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For many years we have been told that artificial sweeteners are safe for us, but now there seems to be real concern about using artificial sweeteners.

On one hand, they’re claimed to increase your risk of cancer and harm your blood sugar and gut health.

On the other hand, most health authorities consider them safe, and many people use them to reduce their sugar intake and lose weight.
So are they safe or not?

What are artificial sweeteners?

Artificial sweeteners, or sugar substitutes, are chemicals added to some foods and beverages to make them taste sweet.
People often refer to them as “intense sweeteners” because they provide a taste similar to that of table sugar but up to several thousand times sweeter.

Although some sweeteners contain calories, the amount needed to sweeten products is so small that you end up consuming almost no calories. Artificial sweeteners are chemicals used to sweeten foods and beverages. They provide virtually zero calories.

Teaspoon of sugar

How do artificial sweeteners work?

The surface of your tongue is covered by many taste buds, each containing several taste receptors that detect different flavors. When you eat, your taste receptors encounter food molecules. A perfect fit between a receptor and molecule sends a signal to your brain, allowing you to identify the taste. For example, the sugar molecule fits perfectly into your taste receptor for sweetness, allowing your brain to identify the sweet taste.

Artificial sweetener molecules are similar enough to sugar molecules to fit on the sweetness receptor. However, they are generally too different from sugar for your body to break them down into calories. This is how they provide a sweet taste without the added calories. Only a minority of artificial sweeteners have a structure that your body can break down into calories.

Given that only very small amounts of artificial sweeteners are needed to make foods taste sweet, you consume virtually no calories.

Artificial sweeteners taste sweet because they are recognized by the sweetness receptors on your tongue. They provide virtually zero calories, as your body can’t break them down.

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Common artificial sweeteners

The following artificial sweeteners are allowed for use in the United States and/or European Union

●     Aspartame. Sold under the brand names NutraSweet, Equal, or Sugar Twin, aspartame is 200 times sweeter than table sugar.

●     Acesulfame potassium. Also known as acesulfame K, it’s 200 times sweeter than table sugar. It’s suited for cooking and baking and sold under the brand names Sunnet or Sweet One.

●     Advantame. This sweetener is 20,000 times sweeter than table sugar and suitable for cooking and baking.

●     Aspartame-acesulfame salt. Sold under the brand name Twinsweet, it’s 350 times sweeter than table sugar.

●     Cyclamate. Cyclamate, which is 50 times sweeter than table sugar, was used for cooking and baking. However, it has been banned in the United States since 1970.

●     Neotame. Sold under the brand name Newtame, this sweetener is 13,000 times sweeter than table sugar and suited for cooking and baking.

●     Neohesperidin. It’s 340 times sweeter than table sugar and suited for cooking, baking, and mixing with acidic foods. Note that it is not approved for use in the United States.

●     Saccharin. Sold under the brand names Sweet’N Low, Sweet Twin, or Necta Sweet, saccharin is 700 times sweeter than table sugar.

●     Sucralose. Sucralose, which is 600 times sweeter table sugar, is suited for cooking, baking, and mixing with acidic foods. It’s sold under the brand name Splenda. Many types of artificial sweeteners exist, but not all are approved for use in every country. The most common ones include aspartame, sucralose, saccharin, neotame, and acesulfame potassium.

Artificial sweetener Sweeter than sugar Brand name found in stores
Acesulfame-K 200x Sunett, Sweet One
Aspartame 180x NutraSweet, Equal
Neotame 7,000x N/A
Saccharin 300x Sweet’N Low, Sweet Twin, Sugar Twin
Sucralose 600x Splenda

Artificial Sweeteners List

The list of FDA-approved artificial sweeteners is lengthy and includes:
  • Acesulfame potassium (Ace-K)
  • Advantame
  • Aspartame
  • Neotame
  • Saccharin
  • Luo Han Guo fruit extracts
  • High-purity steviol glycosides (Stevia rebaudiana)
  • Sucralose

To make matters more complicated, the sweeteners often go by brand names like Nutrasweet, Sunett, Equal, Nectresse, Truvia, and Sweet'N Low. You can see a full list of artificial sweeteners and their brand names approved by the FDA here. Adding to the confusion they have included Stevia which is most definitely not an artificial sweetener by the standards of many.

Fruits and fruit smoothie



Effects on appetite

Some people believe that artificial sweeteners might increase appetite and promote weight gain. The idea is that artificial sweeteners may be unable to activate the food reward pathway needed to make you feel satisfied after you eat. Given that they taste sweet but lack the calories found in other sweet-tasting foods, they’re thought to confuse the brain into still feeling hungry. Additionally, some scientists think you’d need to eat more of an artificially sweetened food, compared with the sugar-sweetened version, to feel full. It’s even been suggested that sweeteners may cause cravings for sugary foods. When you consume artificial sweeteners some data suggests that artificial sweeteners cross the blood-brain barrier and disrupt hippocampal function. This impairs sensitivity to interceptive signals, dysregulates appetitive behavior, and thereby promotes food intake.

Artificial sweeteners have many times the intensity of sweet flavor in comparison to natural sugars, you and your taste buds become accustomed to super sweet things. Those who consume artificial sweeteners may become accustomed to ultra-sweet flavors. This may change their tastes and decrease their enjoyment of naturally sweet foods like fresh fruit as well as healthy foods that may be slightly bitter like whole grains or vegetables.

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Effects on weight

The researchers in this latest study found that the artificial sweetener, sucralose, commonly found in diet foods and drinks, increases GLUT4 in these cells and promotes the accumulation of fat. These changes are associated with an increased risk of becoming obese.

Indeed, the research studied a small number of obese people who consume artificial sweeteners and found that they had more of these fat cells and increased expression of genes associated with fat production.

When consumed in low quantities, artificial sweeteners have been shown to aid weight loss, improve metabolic conditions and even protect against injury during infection. However, this new study suggests that, rather than keeping us healthy, artificial sweeteners, especially when consumed in larger doses, could be contributing to the obesity epidemic.

Beware that some artificial sweeteners have calories.

Artificial sweeteners can be non-nutritive or nutritive, although most artificial sweeteners fall under the non-nutritive umbrella. Non-nutritive sweeteners are synthetic sugar substitutes that are free of calories and carbohydrates. They may be derived from naturally occurring plants or herbs and are many times sweeter than sugar.

The other category of artificial sweeteners is nutritive, which only includes aspartame. The nutritive sweeteners may be lower in calories when compared to sugar and add caloric value to the foods that contain them.

Artificial sweeteners can usher in overeating.

Ever notice how after you consume a diet soda with a meal, you eat more than you normally would or crave more food after your meal is completed? While artificial sweeteners are supposed to help us reduce our calorie intake, the opposite may be true. Artificial sweeteners still trigger our sweet taste sensors, increasing insulin levels in the same way as if you eat sugar.
Woman measuring her waist

Artificial sweeteners and diabetes

Some artificial sweeteners say “sugar-free” or “diabetic-friendly,” but research suggests these sugars have the opposite effect.

Your body responds to artificial sweeteners differently than it does regular sugar. Artificial sugar can interfere with your body’s learned taste. This can confuse your brain, which will send signals telling you to eat more, especially more sweet foods.

Artificial sweeteners can still raise your glucose levels

One 2016 study saw normal-weight individuals who ate more artificial sweeteners were more likely to have diabetes than people who were overweight or obese.

Another 2014 study found that these sugars, such as saccharin, can change your gut bacteria composition. This change can cause glucose intolerance, which is the first step towards metabolic syndrome and diabetes in adults.

For people who don’t develop glucose intolerance, artificial sweeteners may help with weight loss or diabetes control. But switching to this sugar replacement still requires long-term management and controlled intake.

If you're thinking of replacing sugar regularly, talk to your doctor and dietitian about your concerns.

Artificial sweeteners can alter your gut microbiota. As per a recent study in Physiology & Behavior, the consumption of artificial sweeteners alters the gut microbiota and is linked with impaired glucose tolerance. Impaired glucose tolerance raises blood sugars and increases the risk for diabetes.

gut microbiota

Artificial sweeteners and metabolic syndrome

Metabolic syndrome refers to a cluster of medical conditions, including high blood pressure, high blood sugar, excess belly fat, and abnormal cholesterol levels. These conditions increase your risks of chronic diseases, such as stroke, heart disease, and type 2 diabetes. Some studies suggest diet soda drinkers could have up to a 36% higher risk of metabolic syndrome.

In addition, another study on the effects of artificial sweeteners on atherosclerosis found that daily consumption of drinks with artificial sweeteners creates a 35 percent greater risk of metabolic syndrome and a 67 percent increased risk for type 2 diabetes. Atherosclerosis is when plaque builds up inside the arteries leading to strokes, heart attacks, and even death.

There is additional evidence that links artificial sweeteners to the development of glucose intolerance and other metabolic conditions that result in higher than normal blood glucose levels. According to a study published in Trends in Endocrinology and Metabolism, frequent consumption of sweet-tasting, non-caloric foods interferes with metabolic function.

A 2018 study published in Inflammatory Bowel Diseases also revealed that artificial sugar, sucralose (otherwise known as Splenda) and maltodextrin, intensifies gut inflammation in mice that carry Crohn’s-like diseases. Specifically, the artificial sweetener increases the number of Proteobacteria — a microbe bacteria associated with E. coli, Salmonella, and Legionellales — in the mice who carried a Crohn's-like disease.

Additionally, the ingestion of artificial sugar intensified myeloperoxidase (an enzyme in white blood cells) activity in individuals that have a form of inflammatory bowel disease. This study indicates that it may be practical to track Proteobacteria and myeloperoxidase in patients to adjust their diet and monitor the disease and gut health.

bowl with granola, raspberries, coconut flakes, flowers and milk.

Artificial sweeteners and gut health

Your gut bacteria play an important role in your health, and poor gut health is linked to numerous problems. These include weight gain, poor blood sugar control, metabolic syndrome, a weakened immune system, and disrupted sleep. The composition and function of gut bacteria vary by individual and are affected by what you eat, including certain artificial sweeteners. In one study, the artificial sweetener saccharin disrupted gut bacteria balance in four out of seven healthy participants who were not used to consuming them. The four “responders” also showed poorer blood sugar control after as few as 5 days after consuming the artificial sweetener. What’s more, when gut bacteria from these people were transferred into mice, the animals also developed poor blood sugar control. On the other hand, the mice implanted with the gut bacteria from “non-responders” had no changes in their ability to control blood sugar levels. Although interesting, more studies are needed before strong conclusions can be made. Artificial sweeteners may disrupt the balance of gut bacteria in some people, which could increase the risk of disease. However, more studies are needed to confirm this effect.

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Artificial sweeteners and cancer

Since the 1970s, the debate about whether there is a link between artificial sweeteners and cancer risk has raged. It was ignited when animal studies found an increased risk of bladder cancer in mice fed extremely high amounts of saccharin and cyclamate. However, mice metabolize saccharin differently than humans.

When your body is stressed, injured, or sick, part of the natural healing process is a period of inflammation. In a healthy body, inflammation is temporary. It subsides when you recover from the illness or your injury has healed.

Sometimes inflammation doesn’t go away when it should. This is called chronic inflammation, and it can lead to cancer.

Another study has shown that in an environment where there’s ongoing inflammation, cells can become damaged, and in the repair process tumors and other cancerous growths can form.

Some studies have indicated that sucralose may be connected to chronic inflammation. At least one study showed that sucralose made inflammation worse in mice with Crohn’s disease. But it did not have the same effect on mice that did not have Crohn’s.

Another study indicated that sucralose caused inflammation in the livers of mice. The National Cancer Institute has stated that people who have chronic inflammatory bowel diseases like Crohn’s and ulcerative colitis are more likely to get colon cancers. More research is needed to see whether sucralose has similar inflammatory effects in humans.

Although there’s a link between sucralose and inflammation, right now researchers do not think the link is strong enough to suggest that eating and drinking sucralose causes cancer.

There’s no evidence that Splenda (sucralose) causes cancer. Some research suggests it can cause inflammation, particularly in your bowel. Chronic inflammation of the bowels is a risk factor for some types of cancer.

Sucralose also breaks down at high temperatures, and some of the byproducts of the breakdown are carcinogenic. So far, researchers don’t think that either the inflammation or cooking byproducts pose a serious cancer risk to humans.
The key here, as with so many other dietary choices, is to consume Splenda in moderation.
Artificial sweeteners and dental health

woman at dentist

Dental cavities — also known as caries or tooth decay — occur when the bacteria in your mouth ferment sugar. Acid is produced, which can damage tooth enamel. Unlike sugars, artificial sweeteners do not react with the bacteria in your mouth. This means they do not form acids or cause tooth decay. Research also shows that sucralose is less likely to cause tooth decay than sugar, but still, there are some safer options like natural sweeteners - Stevia.

Woman holding her head in her hands

Aspartame, headaches, depression, and seizures

Some artificial sweeteners may cause unpleasant symptoms, such as headaches, depression, and seizures in some individuals. While most studies find no link between aspartame and headaches, worth, noting that some people are more sensitive than others. This individual variability may also apply to aspartame’s effects on depression. For instance, people with mood disorders may be more likely to experience depressive symptoms in response to aspartame consumption. Finally, artificial sweeteners do not increase most people’s seizure risk. However, one study reported increased brain activity in children with absence seizures. Aspartame appears to exacerbate the amount of EEG spike wave in children with absence seizures. Further studies are needed to establish if this effect occurs at lower doses and in other seizure types,” according to a 1992 study in Neurology.

Aspartame “has seizure-promoting activity in animal models that are widely used to identify compounds affecting..seizure incident”, according to a 1987 study in Environmental Health Perspective.

Very high Aspartame doses “might also affect the likelihood of seizures in symptomless but susceptible people” according to a 1985 study in The Lancet. The study describes three previously healthy adults who had grand mal seizures during periods when they were consuming high doses of aspartame.

Artificial sweeteners are unlikely to cause headaches, depression, or seizures. However, some individuals could be more sensitive to these effects than others.

Safety and side effects

Artificial sweeteners are generally considered safe for human consumption. They are carefully tested and regulated by U.S. and international authorities to make sure they are safe to eat and drink. That said, some people should avoid consuming them. For example, individuals with the rare metabolic disorder phenylketonuria (PKU) cannot metabolize the amino acid phenylalanine, which is found in aspartame. Thus, those with PKU should avoid aspartame.What’s more, some people are allergic to sulfonamides — the class of compounds to which saccharin belongs. For them, saccharin may lead to breathing difficulties, rashes, or diarrhea. Additionally, growing evidence indicates certain artificial sweeteners like sucralose reduce insulin sensitivity and affect the gut bacteria. Artificial sweeteners are generally considered safe but should be avoided by people who have phenylketonuria or are allergic to sulfonamides.


What’s your definition of safe?

Whether non-nutritive sweeteners are safe depends on your definition of safe. Studies leading to FDA approval have ruled out cancer risk, for the most part. However, those studies were done using far smaller amounts of diet soda than the 24 ounces a day consumed by many people who drink diet soda. We don’t know what effect large amounts of these chemicals will have over many years.

And there are other health concerns besides cancer. In the Multiethnic Study of Atherosclerosis, daily consumption of diet drinks was associated with a 36% greater risk for metabolic syndrome and a 67% increased risk for type 2 diabetes.

Back to sugar?

Maybe sugar isn’t too bad after all. It’s all in how it’s packaged.

“Sugar-containing foods in their natural form, whole fruit, for example, tend to be highly nutritious—nutrient-dense, high in fiber, and low in glycemic load. On the other hand, refined, concentrated sugar consumed in large amounts rapidly increases blood glucose and insulin levels, increases triglycerides, inflammatory mediators,  and oxygen radicals, and with them, the risk for diabetes, cardiovascular disease and other chronic illnesses.

Red apple

The bottom line

There are conflicting research studies, with some showing that artificial sweeteners increase sweet cravings and body weight, risk of diabetes, metabolic syndrome, gut health, cancer, dental health concerns, headaches, seizures and depression, etc. and others that artificial sweeteners have no effect. It Is safest to limit both artificial sweeteners and sugars, and to be aware of any changes in your taste preferences and cravings so that you understand how these sweeteners affect you personally.

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There are plenty of natural sugar and sweeteners such as:

Fruits, veggies, and plain dairy products have naturally occurring sugar that shouldn't overly concern you. Because fruits and veggies contain other digestion-slowing nutrients like fiber and healthy fats, your body doesn't process the sugar as quickly as it would a cookie or a Twix bar. In other words, the sugar in apples and peppers won't contribute to weight gain and diabetes like a soda will. So maybe think about consuming more of those than artificial sweeteners.

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