Low‐calorie Sweeteners and Other Sugar Substitutes: A Review of the Safety Issues

ABSTRACT Sugar‐free or reduced‐sugar foods and beverages are very popular in the United States and other countries, and the sweeteners that make them possible are among the most conspicuous ingredients in the food supply. Extensive scientific research has demonstrated the safety of the 5 low‐calorie sweeteners currently approved for use in foods in the United States–acesulfame K, aspartame, neotame, saccharin, and sucralose. A controversial animal cancer study of aspartame conducted using unusual methodology is currently being reviewed by regulatory authorities in several countries. No other issues about the safety of these 5 sweeteners remain unresolved at the present time. Three other low‐calorie sweeteners currently used in some other countries–alitame, cyclamate, and steviol glycosides–are not approved as food ingredients in the United States. Steviol glycosides may be sold as a dietary supplement, but marketing this product as a food ingredient in the United States is illegal. A variety of polyols (sugar alcohols) and other bulk sweeteners are also accepted for use in the United States. The only significant health issue pertaining to polyols, most of which are incompletely digested, is the potential for gastrointestinal discomfort with excessive use. The availability of a variety of safe sweeteners is of benefit to consumers because it enables food manufacturers to formulate a variety of good‐tasting sweet foods and beverages that are safe for the teeth and lower in calorie content than sugar‐sweetened foods.