Sweeteners: Addressing Common Questions and Debunking myths

Table of contents

For centuries, various foods, like honey or sugar, have been used to sweeten our food. Today, we also have a range of new sweeteners, which provide low-calorie alternatives to sugar. The EU has established strict rules about which sweeteners may be safely used and what information must be included on labels to inform consumers.

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What are sweeteners and what different kinds are there?

Sweeteners are ingredients added to food to replace sugar. Some sweeteners, often called “intense sweeteners”, provide an intense sweet taste without calories, or with very few calories (for examples see Table 1). Because they are intensively sweet, only very small amounts are needed. Another widely used group of sweeteners are called low-calorie sweeteners, bulk sweeteners or “polyols” (for examples see Table 1). These sweeteners provide fewer calories per gram than does sugar (saccharose) while having the same bulk (volume, see also the article on ‘Replacing sugars’). Rules for the use of both types of sweeteners are laid down in the European Commission regulation on food additives ()1, which covers “food additives, food enzymes, food flavourings and nutrients”. This directive does not apply to foods that have sweetening properties, like sugar, honey or maple syrup.

Intense Sweeteners
Low-Calorie Sweeteners (Polyols)
Acesulfame K
Sorbitol
Aspartame
Mannitol
Cyclamates,
Isomalt
Saccharin
Maltitol
Thaumatin
Lactitol
Neohesperidine DC
Xylitol
Steviol glycosides (from the stevia plant)

Table 1. Types of intense and low-calorie sweeteners commonly used in foods.

Why and how do we use sweeteners?

Sweeteners are used as an alternative to sugar for a number of reasons. Low-calorie sweeteners may be used by people trying to lose weight or control their weight. As sweeteners do not promote tooth decay, they can be used to sweeten things like toothpaste and dental mouthwash. Sweeteners may play a role in contributing to the healthfulness of a diet without having to sacrifice the pleasure of eating sweet foods with some evidence in humans that low-calorie sweeteners can contribute to reduced energy intake and body weight under specific conditions (see also section on ‘Are sweeteners better than sugar?’ for the conditions)2,3. Finally, certain sweeteners have a technical use, aside from their sweetening effect. For example, polyols can be used to keep things like cakes and buns moist.

What is the difference between natural and artificial sweeteners?

Natural sweeteners are extracted from plant sources (e.g. stevia) or produced by animals (e.g. honey), whereas artificial sweeteners are manufactured through industrial processing. The structure of the sweetener chemicals differ between and within the natural and artificial types of sweeteners.

Natural sweeteners may provide some calories, whereas artificial sweeteners contain generally fewer calories per gram than sugar because they are not metabolised by the body in the same way as sugar. Examples of natural sweeteners include stevia (derived from the leaves of the Stevia rebaundiana plant) and erythitol (produced using fermentation or enzymatic processes, usually from glucose). Examples of artificial sweeteners include aspartame, sucralose, saccharin, and acesulfame K.

How are artificial sweeteners made?

Artificial sweeteners are industrially processed from naturally occurring compounds (such as amino acids, the building sources of proteins). The manufacturing process may include fermentation as well as synthetic chemical reactions. For example, aspartame is synthesized by combining the amino acids aspartic acid and phenylalanine, sucralose is made through a process that involves selectively chlorinating sucrose molecules, and acesulfame K is synthesized by chemically transforming acetoacetic acid.

Are sweeteners better than sugar?

There is no consensus from current scientific evidence on whether sweeteners are better than sugar. As sweeteners comprise many different compounds (e.g. aspartame, neotame), they cannot be considered as one group to be compared with sugars in general. Whereas science is clear that negative health outcomes are associated with excessive  energy intake (particularly through the overconsumption of soft drinks), benefits of sweetener uses (such as weight loss) are likely dependent on the specific circumstances in which they are consumed: the type of sweetener, a person’s BMI, in what type of food the sweetener is used (solid or liquid), the duration of time over which a sweetener is consumed, whether there are pre-existing metabolic conditions, etc.2–5. Hence, to understand whether sweeteners are better than sugar, the specific situation a person is in will have to be assessed to understand whether there may be a benefit in replacing sugar with sweeteners.

Are sweeteners safe?

According to EU law, sweeteners (like other food additives) must be authorised before use and continuously re-evaluated for their safety (in accordance with the provisions of the European Commission regulation no 257/). Sweeteners used by food manufacturers are usually subject to certain conditions of use. That is, the law specifies to which foods authorised and approved sweeteners may be added, and the quantities. Assessment of sweeteners is the same as for all food additives and is based on reviews of available safety data. From the available data, a maximum level of an additive that has no demonstrable toxic effect is determined. This is called the 'no-observed-adverse-effect level' (NOAEL) and is used to determine the 'Acceptable Daily Intake' (ADI) figure for each food additive and that includes intense sweeteners. The ADI provides a large margin of safety and refers to the amount of a food additive that under normal circumstances can be taken daily in the diet, over a lifetime, without any health problem. In certain cases, such as the polyols, the law does not specify a maximum level (ADI “not specified”) but stipulates that it must be used in accordance with “good manufacturing practice”, sometimes referred to in technical specifications as “quantum satis”. Manufacturers must not use more than is necessary to achieve the intended purpose. In the case of sweeteners it is expected that daily intake even in people consuming high quantities of sweetener-sweetened products falls well below the presumed toxic threshold5,7 (i.e. scientists do not know what the toxic level in humans is, because only animal studies have been done using that specific sweetener, yet we have sufficient information from animal studies to understand how much people can ingest without any ill effects).

In order to ensure that consumers know which sweeteners have been used in the different food products, sweeteners must be labelled in a certain way. Sweeteners that can be bought in supermarkets must be labelled “…-based table-top sweetener”, where the blank is filled in by the name of the sweetener used. Foods containing intensive sweeteners are also required to state that fact on the label and to name the sweetener in the ingredients list. Polyol sweeteners must note their laxative effects, while those containing the intense sweetener aspartame should state that it is a source of phenylalanine, because people suffering from phenylketonuria cannot metabolise this amino acid.

How do sweeteners relate to our health?

From a scientific point of view, evidence on sweeteners and health effects in people indicates that sweeteners may contribute to decreased energy intake and body weight, as well as improved cardiometabolic risk factors 2,3,5,8–11. Further, polyols and intense sweeteners have been shown to prevent tooth decay9,12, and EFSA acknowledges that compared to table sugar sweeteners reduce blood sugar levels after eating12. However, whether lower blood sugar levels result in long-term health benefits, for instance, on diabetes, is not known as studies so far have come up with contradicting evidence7,12,13.

Finally, sweeteners may be added to non-food products to modify consumer behaviour (such as in tobacco) rather than for calorie reduction purposes14.

Do sweeteners make you fat?

Scientists currently do not know whether sweeteners cause weight gain. Indeed, most scientific evidence shows that sweeteners may have a role in weight management by reducing energy intake and body weight when used as a sugar replacement in the diet of adults, adolescents or children2,3,5,8,9,12,13,15–18.

There have been theories that use of sweeteners causes
• sweetness habituation (i.e. getting used to sweet taste),
• increased cravings for sweetened products, and
long-term metabolic health effects including impacts on genes through parental habits before conception. This may result in an increase in food intake and weight gain. However, these studies are not providing clear answers due to limited data available5,20,21. Another indirect way to gain weight may be through polyols which an effect on our gastro-intestinal health through the gut bacteria; however, it has yet to be clarified whether the impact on the gut microbiota is beneficial or detrimental for humans or even biologically relevant7,22.

The latest World Health Organization’s report on the use of non-sugar sweeteners recommended that non-sugar sweeteners should not be used to achieve weight control (or reduce the risk of non-communicable diseases) in people without diabetes23. However, this report had a few limitations:15

• The guidelines relied heavily on prospective cohort studies, which are generally ranked as having a lower certainty of evidence compared to RCTs as they cannot establish causality. Prospective cohort studies included in the WHO review showed that non-sugar sweetener intake was associated with increased body mass index (BMI), obesity, type 2 diabetes, cardiovascular disease, and all-cause and cardiovascular mortality, while RCTs showed that those consuming higher levels of non-sugar sweeteners had lower body weight and lower BMI than those who consumed lower amounts or no non-sugar sweeteners.
• The prospective cohort studies included in the review used methodologies with a high risk of bias. Such biases included reverse causality (i.e., being at high risk for obesity or chronic diseases leads to increased sweetener intake as an attempt to reduce disease risk. This makes it difficult to determine whether sweetener intake resulted in disease), incomplete adjustments for factors associated with non-sugar sweetener intake and disease risk, and behaviour clustering (i.e., individuals with a high non-sugar sweetener intake may also engage in other behaviours associated with healthy lifestyles, such as having higher quality diets and smoking less). Studies adjusting properly for these factors show that non-sugar sweetener intake contributes to weight and cardiometabolic benefits by reducing or displacing excess calories from sugar24.

The European Association for Study of Diabetes recommends the use of non-sugar sweeteners to replace sugars in beverages and foods as a risk reduction strategy for people with or at risk for diabetes25 i.

Do sweeteners cause cancer?

Scientific evidence and food safety agencies agree that sweeteners do not cause cancer. Despite calls from some experts for stronger, more long-term studies on the individual sweeteners2, the current scientific consensus is that there is no evidence that sweeteners cause cancer. Indeed, international food safety agencies such as the European Food Safety Agency (EFSA) and the US Food and Drug Administation (FDA) have investigated each market-authorized sweetener in detail and concluded that these sweeteners are safe for daily use. EFSA usually provides a maximum value for each authorised food additive (sweeteners are considered food additives) which is often well above the estimated intake of individual people to ensure both short-term and long-term toxicological safety.

So, what are official recommendations on sweeteners?

As sweeteners are food additives, there are no recommendations on their consumption in the same way as we have recommendations for other nutrients like carbohydrates, proteins or fats.  However, with data on beneficial health effects of sweetener consumption being strongly dependent on context (e.g. your body weight, whether sweetener are used as replacement for sugar in solid or liquid foods, how long you replace sugar with sweeteners for, the type of sweeteners) , expert panels supporting public health authorities agree that 2,5,9,13,15,26,27:

What Stevia products are available?

There are many varieties of Stevia sweeteners. The most natural are dried leaves of the Stevia plant. They are especially good for sweetening tea. Liquid Stevia concentrates and Stevia in tablet or powder form are more widely available.

These products are also more versatile. Due to the different product types, there is no generally valid answer to the question of correct use.

Stevia products in the supermarket

By the way, in supermarkets you will also find a variety of foods that contain Stevia as a sweetener. The natural sweetener can make cola, liquorice, jam or chocolate significantly lower in calories.

When buying Stevia in the supermarket, pay attention to the ingredients!

When buying on the internet, there are also a large number of sellers on platforms such as Ebay or Amazon. Especially with these offers, you should not be blinded by the price. Many Stevia products are not approved by the European Food Safety Authority (EFSA).

For consumers, these offers are often very difficult to recognise. In addition, they often come from the Far East. Again and again, ingredients are not listed according to the legal guidelines.

Tip: Check the imprint of the supplier and whether they can be reached by if you have any questions! Here, too, you should pay attention to the ingredients.

Which Stevia product is the best?

Which form of Stevia is better or worse depends solely on the use. Stevia sweetener tablets, for example, are ideal for coffee, tea and other hot drinks.

Stevia extracts or the crystalline spoonale sweetener Stevia is mainly suitable for baking due to its sugar-like consistency, while Stevia liquid sweetener is better for desserts, quark, smoothies or yoghurt.

Which Stevia does not taste bitter?

The sweetener blend Stevia consists of the main components rebaudioside A and stevioside. A high proportion of stevioside often leads to a bitter aftertaste in the composition.

If you want to avoid this, make sure that the product contains an appropriate high percentage (e.g., Rebaudioside-A98%) of Rebaudioside-A, which has a very sweet taste.

How much Stevia can you eat a day?

In order to obtain approval from the European Union, Stevia was subjected to a thorough health safety assessment. The ADI value calculated in this process is 4 mg of Stevia per kg of body weight. The ADI value describes the amount that is not harmful to health even if occasionally exceeded.

What are the disadvantages of Stevia?

A closer look reveals that Stevia also has disadvantages:

- It is especially important to pay attention to the ingredients of the respective product before buying. Some products made with Stevia are supplemented with conventional sugar.

- Some people find the taste of Stevia rather unpleasant.

- Not every form of Stevia is equally heat-resistant and therefore suitable for baking or cooking.

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Does the use of Stevia make sense or not?

It is not easy to make a statement about whether Stevia is useful or not. Especially people who generally use artificial, synthetic sweeteners (such as aspartame, cyclamate or sucralose) may find Stevia a good alternative, as Stevia is of plant origin.

Is Stevia suitable for diabetics? When consuming Stevia, insulin levels do not rise. Therefore, Stevia is used in the production of many diabetic-suitable foods.

Due to the different types of products, there is no generally valid answer to the question of the right use. Here we give you helpful tips on what to look for when buying Stevia.

Sweetening tea with Stevia leaves

There are many varieties of Stevia sweeteners. The most natural are dried leaves of the Stevia plant. They are especially good for sweetening tea.

Stevia leaves are available in different types, also in organic quality, as whole dried leaves, tea fine cut or micro-fine ground.

Stevia liquid sweetener

There is a wide range of liquid Stevia concentrates and Stevia liquid sweeteners. Unfortunately, products that you can buy in supermarkets or drugstores very often contain added fructose, dextrose or even flavourings.

When buying, pay attention to the ingredients. A good Stevia liquid sweetener product should not have the above ingredients.

Bottle caps with (1) and without tamper-evident cap (2).

What is a tamper-evident cap?

A tamper-evident cap is often also called a guarantee cap or first-opening guarantee. Most people know it from beverage bottles.

The closure rings that must first be torn open before the bottle cap can be turned. It is a breakable plastic ring on the bottle. Only when the bottle cap is turned for the first time does the lower locking ring come off the cap.

Tamper-evident closures are used to indicate the integrity, tampering or breakage of a package.

Reputable suppliers do not offer products without tamper-evident closures.

They show you that the products are manufactured according to strict HACCP guidelines (Hazard Analysis and Critical Control Points) as well as the IFS Food Standard, a standard recognised by the GFSI (Global Food Safety Initiative) for auditing food manufacturers.

Here we give you tips on what to look out for:

Are exact ingredients declared? Very often they are not declared correctly! Liquid sweeteners always need a preservative. Without it, sweeteners are the ideal breeding ground for germs, bacteria and viruses.

Take a close look at the bottle caps! Why? Do not buy liquid sweeteners if the bottle does not have a tamper-evident cap!

Stevia sweetener tablets | Stevia tablets | Sweet tablets

The most important thing to know first: There are no Stevia sweetener tablets that are 100% Stevia. Do not be fooled by such offers. The maximum value is usually between 12% and 25%.

For the production of sweetener tablets you always need so-called carrier and tabletting additives. Without these, the production of tablets is not possible.

The most commonly used carriers are Sorbitol, lactose (milk sugar), carboxymethyl cellulose, isomalt, erythritol, sodium hydrogen carbonate or dextrose.

Addition of flavours: Stevia tablets are often made with flavours, especially vanilla flavours. The addition can often be an indicator that high-quality Stevia extracts are not used in the production process. These are primarily used to mask the taste, sweetness.

What is pure Stevia extract?

Very high-quality Stevia extract Rebaudioside-A 98%

These are not offered in supermarkets or drugstores. In individual cases, they are available in organic shops. However, this is often only the lowest quality (usually only Rebaudiosid-A 40% or even only 25%). These extracts are often overpriced.

You can find good pure Stevia extracts on the internet. However, you should look carefully at the suppliers. Often, the suppliers are media or advertising agencies or traders on Ebay who offer many articles from the drugstore sector.

These sellers often do not have the necessary knowledge in the area of Stevia. Many of them do not specialise in this field and are usually only out to make a quick buck.

Here you can get very detailed information about very high-quality Stevia extracts.

You can recognise good Stevia by these properties

High Quality Stevia Extract Rebaudioside-A 60%

Stevia extract is particularly pure and up to 450 times sweeter than sugar. Therefore, you should always dose and sweeten this type of Stevia carefully to avoid making food inedible.

Only buy Stevia from suppliers who specialise in Stevia. Make sure that pure Stevia extracts are labelled with the exact specification and quality.

This is the only way to compare products. The purity of steviol glycosides must be at least 95%. For the higher quality Stevia extract Rebaudiosid-A, you should only buy qualities of more than 60% because of the taste.

Look at the imprint of the seller and whether a number is given. So that you can contact the seller directly if you have any questions.

What is Stevia crystalline sweetener spoonable?

Stevia as a spoonable sweetener is mainly suitable for baking due to its sugar-like consistency, while the liquid version is better for desserts, quarks or yoghurt.

Stevia granules are a mixture of erythritol and Stevia. This crystalline form of the natural sweetener is very easy to dose and is also known as a spoonable sweetener. It is particularly heat-resistant and for this reason can also be used for cooking or baking.

Stevia spoonable sweeteners completely replace the sugar in the baking recipe, so it can be used 1:1 as in the original recipe.

Stevia crystalline spoonable sweetener without maltodextrin!

Caution: There are also spoonable sweeteners with maltodextrin! These products consist of more than 95% maltodextrin and are cheap in relation to the Stevia crystalline spoonable sweetener.

Per 100 grams of maltodextrin, there are 95 grams of carbohydrates, which corresponds to about 380 kilocalories (kcal). Look at the small print of the ingredients list to see which ingredients are used.

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