Are Artificial Sweeteners Harmful to Your Health?

Almost half of all American adults consume foods or drinks sweetened with artificial sweeteners such as aspartame, sucralose, stevia, saccharin, and advantame at least occasionally. This number continues to grow as more people aim to cut down on sugar for health purposes, though many are still not quite ready to give up their sweet treats entirely.

A recent review conducted by the World Health Organization (WHO) might make you rethink that daily diet soda or sugar-free dessert. The researchers examined 283 separate studies on artificial sweeteners and discovered that while they’re popular, these sweeteners may have unforeseen negative effects on health, particularly if consumed regularly over a long period of time.

In fact, the WHO recommends that people—except those already diagnosed with diabetes—should avoid artificial sweeteners altogether. "The WHO's warning about the harmful effects of artificial sweeteners aligns with the guidance of many major health organizations, which state that processed foods, including artificial sweeteners, do not contribute to a heart-healthy diet," says Charles German, MD, MS, assistant professor of cardiology at the University of Chicago.

Here’s what the studies have revealed about artificial sweeteners and their potential impact, particularly if you're a fan of diet drinks or sugar-free snacks.

Artificial sweeteners may elevate your risk of developing type 2 diabetes.

Type 2 diabetes has become one of the most widespread health issues, where your body struggles to effectively use insulin to process glucose (or sugar). While it might seem that non-sugar sweeteners like aspartame could help reduce your sugar intake, especially if you're at risk for type 2 diabetes, the results are not so clear.

However, the WHO’s review of multiple studies found that consuming more artificial sweeteners actually increased the likelihood of developing type 2 diabetes, without offering any improvement in glycemic control. In fact, those who consumed artificial sweeteners had higher fasting glucose levels.

Non-sugar sweeteners could raise your risk of cardiovascular problems.

The WHO's study review revealed that consuming more artificial sweeteners increased the chances of strokes, heart attacks, and other cardiovascular incidents by nearly 30%. It also heightened the risk of death if someone experienced a stroke or heart attack, and was associated with a greater likelihood of developing hypertension.

"I believe people should be concerned about the connection between artificial sweeteners and heart disease, especially if they already have pre-existing risk factors for heart disease," says Dr. German.

Artificial sweeteners could elevate your risk of mortality.

One of the most alarming findings showed that consuming excessive artificial sweeteners (equivalent to four or more artificially sweetened drinks per day) raised the risk of death by 12%, even after adjusting for people with high blood pressure, cholesterol, type 2 diabetes, or other heart-related conditions.

Sugar-free foods and beverages might reduce your calorie intake—but not your weight.

They’re known as "diet" sodas for a reason, and the review of studies found that consuming more artificial sweeteners led to a reduction of over 500 calories and 39 grams of sugar per day. However, despite consuming fewer calories, this didn't always result in weight loss. While some short-term studies reported weight loss, longer-term studies showed that artificial sweeteners might actually increase the risk of weight gain.

Other research revealed that consuming more non-sugar sweeteners could increase your appetite—which is likely not the desired outcome for those using artificial sweeteners.

Artificial sweeteners had mixed effects for pregnant women and their babies.

The good news: Consuming products with artificial sweeteners didn't affect the risk of gestational diabetes. However, it was linked to a higher risk of preterm birth.

When it comes to children of women who consumed artificial sweeteners, the results were mixed regarding their BMI. One study suggested that using non-sugar sweeteners doubled the risk of the baby being overweight by their first birthday, while another study found no connection between artificial sweetener use and BMI at age seven.

Artificial sweeteners had minimal to no effect on other health issues.

Most studies reviewed by the WHO found no correlation between artificial sweeteners and cancer risk, with the exception of a potential increase in bladder cancer, particularly with saccharin use. There was also no observed impact on the likelihood of developing chronic kidney disease.

So, what’s the final verdict?

The elevated risks of developing type 2 diabetes, cardiovascular diseases, and other health problems may prompt you to reconsider your sugar-free sweetener usage—especially if you rely on them to manage your blood glucose or other health conditions that could potentially worsen with artificial sweetener consumption.

"Artificial sweeteners should be limited or avoided whenever possible, and the focus should shift toward natural, unprocessed foods," says Dr. German. "We don't have definitive information on what quantity may be deemed safe, and it likely varies depending on the person,"

While you might not want to cut them out completely, it’s probably wise to reduce your intake and explore more natural alternatives to satisfy your sweet tooth—or consider eliminating those sugar cravings altogether.

"People should explore other methods to reduce their free sugar consumption, such as eating foods with naturally occurring sugars like fruit or choosing unsweetened food and drinks," says Francesco Branca, WHO Director for Nutrition and Food Safety. "Non-sugar sweeteners aren’t necessary for a balanced diet and provide no nutritional benefit. Reducing the overall sweetness in the diet, starting early in life, will enhance overall health,"