Artificial Sweeteners vs. Sugar: Understanding the Acceptable Daily Intake (ADI)
The Acceptable Daily Intake (ADI) is a critical benchmark established by health authorities like the FDA and WHO to determine the maximum amount of a substance—such as a non-nutritive sweetener (NNS) or sugar—that can be consumed daily over a lifetime without significant health risks. To explore the differences between artificial sweeteners and sugar, let’s examine their ADI values and how these translate into real-world examples, using an individual weighing 180 pounds and soda as a reference.
1. Calculating ADI: Artificial Sweeteners (NNS)
Artificial sweeteners such as aspartame, sucralose, and saccharin are widely used in foods and beverages. The ADI for these sweeteners is measured in milligrams per kilogram of body weight per day (mg/kg/day). For a 180-pound person (equivalent to approximately 82 kg), let’s calculate the ADI and provide examples using a standard 12-ounce can of soda.
Aspartame
ADI: 50 mg/kg/day
Example: A typical diet soda contains about 200 mg of aspartame per can. This means:
A person weighing 180 pounds could theoretically drink over 20 cans of diet soda per day and still remain within the ADI for aspartame.
Sucralose (Splenda)
ADI: 5 mg/kg/day
Example: A diet soda with sucralose contains approximately 70 mg per can. This means:
A 180-pound individual could consume nearly 6 cans per day of a sucralose-sweetened soda.
2. Calculating ADI: Sugar
Unlike NNS, sugar is calorie-dense and lacks an official ADI. Instead, health organizations recommend limits for “added sugars” to reduce risks like obesity and diabetes. The American Heart Association (AHA) advises that men consume no more than 36 grams (9 teaspoons)of added sugar daily and women no more than 25 grams (6 teaspoons).
A single 12-ounce can of regular soda typically contains 39 grams of sugar, which is already over the daily recommended limit for both men and women.
For a 180-pound person:
•A single can of soda exceeds the daily recommended sugar intake.
•If consumed regularly, drinking just 1 can per day could increase risks of weight gain, metabolic syndrome, and other health complications.
What Happens in the Body After Consuming a Can of Soda: NNS vs. Sugar-Sweetened
When you drink a soda sweetened with either a non-nutritive sweetener (NNS) or sugar, the body reacts differently at every stage—from taste perception to metabolic processing. Here’s a step-by-step comparison:
1. Taste Perception
NNS Soda:
Non-nutritive sweeteners like aspartame or sucralose bind to sweet taste receptors on the tongue (primarily T1R2 and T1R3 receptors). These receptors send signals to the brain, producing a perception of sweetness that can be hundreds of times more intense than sugar. However, because NNS do not provide calories, the brain may not trigger the same rewarding dopamine release as sugar does.
Sugar-Sweetened Soda:
Sugar also binds to T1R2 and T1R3 receptors, signaling sweetness to the brain. However, sugar activates the brain’s reward system more strongly due to its caloric content, leading to a dopamine release that reinforces pleasure and cravings.
2. Absorption and Blood Sugar Response
NNS Soda:
Non-nutritive sweeteners do not significantly raise blood glucose levels because they provide minimal or no calories. Most NNS (e.g., sucralose, aspartame) are either not absorbed by the gut or are metabolized into non-glucose compounds. For example:
•Aspartame: Breaks down into phenylalanine, aspartic acid, and methanol, none of which contribute to blood sugar. Those may sounds scary but they are very common in our diet. Found in high amounts in meat, fruits and vegetables.
•Sucralose: Passes largely unchanged through the digestive tract. (in other words, we just pee it out)
Sugar-Sweetened Soda:
The high sugar content (approximately 39 grams per can, mostly in the form of sucrose or high-fructose corn syrup) is rapidly absorbed in the small intestine.
•Sucrose: Splits into glucose and fructose.
•Glucose: Quickly raises blood sugar levels, prompting the pancreas to release insulin to help cells absorb it. This can lead to a temporary spike in energy.
•Fructose: Metabolized in the liver, where excess amounts are converted into fat, potentially contributing to insulin resistance and fatty liver disease.
3. Gut Microbiome Impact
NNS Soda:
Non-nutritive sweeteners can influence the gut microbiome, though effects vary depending on the type of NNS and individual differences. For example:
•Sucralose: Studies suggest it may alter the balance of gut bacteria, potentially altering strains in our gut. We still don't have good data on if the changes are good, bad, or neutral.
•Aspartame: Has minimal direct effects on the microbiome.
•Long-term changes in the microbiome may affect glucose tolerance, although the clinical significance of this is still debated and being studied.
Sugar-Sweetened Soda:
Sugar is readily fermentable by gut bacteria, promoting the growth of strains that thrive on sugar, such as Firmicutes. Over time, excessive sugar consumption can lead to an imbalance (dysbiosis), favoring harmful bacteria that contribute to inflammation and metabolic diseases.
4. Insulin and Energy Regulation
NNS Soda:
Non-nutritive sweeteners do not directly stimulate insulin release because they do not contain glucose. However, some studies suggest that the brain may interpret the sweet taste as a signal to prepare for sugar, potentially causing small insulin releases (“cephalic phase” response), though this is minimal and non significant in comparison to normal food intake.
Sugar-Sweetened Soda:
The large influx of glucose causes a spike in insulin secretion, which facilitates the rapid uptake of sugar into cells. This can lead to an energy surge followed by a “crash” as blood sugar levels drop once the glucose is metabolized.
5. Metabolic Effects and Long-Term Implications
NNS Soda:
•Provides sweetness without adding calories, so there is no immediate energy intake or storage.
•Long-term impacts may include changes to gut microbiota and potential effects on hunger signaling, with some evidence suggesting that habitual consumption could alter appetite regulation and cravings. Individual monitoring is necessary, do you notice you get hungrier or crave other sweet things more when drinking zero calorie beverages? We will discuss this further in the section on dieting.
Sugar-Sweetened Soda:
•Provides a quick source of energy, but the caloric surplus is often stored as fat, especially when consumed in excess.
•Regular consumption contributes to weight gain, insulin resistance, and increased risk of type 2 diabetes due to repeated blood sugar spikes and liver fat accumulation.
Non-Nutritive Sweeteners (NNS) vs. Sugar and Cancer Risk
NNS and Cancer Risk
Non-nutritive sweeteners (NNS), such as aspartame, sucralose, and saccharin, have been extensively studied for their safety, including their potential to increase cancer risk. Here are the key points from studies:
1.Aspartame:
•A large 2022 cohort study published in PLOS Medicine found a small positive association between aspartame consumption and increased cancer risk (notably breast and obesity-related cancers). However, this was a cohort study, which means it could not prove causation. Cohort studies are observational by design, which means they can identify associations but cannot establish direct causation. In the case of the 2022 cohort study linking aspartame consumption to cancer risk, several potential confounding factors could influence the results. These confounders are variables that may independently affect cancer risk, leading to an apparent (but not causal) relationship with aspartame. Here are some possibilities:
•Overall Diet Quality: Individuals who consume more aspartame may also have other dietary habits that contribute to cancer risk, such as low intake of fruits, vegetables, and fiber or high intake of processed foods.
•Substitution for Sugar: People who consume aspartame may be replacing sugar in response to underlying health conditions like obesity, diabetes, or metabolic syndrome, which themselves increase cancer risk.
•Reverse Causation: Aspartame consumption is often higher in individuals trying to manage weight or reduce sugar intake. Obesity, which is strongly linked to cancer risk, could be a confounding factor here.
•Some animal studies suggested a potential risk, but their relevance to humans is debated due to differences in metabolism and exposure levels.
2.Saccharin:
•Early studies in rodents showed bladder cancer at high doses, leading to a warning label. However, later studies showed that this mechanism is specific to rodents and not applicable to humans. Saccharin is no longer classified as a human carcinogen by the International Agency for Research on Cancer (IARC).
3.Sucralose:
•Studies on sucralose, such as those by the National Toxicology Program (NTP), have shown no convincing evidence linking it to cancer in humans at normal consumption levels.
4.Stevia:
•Steviol glycosides have not been associated with cancer risks in human studies.
As you can see, headlines on this topic often do not take into account the mass amount of information in the studies that may or may not be missing. This can often lead to dramatization of the subject to increase traffic to their site and sharing of their articles. However, you should be informed of all risks, even if minimal and largely unknown, but if you want to research this yourself, be sure to look past the headlines.
Sugar and Cancer Risk
Excessive sugar consumption has an indirect link to cancer risk, primarily through its effects on weight gain and metabolic health:
1.Obesity as a Mediator:
•Sugar contributes to weight gain by providing excess calories without nutritional benefit. Being overweight or obese is a well-established risk factor for several cancers, including: Breast (postmenopausal), Colorectal, Pancreatic, Endometrial, and Liver.
Obesity creates a pro-inflammatory and hormone-altered environment, which promotes cancer development.
2.Insulin Resistance:
•High sugar intake can lead to insulin resistance, which elevates circulating insulin and insulin-like growth factor-1 (IGF-1). Both insulin and IGF-1 promote cell proliferation and reduce apoptosis (cell death), processes that can favor cancer development.
3.Systemic Inflammation:
•Chronic high sugar consumption can lead to systemic inflammation, which is another known contributor to cancer progression.
Weight gain and obesity are major factors in cancer risk. According to the American Cancer Society and the World Cancer Research Fund, approximately 13 types of cancer are strongly linked to being overweight or obese.
Summary
•NNS: Evidence linking NNS to cancer is weak and mainly arises from animal studies or observational studies that cannot prove causation. Regulatory authorities continue to deem them safe within established ADIs.
•Sugar: While not directly carcinogenic, sugar promotes cancer risk through weight gain, insulin resistance, and inflammation.
•Weight Gain: A well-established driver of cancer risk due to inflammation, hormonal changes, and impaired immune function.
For cancer prevention, managing weight and reducing excessive sugar intake may be more impactful than avoiding non-nutritive sweeteners at moderate consumption levels.
Research on Weight Loss and Diet Sodas
Numerous studies have explored whether diet sodas (sweetened with non-nutritive sweeteners or NNS) can help with weight loss, particularly when used as a replacement for sugar-sweetened beverages (SSBs). Here’s a summary of the findings:
Diet Sodas vs. Regular Sodas in Weight Loss
Caloric Deficit: Replacing SSBs with diet sodas reduces calorie intake because diet sodas are essentially calorie-free. Studies have consistently shown that people who replace high-calorie drinks with diet sodas consume fewer calories overall, which can support weight loss.
Key Studies:
•A 2016 systematic review and meta-analysis published in Obesity Reviews found that substituting SSBs with NNS-containing beverages reduced body weight, BMI, and waist circumference.
•A 2012 randomized controlled trial (RCT) in The American Journal of Clinical Nutrition showed participants who replaced SSBs with diet sodas lost more weight than those who consumed water or continued SSBs.
•A 2014 study in Obesity compared diet soda drinkers to water drinkers during a weight-loss program. Both groups lost weight, but the diet soda group experienced slightly greater weight loss and better adherence to the diet.
Mechanism of Weight Loss:
•Calorie Reduction Without Deprivation: Diet sodas allow people to enjoy sweet-tasting beverages without contributing to total energy intake, which may help sustain adherence to a calorie-restricted diet.
•Reduced Hunger/Cravings: Some studies suggest that diet sodas may help reduce cravings for sweet, high-calorie foods, although this effect varies among individuals. Some have found it increases cravings for "the real deal"
Criticisms and Controversies
•Some people may compensate for the calorie savings from diet sodas by eating more food elsewhere in their diet, negating the calorie deficit. (I got the diet soda, so that means I can have a large French fry instead of the small)
•However, controlled studies where calorie intake is monitored suggest this compensation is minimal or nonexistent for most individuals. (be smart about it)
Long-Term Effects
•The National Weight Control Registry (tracking people who have successfully lost and maintained weight loss) reports that many long-term weight loss maintainers use diet sodas as part of their strategy.
•A 2021 study in Nutrients found that long-term use of NNS beverages was associated with improved weight control compared to continued consumption of SSBs.
Diet Soda vs. Water for Weight Loss
Studies comparing diet sodas to water have mixed results:
•Diet Soda Equal or Slightly Better: Some studies, like the 2014 Obesity trial, found diet sodas to be just as effective—or even slightly better—for weight loss compared to water. This may be due to better adherence to dietary changes when people are allowed to enjoy a sweet beverage. (maybe I don't need desert if I have diet orange Fanta with dinner)
•Water Slightly Better: Other studies suggest that replacing SSBs with water may lead to slightly better outcomes for metabolic health, but the differences in weight loss are typically small. Individual cravings play a role in this.
Conclusion
•Replacing Regular Sodas with Diet Sodas: Studies overwhelmingly show that switching from regular sodas to diet sodas can lead to weight loss, primarily due to reduced calorie intake.
•Diet Sodas vs. Water: Both can support weight loss, but diet sodas may be easier for some individuals to sustain in the long term as part of a calorie-reduced diet.
•Sustainability: The success of using diet sodas for weight loss depends on maintaining an overall calorie deficit and not compensating with increased caloric intake elsewhere.
For individuals aiming to lose weight, replacing SSBs with diet sodas appears to be an effective strategy supported by scientific evidence. However, there are still unknowns with artificial sweeteners, and it all comes down to risk assessment and if you think it's beneficial for you to switch from regular sugar to zero calorie options. Of course water is going to win out, but if you need that sweet fizzy stuff like I do then here is the information we currently know.
“Natural” non-nutritive sweeteners, such as stevia and monk fruit, as well as sugar alcohols like erythritol and xylitol, are popular alternatives to both sugar and artificial sweeteners. Studies suggest these sweeteners have minimal impact on blood sugar and insulin levels, making them suitable for people with diabetes or those managing their weight. Stevia and monk fruit are derived from plants and are calorie-free, while sugar alcohols like erythritol and xylitol provide fewer calories than sugar and may even promote dental health. However, excessive consumption of sugar alcohols can cause digestive discomfort in some individuals. Current research shows no significant link between these “natural” sweeteners and cancer or other major health risks when consumed in moderation.
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