Safety of sugar substitutes

Government health agencies oversee ingredients that product-makers add to food. These agencies check ingredients, such as sugar substitutes, before foods or drinks that contain them can go on sale. In the United States, the Food and Drug Administration (FDA) allows the following sugar substitutes to be used:

• Acesulfame potassium (Sweet One, Sunett).
• Advantame.
• Aspartame (NutraSweet, Equal).
• Neotame (Newtame).
• Saccharin (Sweet'N Low).
• Sucralose (Splenda).
• Luo han guo (Monk Fruit in the Raw).
• Purified stevia leaf extracts (Truvia, PureVia, others).

Other countries, such as those in the European Union, have more sugar substitute options than does the United States.

The FDA allows product-makers to use sugar alcohols, such as sorbitol and xylitol, too. The agency doesn't consider sugar alcohols to be food additives.

The FDA and food safety agencies in other countries also suggest how much of a sugar substitute you can safely have each day. This amount is called the acceptable daily intake (ADI). It varies by a person's weight and the type of sugar substitute used. Acceptable daily intakes aren't the same everywhere. They're different in the United States and Europe, for example.

In general, artificial sweeteners are safe in limited amounts for healthy people, including pregnant people. But limit or cut out sugar substitutes:

• If you're living with a rare genetic disease called phenylketonuria. Foods and drinks with aspartame can lead to serious health problems.
• If you have a bowel disease. Using sugar substitutes might make your symptoms flare up.

Dietary guidelines for Americans say adults shouldn't give sugar substitutes to children under 2 years old. In general, experts need to do more studies to learn what long-term health effects sugar substitutes might have on children. Most studies have looked at the effects in adults.