Baptist Health Experts on Sugar vs. Artificial Sweeteners and How They Affect Your Health

The widespread use of artificial sweeteners in drinks and packaged or processed foods is not slowing down. Yet, most people consume them without even realizing it. Most diet soft drinks or foods sold as having “no added sugars” often contain artificial sweeteners.

Added sugars – whether artificial or natural -- contribute calories to your diet, but no essential nutrients. Eating and drinking too many added sugars makes it difficult to achieve a healthy eating pattern without taking in too many calories. And too much sugar in your diet can lead to health problems such as weight gain and obesity, type 2 diabetes, and heart disease. (Naturally occurring sugars such as those in fruit are not added sugars.)

“New research shows more and more how fake sugars negatively affect our gut and metabolic health, and they may be bad for our hearts,” explains Jonathan Fialkow, M.D., chief of cardiology at Baptist Hospital and Chief Population Health Officer at Baptist Health. “They may actually boost food cravings, and perhaps worse of all insulin resistance, which is a condition that's a precursor to type 2 diabetes. So it begs the question: Is your sweet tooth killing you?”

Dr. Fialkow recently hosted the Resource LIVE: Artificial Sweeteners: Is Your Sweet Tooth Killing You? His guests: Angel Alejandro, M.D., endocrinologist with Baptist Health Medical Group; and Amy Kimberlain, R.D., registered dietitian at Baptist Health Miami Cardiac & Vascular Institute. (Click on video below or listen to the Baptist HealthTalk Podcast.)

The potential health risks of artificial sweeteners have been the subject of recent headlines.  A sugar substitute known as erythritol – an artificial sweetener which is added to “low-calorie” products -- has been linked to a higher risk of blood clotting, stroke and heart attack in a new study. This substance is a form of sugar alcohol, which is commonly used to add bulk to other sugar substitutes such as stevia, monk-fruit or keto-based products.

The health risks of consuming what is commonly known as “added sugar” keeps mounting with every new study. Earlier this year, researchers found that diets with too much added sugar raise the risks of cardiovascular disease, an elevated BMI (body mass index) and a greater waist circumference. A new review of 8,601 previous studies found that too much added sugar is linked to significantly higher risks of 45 health issues.

“Added sugars” include sugars that are added during the processing of foods (such as sucrose or dextrose), foods packaged as sweeteners (such as table sugar), sugars from syrups and honey, and sugars from concentrated fruit or vegetable juices. They do not include naturally occurring sugars that are found in milk, whole fruits, and whole vegetables. 

“The problem is we now have these artificial sweeteners, which mimic that sweet taste and are are hundreds of times more sweet than table sugar,” explains Dr. Alejandro. “And that's what we're concerned about. The other problem is sometimes you don't know what's in the food until you actually go and read the label. It's estimated that the average American consumes 77 grams of sugar per day --  when the recommendation is only 25 grams for women and 36 grams for men. And sometimes those sugars are being snuck into our diet and we don't even realize it.”

Added sugars have many different names. Examples of added sugars include brown sugar, cane juice, corn syrup, dextrose, fructose, fruit nectars, glucose, and high-fructose corn syrup.

Explains Ms. Kimberlain: “In regard to the added sugar .. it could be molasses; it could be agave. There are so many different ones that are added, and they are added in with different names. There's up to 50 different names. It's really identifying on the (nutrition) labels where there is an item to be able to see how much is added.”

The American Heart Association’s recommendations for sugar intake: Men should consume no more than 9 teaspoons (36 grams or 150 calories) of added sugar per day. For women, the number is lower: 6 teaspoons (25 grams or 100 calories) per day. Consider that one 12-ounce can of soda contains 8 teaspoons (32 grams) of added sugar, states the AHA.

“People may not know that conversion,” said Ms. Kimberlain. “One teaspoon is equal to four grams. We need to know where we're getting that ultimate amount of added sugar from, and then be able to identify how much we're taking in. That's the added-sugar side. And I am an advocate for people to also figure out how much artificial sweetener they may be taking in as well. They may not understand where it's included and how much they're actually taking in.”