May 27, 2025
The Sugar Swap Dilemma
Are artificial sweeteners really a healthy alternative?
Zeno L. Charles-Marcel and Peter N. Landless

Q: I am trying to live and eat more healthily and have friends who do not lose weight even when using artificial sweeteners. Are these safe and effective for me to use in my quest for better health and weight loss?
A: Natural sweeteners and artificial sweeteners differ fundamentally in their origins, composition, and how they affect the body. Artificial sweeteners, often touted as healthier alternatives to sugar, have become a focal point of scientific research regarding their potential health risks. Studies have produced mixed results, leading to ongoing debates about their safety and long-term effects.
Natural sweeteners, such as honey, maple syrup, and Stevia, are derived from plants or animal sources and undergo minimal processing. They often retain some nutrients and antioxidants, which can provide additional health benefits. Honey has antibacterial properties, and Stevia is known for its low-calorie content while having a negligible impact on blood sugar levels. Honey can be a healthier choice than sugar and should be used in moderation.
Artificial sweeteners are synthetically manufactured compounds designed to replicate the sweetness of sugar without the calories. Common examples include aspartame, sucralose, erythritol, and saccharin. While they are much sweeter than sugar, their long-term health effects are still a topic of debate and have been for decades. Some studies suggest potential links to metabolic issues, increased cravings, and gut health disruptions not associated with natural sweeteners. Natural sweeteners tend to be more beneficial in moderation, while artificial sweeteners may carry risks that warrant caution.
Research indicates that certain artificial sweeteners may disrupt gut microbiota, which plays a crucial role in digestion and overall health. The consumption of aspartame may alter the composition of gut bacteria, potentially leading to metabolic issues. Other studies have drawn correlations between high consumption of artificial sweeteners and an increased risk of metabolic syndrome, obesity, and type 2 diabetes, indicating that these substances are not as harmless as once believed.
Recent studies have highlighted the risk of cardiovascular events (heart attacks and strokes) associated with the use of erythritol, a natural four-carbon sugar alcohol commonly used as a sugar substitute in processed foods. Further experimental studies have shown that erythritol increases the activation of platelets (blood cells that are key in clot formation or thrombosis-causing strokes and heart attacks) in human blood. The consumption of one erythritol-sweetened drink can produce the levels that may activate the platelets.
In summary, some artificial sweeteners may aid in reducing caloric intake, but their potential health risks cannot be overlooked. While moderation is key, the safest approach is to limit the intake of artificial sweeteners and focus on a balanced diet rich in whole foods. More research is necessary to understand the long-term effects of these substances fully and to determine which, if any, can be recommended safely. Exercise, rest, moderation, balanced nutrition, and a focus on whole foods are advisable for maintaining overall health.
“How sweet are Your words to my taste, sweeter than honey to my mouth! Through Your precepts I get understanding” (Ps. 119:103, 104).
About the Author
Zeno L. Charles-Marcel, a board-certified internist, is the director of Adventist Health Ministries at the General Conference.
Zeno L. Charles-Marcel, a board-certified internist, is the director of Adventist Health Ministries at the General Conference. Peter N. Landless, a board-certified nuclear cardiologist and General Conference Adventist Health Ministries director emeritus, is also a board-certified internist.
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