If you’ve swapped sugar for a diet soda or a packet of pink or yellow sweetener, you’ve probably wondered: is this actually helping me lose weight or manage my blood sugar? The honest answer is “it’s complicated.”
First, let’s talk about some myths out there. Many people tell me they have heard artificial sweeteners cause cancer, but evidence does not support a significant cancer risk, not any more than many other commonly used products. Another belief is that artificial sweeteners fool our body into thinking we are consuming real sugar and we gain weight or have increased blood glucose because of this, so you are better off eating or drinking the real stuff. While this one has a small nugget of truth hidden in there, it is an extreme exaggeration at best. And one last commonly held belief is honey is a healthier sweetener than sugar, but this one also has been twisted around and is not exactly a beneficial belief if you want to lower your blood sugar or lose weight.
Now let’s talk about what real evidence tells us.
Artificial sweeteners (like aspartame, sucralose, and acesulfame-K) can help you lose a small amount of weight—usually around a pound or two—but only when they directly replace sugary drinks or foods you’d otherwise be eating. Of course, if and individual has a diet high in sugar and reduces that significantly using artificial sweeteners they could see more significant weight loss. So how do these substitutes affect blood sugar? In the short term, these sweeteners don’t spike your blood sugar. The catch is what happens over time: several large studies have linked regular use to a higher risk of developing type 2 diabetes and heart-related issues, likely because these sweeteners can disrupt your gut bacteria in ways that affect blood sugar control. One sweetener in particular, erythritol, has raised extra red flags for blood clotting and cardiovascular risk. On the other hand, high sugar intake can lead to diabetes, which also significantly increases cardiovascular risk.
Honey and agave aren’t off the hook either. They still contain real sugar and calories. Honey has a slight edge—it may modestly improve cholesterol and fasting blood sugar compared to table sugar—but it’s not a “free” food, especially if you have diabetes or prediabetes. It will raise blood sugar and does add to your caloric intake, while artificial sweeteners do not.
Here are some takeaways to think about if you’re using artificial sweeteners, or considering using them:
- Water is still your best swap for sugary drinks—better than diet soda or juice. As far as I am aware, no one has decided it is cancer-causing or harmful, ever.
- Artificial sweeteners can be a tool to safely reduce sugar intake.
- The use of artificial sweeteners in moderation can lower blood sugar and help promote weight loss in the short term.
- If you use artificial sweeteners, treat them as a bridge away from sugar, not a permanent daily habit.
- Any harmful effects of artificial sweeteners are dose dependent and increased with exposure over time. Just as you do with sun exposure or alcohol intake, avoid excessive exposure, if you choose to partake.
- If you choose honey, treat it like sugar: small amounts, and watch portions closely if you’re managing blood sugar.
- Your own health and medical conditions are an important factor in your overall risks, so you should talk to your own health care provider (as always) before applying blanket advice from a blog.
While this topic is murky and a lot to sift through, I hope this has provided some insight into some of the information circulating out there.
