With growing concerns about the health risks of excessive sugar consumption—like obesity, diabetes, and heart disease—alternative sweeteners are gaining attention as potential solutions to satisfy our sweet tooth without the harmful effects of sugar.

Is it possible?

That’s the promise of sucralose—a zero-calorie sweetener that’s rapidly replacing sugar in everything from coffee to desserts and more.

But is it truly a better and safer alternative, or does this sugar substitute come with hidden risks?

In this article, we'll investigate the science related to sucralose and why it is commonly paired with another sweetener called Acesulfame potassium, and try to get closer to the truth.

So, what exactly is sucralose?

While there are a number of artificial sweeteners on the market, sucralose is a non-caloric sweetener that is extensively approved globally for use in foods and beverages. It is obtained from sucrose (sugar) by the selective replacement of three hydroxyl groups. 

Sucralose has a sweetness potency of about 600 times that of sugar, which means a very small amount of sucralose (1/600th) can replace sugar on a weight basis to achieve the same level of sweet taste. To put sucralose's sweetness into perspective, imagine this: one teaspoon of sucralose is as sweet as 600 teaspoons of sugar. 

That’s like swapping out an entire 5-pound bag of sugar with just a tiny packet of sucralose—and still getting the same level of sweetness.

Unlike sugar, sucralose is not digested or metabolized for energy and no calories are obtained from ingesting it. Sucralose also does not affect blood glucose levels.

These properties result in the use of sucralose to produce foods and beverages that are suitable for individuals with diabetes or those aiming to reduce calorie or carbohydrate intake.

History, Regulatory Status, and Health Agency Stances

Discovered in the late 1980s⁽¹⁾, sucralose underwent extensive chemical characterization and toxicology studies as required for pre-market regulatory investigation into the safety of a proposed new food additive. The general principles for the premarket safety assessment of new food additives, such as a non-caloric sweetener, were first established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) in 1958. Although these principles continue to be the foundation for approvals by regulatory agencies globally, recent revisions include current knowledge and advances in toxicological science⁽²⁾.  

A detailed description of the studies required is publicly available⁽³⁾ and is similar to those required by other regulatory agencies including the Redbook by the US Food and Drug Administration (FDA). These guidelines establish the types of studies to be conducted and the appropriate study protocols to be used in investigating the safety of a new food ingredient.

Regulatory agencies necessitate complete chemical characterization of the ingredient, studies that demonstrate its intended functionality and stability in food, the method of manufacture, the detection method including data that validate the analytical method development, and comprehensive toxicological research. 

Toxicology testing requirements include the evaluation of genetic effects, pharmacokinetics (pharmacokinetics is how a substance moves through your body, like a journey from the moment you take it until it's gone) and metabolism, toxicology studies in rodents and in non-rodent species including life-time exposures to ensure no evidence of adverse effects on growth and development, organ function or structure, blood chemistry, and/or potential to cause cancer.

Multigenerational studies assess potential effects on male or female reproduction, pregnancy, and offspring health and development.

Additionally, clinical studies are often conducted to compare the absorption, distribution, metabolism, and excretion (aka pharmacokinetics) in experimental animals to data from humans, to demonstrate the appropriateness of the animal models used in safety testing. All data from the investigative studies must be submitted to the regulatory agencies such as the FDA.

During the regulatory review process, study designs and data are critically reviewed by expert scientists to determine if there is sufficient evidence to establish the safe level of the food additive that can be consumed by the entire population daily, which is called the acceptable daily intake (ADI). The ADI is based on the No Observed Adverse Effect Level (NOAEL), which describes the highest dose that was fed to animals in long-term studies with no toxicological effects. The NOAEL is then divided by a safety factor to ensure the resulting ADI is safe for all potential consumers, including subgroups such as children.

Sucralose was first approved by JECFA in 1989, after reviewing extensive studies.

However, further studies were requested, including assessment of safety of long-term consumption by individuals with diabetes. In 1991, following the evaluation of data from additional studies in both animals and humans, the committee allocated a permanent ADI of 0–15 mg/kg bodyweight per day (bw/d) based on the NOAEL of 1500 mg/kg bw/d from a long-term study in rats, and a safety factor of 100⁽⁴⁾.  

As the rat study included in utero (in the uterus/womb) exposure, as well as exposure during postnatal (after childbirth) growth and development, this study was the most comprehensive study for establishing the ADI.

Other major food safety and health regulatory agencies around the world, including Health Canada, 2016, US FDA, 1998, US FDA, 1999, US FDA, 2015, the European Union, Australia, New Zealand, Japan and others conducted intensive reviews of all the data generated in safety investigations.

All these agencies have approved sucralose for its intended use as a sweetener in a variety of products⁽³⁾.

Furthermore, major health associations, such as the American Heart Association⁽⁵⁾, the American Diabetes Association⁽⁵⁾ and the Academy of Nutrition and Dietetics⁽⁶⁾ have conducted detailed reviews of the available literature on low calorie sweeteners including sucralose, and substantiate that approved no calorie sweeteners can be safely used in nutritional strategies for lowering sugar intake.

Stability of Sucralose in Food Products

Testing of the stability of food additives during typical food processing and in the matrices of the foods and beverages that will contain them is required by regulatory agencies. If the food additive is found to be not stable during processing, the identification and safety of any formed compounds must be assessed. The testing of the stability of the food additive in a few food and beverages such as carbonated soft drinks, hot pack still beverages, yogurt, yellow cake and powdered dry mixes - represent the extremes of these conditions that are likely to be encountered in all processed foods for a low calorie sweetener⁽⁷⁾.

Stability experiments conducted for sucralose added to carbonated soft drinks, still drinks, dry mixes and strawberry milk illustrated extremely high stability even during extended storage conditions⁽⁸⁾.

Based on research and other stability experiments, sucralose was determined to be suitable and safe for use as a general purpose sweetener in heated beverages and foods that require cooking, such as in baked goods⁽⁹⁾.

In short, the properties of sucralose contribute to its suitability as a non-caloric sweetener for a wide variety of products including beverages, baked goods, breakfast cereals, desserts, jams and jellies and more.

These include high sweetening potency, non-reactivity in food systems, low viscosity, and no effect on food color or surface tension^(8). Sucralose is highly stable in the ranges of temperatures and pH that are encountered in food and beverage processing and no evidence has indicated development of significant levels of either breakdown or thermal byproducts in a matrix that compares to food and beverage applications⁽¹⁰⁾.  

These functional properties, in combination with the totality of data on safety and intended technical effects, led to the approval of sucralose as a general purpose sweetener, which can be used in any application where the intended technical effect is to impart sweetness⁽¹¹⁾.

Safety Assessment of Sucralose

An important aspect of the safety assessment of a potential new food additive is consideration of whether the experimental animals used in the toxicology studies represent a good model for the safety assessment in humans.

Comparison of the toxicokinetics (i.e. how the test compound is absorbed, distributed, metabolized and excreted) in different species to that in humans is used to identify the experimental animal species that most closely represent humans. Potential differences between males and females are also evaluated.  Many different species (i.e., mice, rats, dogs, rabbits, and humans) were utilized to evaluate the toxicokinetics of sucralose.

In all animals tested, sucralose behaves in a similar way: only a small amount is absorbed, and most of it leaves the body unchanged in the feces. A tiny portion is processed by the body and excreted in the urine, but there’s no evidence that sucralose stays or builds up in the body. This processing involves glucuronidation, a natural detoxification pathway the body uses to safely remove substances like medicines and other environmental chemicals.

The way sucralose is absorbed, used, and removed by the body in humans is very similar to what happens in rats, dogs, and mice, making them reliable models for studying its safety. There’s no evidence that sucralose breaks apart or changes in these animals or humans. It also doesn’t break down to provide energy, confirming that sucralose isn’t a source of calories.

Genotoxic Potential of Sucralose

The toxicological assessment of a food additive usually begins with evaluation of genetic toxicology as these studies are considered screening tests both for potential cancer development and certain adverse reproductive effects. The genetic toxicology studies are rapid and less costly than long-term animal experiments; thus, obtaining definitive evidence of lack of genetic toxicology is recommended before investment in additional toxicology studies. At the outset, it is instructive to note that sucralose is not electrophilic, meaning it does not have a tendency to attract or acquire electrons, nor does it contain structural alerts for genotoxic or carcinogenic activity⁽¹²⁾.

Sucralose was exposed to a full battery of in vitro and in vivo mutagenicity and clastogenicity studies, and results were submitted to regulatory agencies around the world⁽¹³⁾.

The weight of evidence from the genetic toxicology studies described above is that sucralose does not have potential to induce genetic effects or cancer in humans. The Scientific Committee on Food (SCF) stated in its opinion that sucralose as such was considered to have no genetic toxicology potential⁽¹⁴⁾.

Acute Toxicity Studies

Most often, following determination of negative findings in genetic toxicology studies, the next step in toxicological assessment of a food additive is determination of acute toxicity following a one-time exposure to a high dose in animal models. A commonly reported value of acute toxicity, the LD50, (i.e. the dose that results in death of 50% of the animals) is based on a standardized Good Laboratory Practice experimental protocol evaluating animal health for 14 days after dosing. The acute toxicity of sucralose in mice and rats was evaluated at doses of 16,000 and 10,000 mg/kg body weight, respectively, administered by oral gavage⁽⁸⁾.

No deaths occurred in either species and no evidence of toxicity was observed during the following 14 days based on measurement of body weights, animal behavior and gross evaluation of animal tissues through necropsy at the end of the experiment. Therefore, the LD50s for these experiments are actually unknown, and are simply reported as greater than the doses tested (i.e. >16 g/kg in mice and >10 g/kg in rats). Based on this study, and given the tiny amount of sucralose used to sweeten products, it has extremely low acute toxicity potential.

Long-Term Chronic Toxicity and Carcinogenicity of Sucralose

The scientific data that are collectively considered in assessing the carcinogenic potential of a chemical compound include attributes of the compound, mutagenicity data, studies on the metabolic fate and toxicokinetics of the compound, all growth and physiological data from short and long-term bioassays and the appropriate evaluation of preneoplastic and neoplastic findings⁽¹²⁾.

The chemical structure of sucralose predicts a low order of reactivity, no biotransformation potential, and no identified structural alerts for genotoxic or carcinogenic activity. Stability testing shows sucralose is remarkably resistant to both chemical and enzymatic degradation. The results of in vitro and in vivo assays of sucralose revealed no confirmed genotoxic activity, consistent with the chemical structure and metabolism of sucralose.

Following ingestion, sucralose is not metabolized in the gut and approximately 85% of sucralose is excreted intact.

The trivial amount absorbed is not metabolized to reactive intermediates and neither the parent molecule nor metabolites react with biological macromolecules (e.g., DNA). The small percentage of sucralose that undergoes metabolism is not catabolized (broken down) but is biotransformed to glucuronide conjugates that are toxicologically and biologically insignificant.

Sucralose was tested at doses up to 50,000 ppm, the maximum dose the FDA recommends for any compound.

The FDA established an NOEL of 1.0% sucralose in the diet, equivalent to about 500 mg/kg body weight/day and the Joint FAO/WHO Expert Committee on Food Additives established an “Acceptable Daily Intake” (ADI) of 0–15 mg/kg body weight/day. You can view a chart on the FDA website that details the safe levels of all sweeteners here.

Randomized, double-blind clinical trials conducted over a period of approximately 3 months in which sucralose was consumed daily in amounts greater than the maximum ADI showed that sucralose was well-tolerated and without evidence of toxicity or other changes that might suggest a potential for carcinogenic effects⁽¹⁵⁾.

In summary, review of the evidence retrieved, including key studies recommended by international regulatory bodies and toxicology experts, confirm that sucralose is noncarcinogenic and safe to ingest. Sucralose does not demonstrate carcinogenic activity even when exposure levels are several orders of magnitude greater than the range of anticipated daily ingestion levels⁽¹²⁾.

Human Clinical Studies on Sucralose

International food agencies around the globe conduct safety assessment of food ingredients, such as low-calorie sweeteners, using similar assessment approaches.  In all cases, safety related to exposure to a food ingredient is based on assessment of the chemistry and structure of the ingredient, results from extensive genetic and animal toxicology studies, and the predicted levels of consumption of that ingredient as discussed above. 

Typically, human clinical studies are not a requirement for novel food ingredient or food additive approvals, although human studies are often done to establish the appropriateness of animal models used/to be used in safety investigations.

In a review of the FDA safety assessment process, it was noted that a 100-fold ‘‘safety factor” is used when establishing safe intake quantities, to account for both inter-species variations and normal genetic variations and the range of susceptibilities that is possible across the human population, and that this approach has been used by regulatory agencies including FDA for many decades, and has proven to be reliably protective of public health⁽¹⁶⁾.

The human studies with sucralose originally conducted were specifically designed to assess overall safety and tolerance of consumption of sucralose, and thus included many physiological and biochemical measurements. Most important, from a safety assessment perspective, are those involving repeated daily consumption of sucralose⁽¹⁷⁾.

As sucralose was intended to be used as a sugar replacement by individuals with diabetes, studies with both Type 1 insulin-dependent (T1D) and Type 2 non-insulin dependent (T2D) diabetic subjects were conducted to determine if sucralose consumption had any effect on blood glucose control and insulin prior to approval. These included both acute (single dose) and repeated daily exposure (3 month) studies in people with diabetes.

Repeated Daily Consumption of Sucralose in Human Subjects

Studies conducted on repeated daily sucralose demonstrated that daily sucralose consumption of up to 10 mg/kg bodyweight for 13 weeks had no adverse effect on any health parameters measured (blood biochemistry, ECG, hematology, urinalysis, blood insulin and blood sucralose concentrations)⁽¹⁸⁾.  

No evidence of sucralose accumulation in the blood confirmed the results of toxicokinetic studies in animals. Consumption of sucralose had no effect on blood glucose or insulin levels in either the pilot or follow-up tolerance studies and did not affect the normal insulin response to sucrose. This research resulted in a very comprehensive assessment of the tolerability to sucralose, and confirmed no adverse effect of repeated sucralose consumption at levels much higher than the EDI (estimated daily intake) of 1.1 mg sucralose/kg bodyweight/day⁽¹⁸⁾.

In a double-blind randomized placebo-controlled study, healthy males consumed 1000 mg of either sucralose or a placebo of cellulose daily for 12 weeks.

• The average dose based on body weight was 13.22 mg/kg bw/d. 
• HbA1c and fasting glucose, insulin and C-peptide were measured weekly.
• Oral glucose tolerance tests were conducted at baseline and after 6 and 12 weeks, within 15 min of consuming sucralose or the placebo.
• All measures of glucose control were within normal range throughout the study, and there were no differences between groups in changes from baseline in any measure.

This study thus revealed no effect of daily consumption of 13 mg/kg bw/d sucralose on either glucose control or measures of insulin sensitivity⁽¹⁷⁾.

Diabetic Participants

A double-blind, placebo-controlled, randomized multi-center repeated-dose study was conducted in subjects with type 2 diabetes for 3 months⁽¹⁹⁾.

• A 6-week screening established eligibility and baseline glucose homeostasis.
• Subjects received 667 mg encapsulated sucralose or placebo (cellulose) capsules daily for 13 weeks. Fasting HbA1c, plasma glucose and serum C-peptide levels were measured every 2 weeks.
• Subjects were also monitored during a 4-week follow-up phase during which all subjects received placebo capsules.
• There were no significant differences in the primary measure of blood glucose control, HbA1c, between groups at baseline or throughout the experiment.
• Similarly, sucralose had no effect on fasting glucose, C-peptide levels or diabetic therapeutic regime (i.e. medications) during the 3-month study.
• Four weeks after the treatments ended, there was a significant reduction in fasting plasma glucose in the sucralose-treated group relative to baseline and compared to the placebo-treated group, with no differences in serum C-peptide.
• This study where daily sucralose consumption was approximately 7.5 mg/kg bw/d, or about 6–7 times the estimated average daily intake, demonstrates no effect of repeated daily consumption of sucralose in persons with type 2 diabetes and further supports the safety of human sucralose consumption.

In summary, all the clinical studies that have evaluated the effects of long-term ingestion of sucralose support its safety under the intended conditions of use. No adverse effects were observed on glucose homeostasis, as determined by fasting and post-prandial (aka after eating) blood glucose, C-peptide, and insulin, and on HbA1c, the latter being a biomarker that reflects average blood glucose levels over extended periods of time.

Estimates of Consumption of Sucralose

For sucralose with an ADI of 0–15 mg/kg bw/d, the estimated exposure ranged from 1% to 3% of the ADI for average consumers, and 6%–15% of the ADI for high consumers in the 95% percentile of intakes. The highest reported intake for sucralose (2.25 mg/kg/d) was reported in a food diary study by the Food Standards Australia New Zealand in 2004⁽²⁰⁾.  

For perspective, for a 70-kg (154-lb) adult to reach the estimated toxic dose of sucralose (10,000 mg/kg), such a person would need to consume about 700 grams (0.7 kg) of sucralose in one sitting. This is thousands of times higher than normal dietary exposure.

The results of well-conducted consumption estimates, even using conservative approaches such as use of maximum use levels, consistently find that the intakes of sucralose in all members of the population remain well below the ADI. These results support the initial estimates by regulatory agencies (US FDA, 1998, US FDA, 1999)⁽¹¹⁾ that expected intakes would be below the ADI, and even for high intake consumers, average daily intakes are likely less than 3 mg/kg/d.  Recent studies specifically in children and those with special dietary needs have provided additional confidence that consumption of sucralose is at safe levels in these unique population subgroups⁽³⁾.

Sucralose Compared to Sucrose as a Sweetener

Both sucralose and sugar (sucrose) provide sweet taste. However, sucralose is 600 times sweeter than sugar, so only a tiny amount is needed to provide the same level of sweetness as sugar.

Sucralose is calorie-free, while sugar contains about four calories per gram. When we consume sugar, our body breaks it down into glucose and fructose, uses what it needs, and stores the rest in various forms for future use.

In contrast, when we consume sucralose, it quickly passes through the body unchanged, without being broken down or stored.

Although there is an increase in weight reduction intervention programs worldwide, the number of overweight and obese individuals is still growing, as are instances of metabolic diseases and cancer.  In this context, changes in intestinal barrier function and the composition of intestinal microbiota may play an important role⁽²¹⁾.

Endotoxemia is described as changes in intestinal barrier function that may lead to an elevated translocation of bacterial toxins such as lipopolysaccharide into the blood stream. This development culminates in an increase in pro-inflammatory markers leading to a low-grade inflammation⁽²²⁾.

Metabolic endotoxemia has been defined as a state induced by dietary patterns. Several dietary factors have been suggested to be critical in the development of metabolic endotoxemia, including saturated fats and sugars like fructose.  Although the World Health Organization (WHO) recommended in 2015 that the intake of free/added sugars should constitute ≤ 10% of total daily energy intake, sugar intake is still markedly high in many industrialized countries. For instance, in Austria and Germany, added sugar contributes to ~14% of energy intake⁽²³⁾, while in the Netherlands it is 12%⁽²⁴⁾.

A recent study investigated how artificial sweetener sucralose impacts our gut health and found that it may be a safer alternative to consuming sugar⁽²⁵⁾.

The aim of the study was to assess the effects of an acute intake of sucralose in physiological doses compared to an iso-sweet intake of sucrose on post-prandial endotoxemia in healthy young adults. Following a 2-day standardization of their diet, healthy men and women received a beverage containing either sucrose, sucralose (iso-sweet) or an isocaloric combination of sucralose + maltodextrin. Plasma endotoxin levels were measured after consumption of the respective beverages. Moreover, the effect of sucrose and sucralose on intestinal permeability was assessed.

Major Findings

The intake of the sucrose-sweetened beverage resulted in a significant increase in bacterial endotoxin levels (~45% after 120 min) in the peripheral blood while no similar changes were found after the intake of either the sucralose-sweetened beverage or the sucralose-sweetened beverage enriched with maltodextrin. These results indicate that an acute intake of sucrose in concentrations found in “normal,” sweet-tasting beverages but not the intake of sucralose may result in post-prandial endotoxemia in healthy young adults.

This data suggests that the intake of a sucralose-sweetened beverage in a physiological amount, e.g., 1 L, has no effect on intestinal barrier function in healthy young adults.

This was the first study which examined the effect of an acute intake of sucralose on endotoxin levels in healthy, normal-weight human subjects. The results of this research also add further weight to the hypothesis that dietary sugars like sucrose may be critical in the development of intestinal barrier dysfunction suggested to contribute to the development of various metabolic diseases like metabolic dysfunction-associated steatotic liver disease and type 2 diabetes⁽²⁶⁾.

What is Acesulfame Potassium and Why is it Combined with Sucralose?

Acesulfame potassium — also known as acesulfame K, or ace K — is an artificial sweetener. It is approximately 200 times sweeter than sugar and is utilized to give food and drinks a sweet taste without adding calories. Acesulfame acts by stimulating sweet-taste receptors on the tongue, so a person can enjoy the taste of sweetness without consuming sugar.

Sucralose and acesulfame potassium are often used together in food and beverages because their combination creates a more "sugar-like" taste profile by masking the potential bitter aftertaste of acesulfame potassium, while also allowing for a lower overall amount of sweetener needed to achieve the desired sweetness level; essentially, they work synergistically to enhance each other's taste qualities⁽²⁷⁾. 

Interestingly, the body may not break down or store acesulfame potassium as it does with other food. Instead, the body absorbs it and then passes it, unchanged, through urine.

The FDA regulates acesulfame potassium (Ace-K) as a food additive. The FDA approved acesulfame potassium for use in specific food and beverage categories in 1988 and in 2003 approved it as a general-purpose sweetener and flavor enhancer in food, except in meat and poultry, under certain conditions of use.

It is heat stable, meaning it stays sweet even when used at hot temperatures during baking, making it suitable as a sugar substitute in baked goods. To determine the safety of acesulfame potassium, the FDA reviewed more than 90 studies designed to identify possible toxic effects, including studies on reproductive effects, carcinogenicity, and metabolism.

Acesulfame potassium has been FDA-approved as a food additive for more than three decades, and its safety has been repeatedly recognized by many international health authorities. All types of foods and beverages, including those made with acesulfame potassium, can have a place in a variety of healthy eating patterns.

Choosing foods and beverages sweetened with low- and no-calorie sweeteners such as acesulfame potassium is one way to reduce consumption of added sugars and keep calories in check—which are both crucial components in maintaining good health.

Natural sweeteners compared to sucralose

Stevia

Stevia is a natural sweetener that’s derived from the leaves of the South American shrub Stevia rebaudiana. This plant-based sweetener can be extracted from one of two compounds called glycosides — stevioside and rebaudioside A. These compounds don’t contain any calories, are up to 450 times sweeter than sugar, and may taste slightly different than sugar⁽²⁸⁾.  Chemical compounds found in the stevia plant interact with both the sweet and bitter receptors, leading to its signature bitter aftertaste. 

While stevia is considered generally safe, some studies suggest that it may harm your gut microbiome. A recent study found that certain components of stevia may inhibit bacterial communication (quorum sensing) rather than killing bacteria outright; potentially influencing the balance of gut microbes, but the long-term implications are unclear⁽²⁹⁾. 

Overall, more research is needed. The ADI for stevia glycosides, as set by the FDA is: 4 mg/kg of body weight per day (steviol equivalents). For a 70-kg adult, the safe daily intake is 280 mg per day.

Stevia has no known fatal amount, however adverse effects for most appear at over 4mg/kg body weight. Assuming an energy drink has 100mg of stevia, that would mean a 150lb individual would have to consume 2.8 cans for adverse effects.

Monk Fruit

Monk fruit extract is obtained from the Siraitia grosvenorii plant, which is native to China⁽³⁰⁾. Even though monk fruit is about 150-250 times sweeter than table sugar, it doesn’t contain any calories. This sweetness comes from compounds called mogrosides, primarily mogroside.  Because monk fruit doesn’t have any calories or affect blood sugar levels, it may promote weight loss and improve blood sugar levels if used in place of regular sugar. However, there’s currently a lack of human studies on this sweetener.

Keep in mind that monk fruit extract is often mixed with other sweeteners, so be sure to read the label before consuming it.  As an example, monk fruit sweeteners are often blended with erythritol to enhance texture and flavor. A recent study found that erythritol consumption could be linked to an increased risk of heart attack and stroke, indicating that the combination of monk fruit with erythritol may carry potential health risks⁽³¹⁾.

Monk fruit does not have a specific numerical ADI because it is natural and has demonstrated minimal toxicity in studies, and therefore no standardized amount for adverse effects.

Sugar alcohols

Sugar alcohols, also known as polyols, are a type of carbohydrate naturally found in fruits and vegetables. Popular sugar alcohols used as sugar alternatives include erythritol, xylitol, and maltitol.

The bacteria in your mouth don’t ferment sugar alcohols, so they don’t damage your teeth the way that regular sugar does. Plus, they have substantially fewer calories and don’t significantly affect blood sugar levels, making them a smart alternative for those with diabetes⁽²⁸⁾.

Erythritol contains just 0.2 calories per gram, while xylitol provides 2.4 calories per gram. For reference, sucrose — or table sugar — packs 4 calories per gram⁽³²⁾. Although sugar alcohol is considered generally safe, some may cause digestive upset when eaten in large amounts. For example, sorbitol may trigger laxative effects in doses of 20–50 grams, while erythritol may cause stomach upset if you eat over 455 mg per pound (1,000 mg per kg) of body weight⁽³²⁾.  No formal ADI has been set for sugar alcohols by the FDA.

Allulose

Allulose, also known as D-allulose, is a monosaccharide (or sugar) that exists naturally in certain fruits.  It has 70% of the sweetness of table sugar and provides just 0.2 calories per gram.  Unlike many other zero and low-calorie sweeteners, allulose closely mimics the taste of regular sugar. Human data indicates that allulose may help reduce blood sugar and insulin levels in people with and without diabetes⁽³³⁾.

Keep in mind that large doses may lead to symptoms like bloating, diarrhea, and abdominal pain, so you should stick to a maximum single dose of 0.19 grams per pound (0.4 grams per kg) of body weight and a maximum daily dose of 0.4 grams per pound (0.9 grams per kg)⁽³⁴⁾.  

For a 70-kg individual, this translates to approximately 28 grams per day. Higher doses (> 0.5 g/kg) may cause mild gastrointestinal symptoms, such as bloating or diarrhea, particularly in sensitive individuals. The ADI for allulose has not been officially established by the FDA.

Summary

The safety of sucralose has been extensively evaluated by regulatory agencies around the world, and it is approved globally for use in foods and beverages as a non-caloric sweetener. Detailed metabolism studies using radiolabeled sucralose to allow accurate determination of its fate demonstrate very little absorption from the gastrointestinal tract, and most ingested sucralose is excreted unchanged in the feces. There is no retention or build-up in the body with long-term use, and no evidence of either dechlorination or hydrolysis of sucralose to metabolites in any species.

Unlike sucrose, there is no digestion or breakdown, confirming that sucralose is not a source of energy or calories.

The toxicology studies required for approval of sucralose require use of multiple doses, measurement and reporting of an extensive list of endpoints, including growth, food consumption, blood chemistry and enzyme levels, hematology, clinical analyses of urine, eye examinations, changes in animal behavior and ultimately, tissue weights, histological examinations, and pathology findings.

Studies to assess long-term exposure, reproduction and development, neurotoxicity, genetic toxicity and cancer development have repeatedly demonstrated that sucralose has no safety concerns.

In summary, the extensive database of studies assessing genetic toxicology, short- and long-term safety, animal and human absorption, distribution, metabolism and excretion, reproductive, development, and neurological effects and, most recently human clinical trials in healthy and diabetic subjects by numerous researchers provide a clear demonstration of safety of the use of sucralose as a non-caloric sweetener in foods and beverages.

There's another sweetener that has been in the news lately for its possible links to heart attacks, but is it really true?

If you'd like to learn more and know whether you need to worry about it, I wrote an article that dives deep into the research here.



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