-free soft drinks) meet strict safety standards.

Weight Management: Helpful Replacement, Not a Magic Wand

When low- or no-calorie beverages intentionally replace sugar-sweetened beverages, meta-analyses report small but favorable changes in body weight, BMI, and risk factors, often in the same direction as water substitution. However, consuming the same amount of artificially sweetened beverages as sugar-sweetened beverages may have similar health risks if overall calorie intake is not reduced.

Low- and no-calorie sweeteners provide fewer calories than sugar, which is why they can help with weight management. In observational studies, higher sweetener intake sometimes coexists with higher weight, but those designs cannot prove cause (people who struggle with weight often choose “diet” products). The practical takeaway: LNCS can support an energy-reduction strategy if you avoid “calorie payback” elsewhere.

Expert note: The effect size hinges on actual substitution. If a diet soda displaces 150–200 kcal from a sugary drink and you don’t compensate later, that’s where the benefit comes from. Sugar-sweetened beverages add calories, while sweeteners do not.

Diabetes, Blood Sugar & Glycemic Control

Short-term trials typically show neutral glucose and insulin responses (i.e., blood glucose levels) to LNCS compared with water. Still, a controlled 2022 study found that different sweeteners can shift glucose tolerance among individuals via the microbiome. People with diabetes often use low-calorie sweeteners to help manage blood glucose.

Try this: For 2 weeks, change one variable (e.g., replace a daily diet soda with water or a low-calorie sweetener). Track fasting and post-meal glucose on the same weekdays; note sleep, fiber, and activity. Tracking your blood glucose can help you assess the impact of switching to a low-calorie sweetener. Let your data guide you.

Metabolic Syndrome & Cardiometabolic Risk

Over weeks to months, moving from sugary drinks to LNCS aligns with minor improvements in weight-related markers. However, energy drinks are a significant source of added sugars and can contribute to weight gain. Dietary guidelines recommend limiting intake of sugary beverages, including energy drinks, to reduce the risk of weight gain and cardiometabolic disease.

Long-term cardiometabolic outcomes remain harder to pin down because behavior and diet patterns confound results. The association of erythritol with thrombosis/MACE and sustained plasma elevations after a controlled load warrants prudence among those with established cardiovascular risk until more definitive trials are available.

Expert note: If you’re at high cardiovascular risk, consider limiting high-dose erythritol and scanning labels on “keto” or “zero-sugar” products where it is common.

Gut Microbiome: Heterogeneous Human Evidence

Animal data are inconsistent and often use non-dietary dosing. In humans, some randomized trials show minimal microbiome change, whereas others report composition or functional shifts that are sweetener-specific and individual. Fiber intake, overall diet quality, sleep, and stress seem to modulate these effects.

A fiber-rich pattern (legumes, whole grains, veggies) promotes SCFA production, which supports gut and metabolic health, likely more impactful than the type of sweetener alone.

(SCFA: short-chain fatty acids, beneficial compounds produced by gut bacteria when they ferment fiber.)

Oral Health: Non-Cariogenic Sugar Alcohols, with Nuance for Xylitol

Because LNCS are not fermented by oral bacteria, they don’t directly produce enamel-eroding acids. Xylitol, a sugar alcohol, is commonly used in sugar-free chewing gum to help reduce the risk of tooth decay. Xylitol has long been marketed as “tooth-friendly,” yet recent evidence is mixed regarding its consistent cavity-prevention benefits across settings and doses. Good hygiene habits and dental visits remain the foundation.

Regulating Sweetener Intake

Managing how much and what type of sweetener you consume is key to maintaining a balanced and evidence-based approach to nutrition. While low- and no-calorie sweeteners (LNCS) can help reduce overall sugar intake, excessive or unbalanced use may affect taste preferences and digestive comfort in some individuals.

Health authorities such as the World Health Organization (WHO, 2023) and the European Food Safety Authority (EFSA) emphasize moderation and awareness. Each approved sweetener has an Acceptable Daily Intake (ADI), the amount considered safe to consume every day over a lifetime. Staying below these limits ensures safety, while using sweeteners as true replacements (not additions) to sugar maximizes benefit.

Example: The ADI for aspartame is 40 mg/kg body weight per day, while for sucralose it is 5 mg/kg. That means an average adult weighing 70 kg can safely consume up to about 2,800 mg of aspartame far more than typically found in daily diets.

To regulate your sweetener intake:

• Check ingredient lists for both added sugars and for sweetener products labeled “sugar-free”; these may still include polyols or caloric blends.
• Avoid “double sweetening” replacing sugar with LNCS and still adding syrups or flavored creamers defeats the purpose.
• Alternate sweetener types if you consume them regularly; for example, rotate between stevia-based and sucralose-based products to prevent sensory fatigue.
• Use natural options mindfully. Stevia or monk fruit can be great sugar alternatives, but honey or agave still count toward total sugar intake.
• Listen to your body; bloating or digestive discomfort can occur with high amounts of sugar alcohols like erythritol or xylitol.

Mini Reference Table: Sweeteners at a Glance

(Sweetness is relative to sucrose = 1, where sucrose is also known as 'common table sugar' or 'table sugar.' ADI = acceptable daily intake, mg/kg/day. ADI represents the amount considered safe to consume daily over a person's lifetime. “Pros/Cons” reflect peer-reviewed evidence summarized in the references.)

Smart Cooking & Daily Use

If you bake:

• Sucralose or acesulfame-K (often used in blends) handle heat well, though you can expect subtle differences in browning and texture compared with sugar.
• These sweeteners are generally recognized as safe for baking; however, very high heat (>180 °C / 356 °F) can cause a slight breakdown in sucralose, potentially forming trace chlorinated byproducts such as chloropropanols, especially in recipes that include fats or oils.
• To minimize risk, avoid prolonged high-temperature baking with pure sucralose, and use mixed formulations or temperature-stable options (like acesulfame-K, stevia, or monk fruit).
• Try unsweetened applesauce or yogurt to restore moisture and texture when reducing sugar.
  Natural sweeteners like maple syrup or honey can be used in some recipes to add flavor and trace nutrients, though they contribute calories and sugars.

If you drink:

• For a low-effort win, replace one sugary drink with sparkling water, unsweetened tea, or a low-/no-calorie sweetened beverage you tolerate well.
• Regularly rotating sweetener types (for example, alternating between stevia- and sucralose-based drinks) may help prevent taste fatigue and maintain variety.

If you snack:

• Pair a sweetened yogurt with nuts or chia seeds (protein + fiber) to increase satiety and stabilize blood sugar levels later in the day.
• This also helps blunt post-meal cravings that sometimes follow very sweet tastes, even from calorie-free sources.

Note for home cooks:

• Avoid caramelizing or frying with artificial sweeteners; they don’t behave like sugar chemically and can degrade when heated.
• When baking, keep temperatures moderate and times short for the best flavor and safety.
• If a recipe calls for long, high-heat baking, natural low-calorie options like erythritol or stevia blends are safer and more stable choices.

Practical Guide: Using Sweeteners Wisely

1. Start with the big win: Swap one sugar-sweetened drink/day for water or an LNCS drink you tolerate. Many sweeteners are used to taste sweet without added sugar.
2. Lower the “sweetness set point”: Gradually taper the number of sweet exposures across the day.
3. Build satiety: Prioritize protein and soluble fiber at meals; people often crave sweets less when they feel truly full.
4. Check labels: Many “stevia” or “monk fruit” products are blends (e.g., with erythritol or maltodextrin). Many products labeled as 'low carb' use sweeteners that taste sweet but do not add significant carbohydrates.
5. Mind your gut: Increase slowly if you’re sensitive to polyols (bloating/gas).
6. Special groups: PKU → avoid aspartame; pregnancy/children → prefer water/milk/unsweetened choices when feasible; high CVD risk → be cautious with large erythritol loads.

Final Note

Research shows sweeteners can be useful tools for cutting added sugar, especially as a bridge while you lower your overall “sweetness set point.” Focus on whole-diet quality (protein, fiber, minimally processed foods) and pick the smallest amount of sweetness that keeps you satisfied.

References

1. Brown RJ et al., 2010 – Artificial sweeteners: a systematic review of metabolic effects in youth
2. Radenkovic S., 2023 – Investigating the effects of artificial sweeteners
3. Mora MR & Dando R., 2021 – The sensory properties and metabolic impact of natural and synthetic sweeteners
4. Liu Q et al., 2025 – Deciphering the multifaceted effects of artificial sweeteners on body health
5. Ruiz-Ojeda FJ et al., 2019 – Effects of sweeteners on the gut microbiota
6. Conz, A., Salmona, M., & Diomede, L. (2023). Effect of non-nutritive sweeteners on the gut microbiota. Nutrients, 15(8), 1869.
7. McGlynn, N. D., Khan, T. A., Wang, L., et al. (2022). Association of low- and no-calorie sweetened beverages as a replacement for sugar-sweetened beverages with body weight and cardiometabolic risk: Systematic review and meta-analysis. JAMA Network Open, 5(3), e222092.
8. Bárbara Ortiz-Sáez et al., “Is xylitol effective in the prevention of dental caries? A systematic review.” J Clin Exp Dent. 2024;16(10):e1307-15.
9. IARC Working Group. “Some chemicals (e.g., aspartame)…” IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, vol 121 (2023).
10. Suez, J., Cohen, Y., Valdés-Mas, R., et al. (2022). Personalized microbiome-driven effects of non-nutritive sweeteners on human glucose tolerance. Cell, 185(18), 3307–3328.e19.
11. The Lancet Oncology Editorial (McConway, K.). (2023). Aspartame: It is the risk that matters, not the hazard. The Lancet Oncology, 24(10), 1161.
12. Witkowski, M., Nemet, I., Alamri, H., et al. (2023). The artificial sweetener erythritol and cardiovascular event risk. Nature Medicine, 29(3), 710–718.
13. EFSA Panel on Food Additives and Flavourings. (2023). Safety evaluation of steviol glycosides (Reb M produced by Y. lipolytica). EFSA Journal, 21(12), e08387.
14. Rogers P.J., Appleton K.M. “The effects of low-calorie sweeteners on energy intake and body weight: a systematic review and meta-analyses of sustained intervention studies.” Int J Obes (Lond). 2021;45(3):464-478. doi:10.1038/s41366-020-00704-2.

FAQ

1. Do sweeteners help with weight loss?

They can when they truly replace added-sugar calories without compensation. Meta-analyses show small but meaningful benefits over weeks to months.

2. Are they safe for people with diabetes?

Most trials show neutral short-term effects of glucose and insulin. Because responses can vary, a short self-experiment with glucose monitoring can be illuminating.

3. Are sweeteners approved and safe to use?

Only sweeteners approved by regulatory agencies such as the FDA, European Union, and World Health Organization are allowed in foods. These agencies set acceptable daily intake levels to ensure safety.

4. Will they ruin my microbiome?

Human evidence is mixed and sweetener-specific. Your overall diet (especially fiber), sleep, and stress likely matter more to microbiome health than any single sweetener choice.

5. Do they cause cancer?

For aspartame, a 2023 hazard classification exists, but risk assessors maintained the ADI. Hazard indicates potential under some conditions; risk depends on actual exposure. Staying below ADI is the key regulatory benchmark.

6. What about teeth?

LNCS are non-cariogenic. Xylitol’s cavity-prevention benefit is not consistent across settings; it can still be part of an oral-care routine alongside brushing, flossing, and dental visits.

7. How do sweeteners differ from common sugars?

Common sugars, such as sucrose, glucose, and fructose, are naturally found in foods like fruit and milk, and are also added to processed foods. Sweeteners, on the other hand, are substances used to provide sweetness with little or no calories, including both artificial and natural options. Unlike common sugars, sweeteners do not contribute to blood sugar in the same way.

8. How do sweeteners compare to other carbohydrates?

Sweeteners are not the same as other carbohydrates, which include starches and fibers found in grains, fruits, and vegetables. Other carbohydrates provide energy and have different effects on blood sugar and digestion compared to sweeteners.

9. Do sweeteners taste like regular sugar?

Some sweeteners are specifically designed to mimic the taste of regular sugar, making them suitable for recipes and beverages that require a sugar-like flavor.

10. Are there other sugar substitutes available?

Yes, there are many other sugar substitutes, including sugar alcohols and artificial sweeteners. These other sugar substitutes vary in sweetness, calorie content, and how they are used in foods and beverages.

11. How are sweeteners regulated in other countries and the European Union?

Regulations for sweeteners differ in other countries. The European Union, for example, has its own approval process and may restrict or allow certain sweeteners differently from the United States. Some sweeteners approved in the US may not be permitted in the EU, and vice versa, reflecting regional differences in safety assessments and food additive policies.