Which is worse: Sugar or artificial sweeteners?

Sugar is no bueno. This, we know. After all, study after news report after diet book reminds us that we’re ODing on the sweet, sweet white stuff.Some experts estimate that the average American consumes 350 to 440 calories of added sugars—the equivalent of 22 to 28 teaspoons—every day. And pretty much every medical professional out there agrees that it’s contributing to our weight gain, high blood-sugar levels, and record-high diabetes rates.

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What’s more, according to recent research published in JAMA Internal Medicine, a sugar-filled diet can increase your risk of death by heart disease—even if you aren’t overweight. And eating significant amounts of sugar from any source—be it table sugar, honey, or orange juice, can compromise your immune system’s ability to fight viruses, bacteria, and parasites, according to Debra Nessel, R.D.N., C.D.E., a registered dietitian nutritionist and certified diabetes educator with the Torrance Memorial Medical Center in California.

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A 2015 study from the USDA Agricultural Research Service (sadly funded by National Honey Board) found that honey, table sugar, and high-fructose corn syrup all have similar effects on the body. Some research has linked high sugar intake to cancer. So clearly, artificial sweeteners are the answer, right? Well, not so fast ...

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“Whether non-nutritive sweeteners are safe depends on your definition of 'safe,'” Nessel says. “Studies leading to FDA approval of these sweeteners have ruled out cancer risk for the most part. However, those studies were done using far smaller amounts of diet soda than many people drink. We really don’t know what effect large amounts of these chemicals will have over many years.”

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That’s probably not the shining endorsement you were hoping for. And while sugar-free sweeteners are pretty much the only let’s-make-this-coffee-sweeter option available to people with pre-diabetes or diabetes (Nessels recommends diabetics cap their intake at one or two servings daily), if you’ve got healthy blood-sugar levels, you might want to steer clear of them entirely. “I would recommend sugar in moderation over artificial sweeteners,” says Caroline Cederquist, M.D., creator of bistroMD and author of The MD Factor Diet.

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In one Journal of Behavioral Neuroscience study, rats that consumed the popular artificial sweetener saccharine for 14 days ate more food and gained more weight than rats that ate sugar. Plus, their core body temperatures actually dropped and their metabolisms slowed. That may be because artificial sweeteners are up to 13,000 times sweeter than sugar, which can not only trigger your body to crave more of the sweet stuff but also damage your body’s ability to gauge how many calories you’ve consumed—and how many more you should crave, according to the Harvard School of Public Health. Current research published in the Journal of General Internal Medicine shows that people who consume two or more diet drinks daily are 30 percent more likely to suffer heart attacks and strokes, and are 50 percent more likely to die from heart disease compared to those who rarely who never or rarely drink diet drinks.

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“The bottom line is that even small amounts of artificial sweeteners can play tricks on your body, causing it to overrespond to signals from your taste buds, in many cases leading to weight gain,” Cederquist says.

However, unlike aspartame (i.e. Equal and NutraSweet), saccharine (Sweet 'N Low), and Sucralose (Splenda), Stevia is not synthetically produced; it’s derived from the leaves of an herb common to Brazil and Paraguay. Recognized as safe by the FDA in 2008, Stevia looks pretty benign, health-wise, but it’s also the youngest, least-studied sweetener out there, says certified functional diagnostic nutritionist Brad Davidson, co-founder of the Stark Personal & Sports Fitness Training Center in Irvine, California, and author of The Stark Naked 21-Day Metabolic Reset.

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The Bitter Truth: “Neither sugar nor zero-calorie sweeteners provide any form of positive health effects,” Davidson says. “Honestly, the ultimate way to lose weight and improve your health is to avoid both of them.”

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