In the quest to lower carbohydrate consumption, some people use sugar substitutes. Artificial sweeteners are marketed as a free pass for consumption. However they are not free. Unfortunately your health will pay a price the more you consume. Whether looking at Saccharin, sucralose, or aspartame the data doesn’t look good.

More is known about aspartame (e.g. the little blue packets of Equal or Nutrasweet) than the other artificial sweeteners. The sweetener has repeatedly be shown to cause oxidative stress and depletion of systemic antioxidants. This can be measured in the kidney, liver and brain of rats in a dose-dependent fashion. You want to avoid oxidative stress of course. It is definitely bad for you.
This stress may be one of the reasons why animals ingesting aspartame demonstrate higher values of serum glucose, cholesterol and triglycerides over time as well. This is the hallmark of Metabolic Syndrome (perviously known as Syndrome X). Indeed this seems to be an effect widely seen with human artificial sweetener use in general, an association with the development of obesity and metabolic disease, including insulin resistance, independent of caloric intake.
These negative health effects are a large reason that Pepsi removed aspartame from their marquee drink back in 2015. They replaced the aspartame with sucralose. Unfortunately sucralose, (found in the little yellow packets at your local coffee stand), has its own problems. Firstly, it is an environmental challenge. Sucralose is sugar that is chemically altered by replacing three hydrogen-oxygen groups on the sugar molecule with three chlorine atoms. The result is an “exceptionally stable sweetener that tastes like sugar, but without sugar’s calories.” Since it is not found in nature however, it is resistant to breakdown. Indeed it is used as a very powerful wastewater detection marker for groundwater and septic system leaks.
While most sucralose is passed unchanged through our feces or urine, it is not biologically inert. A portion of ingested sucralose is ultimately metabolized or broken down. Metabolized sucralose is mutagenic. Sucralose changes your bodies ability to detoxify itself and the way drugs behave in the body as well. Sucralose is also known to undergo thermal decomposition at temperatures used in cooking and heating. In these conditions sucralose can generate chloropropanols, a toxic class of compounds.
Saccharin, sucralose, and aspartame all share the common trait of altering gut (intestinal) biota (flora). This change in flora contributes to the reduction in beneficial bacteria and adversely affects insulin sensitivity. I will blog about the importance of gut bacteria another time, but the benefits of having healthy bacteria in your intestines is only beginning to be appreciated. The effects seem to be profound.
Potentially even more concerning is that one recent study found saccharin, sucralose, and acesulfame-potassium in 65% of human mothers’ milk (aspartame was not detected though). This means babies are being exposed to the deleterious effects of these sweeteners as well. It might explain why there has been explosion of pediatric metabolic disease.
The bottom line is that in an effort to avoid the effects of a higher-carbohydrate diet, you end up getting exactly what you didn’t want. This is especially true for diabetics. So that is why I say, avoid artificial sweeteners.
Be Well,
Dr Miller
For further reading, this is a nice overview paper: