Sugar is the fuel of life. In every cell of the human body, sugars are the preferred energy choice. Unsurprisingly, the preference for sugar goes all the way up to the brain, where the desire for sweets can affect the way we think and feel. Although it is okay to indulge in a sugary treat on occasion, we must take care to avoid overloading our diet with sugars and artificial sweeteners.

How does an individual get hooked on sugar in the first place? In animal models, it has been observed that consistent sugar intake increases dopamine levels in the brain. Dopamine is a neurotransmitter — a molecule that is used for communication between brain cells. The effect of dopamine includes the promotion of “reward-seeking behaviors” (i.e., immediate gratification) which often morphs into pursuing the original stimulus for dopamine release. This creates a steady behavioral loop. This has led to theories that eating foods with high quantities of sugar can create an addictive habit and cause dependence in humans.

In Canada, the recommended daily sugar limit for a given individual is 10% of your daily calories. Using 2000 calories as a baseline, this would equate to a daily recommended sugar limit of 50 grams (12 teaspoons). However, a problem with sugar does not necessarily come from the overconsumption of common forms of sugar (termed “natural sugars”) but rather from additionally eating processed foods rich in refined sugars (“artificial sweeteners”). 

Natural sugars are sugar derivatives that can be found in common food groups. For example, lactose and fructose are in milk and fruits, respectively. In contrast, artificial sweeteners are mass-produced sugar substitutes that provide sweetness when added to food and drink (e.g., aspartame). Since these substitutes are not derived from common foods, they are considered to have no calories. Thus, sweeteners can be good when sugar or caloric intake must be limited.

Sugar substitutes are sweet-tasting alternatives to sugar, often containing little to no calories. You’ll typically find them in products labeled “sugar-free,” “keto,” “low carb,” or “diet.” These alternatives are categorized into three main types: artificial sweeteners, sugar alcohols, and novel sweeteners.

Artificial Sweeteners: Artificial sweeteners, also known as nonnutritive sweeteners, are often lab-made chemicals, though some derive from natural sources like herbs. They’re significantly sweeter than regular sugar—anywhere from 200 to 700 times sweeter.

While artificial sweeteners don’t contain sugar or calories, they also lack beneficial nutrients like vitamins, fiber, or antioxidants. The U.S. Food and Drug Administration (FDA) regulates them as food additives.

These sweeteners have long been a go-to option for individuals managing their weight or blood sugar levels. Although there have been concerns about potential health risks, such as weight gain or cancer, research hasn’t reached a definitive conclusion. Studies on humans generally suggest they’re safe when consumed within the FDA’s acceptable daily intake limits.

The FDA has approved several artificial sweeteners, including:

• Acesulfame potassium (Ace-K)
• Advantame
• Aspartame
• Neotame
• Saccharin
• Sucralose

Sugar Alcohols: Sugar alcohols are synthetic compounds typically derived from sugars. Unlike artificial sweeteners, they’re less intensely sweet and are often added to processed foods for texture and taste, such as in chewing gum and hard candies. However, they can cause digestive issues like bloating, gas, or diarrhea in some people.

These substitutes must be listed on nutrition labels, making it easy to spot them. Common examples include:

• Erythritol
• Isomalt
• Lactitol
• Maltitol
• Sorbitol
• Xylitol

Novel Sweeteners: Novel sweeteners come from natural sources, offering benefits from both artificial and natural sweeteners like honey or fruit. They’re low in calories and sugar, making them ideal for avoiding blood sugar spikes or weight gain. Plus, they’re typically less processed and closer to their natural form.

Some popular examples are:

• Allulose
• Monk fruit
• Stevia
• Tagatose

Stevia and monk fruit, in particular, are plant-derived and offer a taste remarkably similar to sugar.

The FDA classifies these sweeteners as “generally regarded as safe” (GRAS), meaning they’re safe for their intended use.

The rapid availability of food and drink embedded with artificial sweeteners has led to significant changes in the physical and mental health of people across the population. This includes consequences such as a greater prevalence of obesity and emotional disorders like depression. In fact, several negative effects on mental health have been linked to the sweetener aspartame. Eating an aspartame-rich diet is associated with cognitive impairment (such as increased memory loss and decreased attention span) and negative mood changes like irritability and anxiety. Interestingly, daily consumption of aspartame has been shown to directly induce anxiety in laboratory mice as well as decrease the potential for cell-to-cell communication with the neurotransmitter gamma-aminobutyric acid — a molecule produced by bacteria from the gut microbiome for communication in the gut-brain axis. Furthermore, overexposure of the microbiome to aspartame has been shown to promote glucose intolerance, which is a metabolic imbalance that can lead to diabetes. Therefore, the consequent effects of too much sugar and artificial sweeteners on the microbiome must be considered.

Given the mass availability of sweetener-loaded foods, we must explore strategies that can help curb cravings as well as find alternatives that can replace sugary snacks. One strategy may be to take chromium supplements, specifically chromium picolinate. In various studies, chromium supplementation has been shown to decrease depression symptoms and binge eating habits among clinical trial patients. Furthermore, in a test group of older adults, it was shown that dietary chromium supplementation had an effect of enhanced cognitive functions such as learning and recall. In terms of food-based chromium sources, chromium-rich foods that can be added to your regular diet include shellfish (e.g., shrimp, mussels, oysters), broccoli, and whole wheat bread. When seeking replacements for sweet snacks, fruits, and Greek yogurt are also healthy choices that can be used to fulfill a sugar craving.

Eliminating sugar entirely from your diet might seem like a healthy move, but it can also mean missing out on vital nutrients found in fruits, whole grains, and dairy products. Extreme diets, like the ketogenic diet, which eliminate all carbohydrates and sugars, may have unintended consequences for your health.

When your body is deprived of sugar, it turns to alternative energy sources. In this case, the liver produces ketone bodies to fuel the body, mimicking a state of starvation. This shift can lead to unpleasant side effects often referred to as “keto flu,” which may include headaches, fatigue, and brain fog.

Instead of cutting out all carbohydrates, dietitians recommend reducing your intake of highly processed foods and beverages with added sugars or artificial sweeteners. This balanced approach helps you maintain essential nutrients while promoting overall health and well-being.

At the end of the day, it is important to remember that too much of anything is bad. Sugar in excessive quantities can negatively affect mental and physical health. However, in moderation and barring underlying health issues, a sweet snack after a tough day or in celebration is not always a bad thing. Throughout your day, just make sure to include healthy alternatives across your meals.