Sept 2, 2025: Many sweeteners are promoted as healthy, natural, or low-calorie alternatives to sugar, but not all are completely safe. While they can provide sweetness without adding extra calories, some may affect metabolism, digestion, or even heart health if consumed in large amounts. Relying on these substitutes without moderation can lead to unwanted side effects, including blood sugar fluctuations or gastrointestinal discomfort. Being aware of the potential risks of various sweeteners helps you make informed choices for your diet. Better overall health and wellbeing can be supported by choosing natural sources of sweetness, such as fruits, and utilizing alternatives sparingly.

Health risks of popular sweeteners and sugar alternatives:
A recent review published in Cardiovascular Research examines the potential cardiovascular risks associated with sugar alcohols, particularly erythritol and xylitol. While these sugar substitutes are commonly used in food products and pharmaceuticals, the review highlights concerns about their impact on cardiovascular health.

1. Cane sugar, raw Raw cane sugar is often promoted as a natural alternative to refined sugar. Despite having trace minerals, it still primarily consists of sucrose and has the same effects on the body as regular sugar. Excessive intake can contribute to weight gain, insulin resistance, type 2 diabetes, and heart problems. A false sense of security may result from relying on it as a "healthy" sweetener because even small amounts can raise blood sugar levels. Moderation remains key, and whole foods like fruits are a better source of natural sweetness with added nutrients.

2. Saccharin
Saccharin is one of the earliest artificial sweeteners, found in diet beverages and sugar-free products. Despite its lack of calories, it may alter gut bacteria, which could have an impact on digestion and inflammation. Some individuals may experience bloating or mild digestive discomfort when consuming it frequently. Those with sensitive stomachs should limit intake, and long-term reliance on saccharin may not be ideal for overall metabolic health.

3. Aspartame
Aspartame is a widely used calorie-free sweetener in sugar-free drinks, yogurts, and snacks. While generally safe in moderation, it can affect appetite regulation in some individuals, sometimes leading to cravings for sugary foods. Because they are unable to metabolize phenylalanine, an aspartame byproduct, people who have phenylketonuria (PKU) may have to completely avoid it in rare instances. Moderation is advised because observational studies suggest that excessive consumption may subtly affect metabolic health.

4. Erythritol
Erythritol is a sugar alcohol that tastes sweet with almost zero calories. While it is generally well tolerated, recent studies suggest high levels in the bloodstream could be linked to increased clotting risk, potentially affecting heart health. Consuming large amounts may also cause gastrointestinal discomfort, including bloating, gas, and diarrhoea. People with cardiovascular issues should be particularly mindful of their intake and combine erythritol with natural sweetening alternatives when possible.

5. Xylitol
Xylitol is another sugar alcohol often found in chewing gums, mints, and low-sugar baked goods. It can even help with dental health and has fewer calories than sugar. However, excessive consumption can lead to gastrointestinal upset, including nausea, bloating, and diarrhoea. Xylitol is extremely irritating to pets, particularly dogs, so they should never be exposed to it. For humans, small amounts are safe, but moderation is essential to avoid digestive issues.

6. Sucralose
Sucralose is a heat-stable sweetener commonly used in baked goods and beverages. While safe in moderate amounts, cooking or baking at high temperatures may produce chlorinated compounds, which could potentially have harmful effects over long-term exposure. Additionally, frequent sucralose consumption may negatively affect gut microbiota, impacting digestion and immunity. Rotating sweeteners and limiting processed foods can reduce potential risks.

7. “Natural” sugars (Agave, coconut sugar, honey)
Many people turn to agave, coconut sugar, or honey believing they are healthier than regular sugar. These options often contain additional vitamins or minerals, but they are still high in fructose or sucrose, which can spike blood sugar levels. Overconsumption may lead to weight gain, insulin resistance, and increased risk of metabolic disorders. While they can be used occasionally, relying on them as daily sweeteners is not recommended, and moderation is crucial.

8. Monk fruit blends (Often mixed with erythritol)
Monk fruit is naturally calorie-free and considered safe. However, most commercial blends combine it with erythritol to bulk the product. While monk fruit itself is generally safe, the erythritol component carries potential cardiovascular and digestive concerns if consumed in excess. People who use these blends should be careful about how much they eat and try to get as much sweetness from natural fruit as possible.