First we were urged to give up our Coke, with its 39 grams of sugar per can. Fair enough in the age of increasing obesity and resulting health problems. But now we’re supposed to give up our Diet Coke, too?

Diet soda has been coming under increasing scrutiny as a potential dietary and health saboteur. Recent findings blame diet soda for everything from increased stroke risk to metabolic abnormalities to stimulating sugar cravings that actually contribute to obesity and diabetes.

Kathy Mankofsky, a registered dietitian with Mercy Dietitian Service, frames the debate this way: “For years people have been using artificial sweeteners to help with weight loss and to try to prevent diabetes. There have been studies where switching from regular sugar to artificial sweeteners decreased caloric intake and people lost weight. People who use sweeteners believe that it helps with weight loss—but does it? Now some people are saying that these sweeteners contribute to weight gain and promote diabetes. This is the current controversy.”

Both sides may have valid points, Mankofsky says. Artificial sweeteners do reduce calories in the diet, which can help promote weight loss. However, two small studies suggest that even artificial sweeteners may increase insulin levels, just as consuming sugar does. So are artificial sweeteners as bad for us as sugar? The jury is still out until more evidence is collected.

“One good question to ask is which sweeteners were used in the study,” Mankofsky says. “We cannot lump them all together just yet. These were small studies and therefore, further studies need to be done to confirm their findings.”

When asked if we should give up diet soda consumption based on recent reports, Shital Mehta, a clinical dietitian SSM St. Joseph Health Center, suggests a wait-and-see approach. “The recent news stories and blog postings are based on few small animal studies and some observational studies,” she notes.

The animal experiment did show a link between consuming artificial sweeteners and overeating leading to weight gain, but it was a small study, Mehta points out. “The observational studies also reported that individuals who use artificial sweeteners are more likely to gain weight or be heavier, and more likely to develop metabolic syndrome (a cluster of symptoms often linked to obesity that increase risk for heart disease and diabetes). But in such studies, it’s impossible to say if diet soda played a direct role in weight gain. Rather, they are more likely to be consumed by individuals with overweight or obesity,” she says.

Mehta notes that a number of artificial sweeteners are approved by the U.S. Food and Drug Administration, and both the Academy of Nutrition and Dietetics and American Diabetes Association support the use of low- and no-calorie sweeteners to help maintain a healthy weight.

However, both dietitians recommend looking for natural sources of sweetness that also provide nutritive benefits, such as fruit and sweet potatoes, and both recommend using artificial sweeteners in beverages and foods only in moderation. In addition, those who think that regular sugar is a better option in beverages and foods should keep in mind that the American Heart Association states that a high sugar intake contributes to obesity, heart disease and Type 2 diabetes, Mankofsky notes.

“Bottom line, if you eat foods sweetened with either regular sweeteners or artificial sweeteners, use only small amounts,” Mehta says. “Artificially sweetened foods can be lower in sugar but not always lower in calories, so always read labels to get accurate information. For beverages, an artificially sweetened option may be a better option, but always read labels.”



All are approved by the U.S. Food and Drug Administration and by the Academy of Nutrition and Dietetics.

  • ASPARTAME (Equal, Nutrasweet)

A combination of the two amino acids phenylalanine and aspartic acid and methanol, which is wood alcohol.

The Center For Science in the Public Interest (CSPI), the consumer advocacy group, puts it on their ‘Avoid’ list due to some controversial studies.

Possible side effects: Headaches.

Caution: Not to be used by those who have Phenylketonuria (PKU). It breaks down at high temperatures and cannot be used in baking.

  • SUCRALOSE (Splenda)

Made by chemically combining sugar with chlorine.

The CSPI puts it on their ‘Caution’ list due to some controversial studies.

Benefits: It does not break down at high temperatures and can be used in baking.

  • SACCHARIN (Sweet ‘n‘ Low)

A synthetic chemical discovered in 1879. It was the first artificial sweetener used in the U.S.

The CSPI puts it on their ‘Avoid’ list. It was on the U.S Department of Health and Human Services list of cancer-causing chemicals until the year 2000. It also used to come with a warning on the label that increased use will result in slightly greater incidence of cancer. In May 2000 saccharin was removed from this list and the warning removed from its labels.

  • STEVIA (Truvia, Purevia, Stevia in the Raw)

An extract from the leaves of the stevia plant. It’s been used in Japan and South America for many years. There are many different sweet parts of the plant, which includes the steviosides and rebaudioside A (which is known as rebiana).

Brand differences: Each brand is mixed slightly differently. For example, Truvia has rebiana and erythritol, which is a sugar alcohol. Erythritol is approved by the FDA and is on the CSPI’s ‘Safe’ list.

Pros: Since it comes from a plant, it may be considered a natural sweetener. It’s the only non-nutritive sweetener that has shown any promise of metabolic stability, and it has not caused abnormalities in blood sugar or insulin levels in the studies done so far. Still, more conclusive studies need to be done.

Cons: It’s not as sweet as the other sweeteners, the cost is slightly higher, and it’s not as readily available in as many foods and drinks. Some people perceive Stevia to have an unpleasant after-taste. (However, some also perceive the other sweeteners as having an aftertaste.) Combining stevia with erythritol is supposed to improve this. There are multiple Stevia formulations avail-able. Various different products are mixed with Stevia, including other sweeteners, to help enhance the taste. If you buy Stevia, make sure to read the label so you know what you are getting.

*provided by Kathy Mankofsky and Mercy Dietitian Service

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