Sweeteners (sugar substitutes): uses, examples, and safety

Sweeteners, or sugar substitutes, are additives that, when added to foods and beverages, provide a sweet taste and, in some cases, enhance flavor, similar to flavor enhancers.[1][2]

Although they offer sweetness comparable to that of sucrose (table sugar), sweeteners contain few or no calories, and in such cases they are classified as zero-calorie or non-nutritive.[3]

They are used in a wide range of foods and beverages, including dairy products such as yogurt and puddings, canned foods, jams, jellies, soft drinks, powdered drink mixes, chewing gum, candy, and toothpaste, as well as in all products marketed as “diet” or “sugar-free”.[4]

According to EU regulations on food additives, not all sweet-tasting substances are classified as sweeteners.[1] Examples include monosaccharides such as glucose and fructose, and disaccharides such as sucrose, lactose, maltose, and trehalose, as well as oligosaccharides. Foods containing these sugars, such as honey, invert sugar, molasses, maple syrup, corn syrup, and certain fruit purees, when used for their sweetening properties, are also excluded.[2][5]

Their presence in products must be indicated in the ingredient list on the label, where they are identified by name and/or by their E number, as with other food additive.[6]

They are commercially available in various forms, including sachets, small tablets, powders, and liquid.

Based on currently available scientific evidence, their use in limited amounts is not considered harmful to human health. However, like other food additives, sweeteners are subject to regular safety reviews.[7]

Contents

Natural and artificial sweeteners

Sweeteners can be extracted from plants, produced using microorganisms, or synthesized chemically.
Examples of plant-derived sweeteners include thaumatin (E957), a mixture of closely related proteins extracted from the fruit of Thaumatococcus daniellii, and steviol glycosides (E960a), which are obtained from the leaves of Stevia rebaudiana. Neohesperidin dihydrochalcone (E959) is produced by hydrogenating a flavonoid glycoside naturally found in the flowers, fruit, and peel of grapefruit and bitter orange.[8][9]

Erythritol (E968) is obtained through bacterial fermentation of plant-derived sugars.[10]

Finally, some sweeteners are entirely synthetic, such as saccharin (E954).[11]

Sweetness intensity

The relative sweetness of sweeteners, compared with sucrose, varies widely from one compound to another.

Some sweeteners, such as polyols, for example sorbitol (E420), erythritol, and xylitol (E967), have a sweetness level slightly lower than or comparable to that of sucrose.
Others, such as cyclamates (E952), are dozens of times sweeter, while compounds like aspartame (E 951), acesulfame K (E950), saccharin (E954), and sucralose (E955) can be hundreds of times sweeter.
Certain sweeteners, including neohesperidin dihydrochalcone (E959), thaumatin (E957), and neotame (E961), are even thousands of times sweeter than table sugar.
Skeletal formula of sweeteners such as sorbitol, xylitol, aspartame, neotame, and acesulfame K.Naturally, the greater the sweetness intensity, the smaller the amount of sweetener required. As a result, their caloric contribution is negligible.[4][9][12]

Examples of sweeteners

The following is an overview of the sweeteners included in the list of food additives approved within the European Union under Commission Regulation (EU) No. 1129/2011, adopted on November 11, 2011. This regulation amended Annex II of Regulation (EC) No. 1333/2008 of the European Parliament and was subsequently updated in 2013.[1]

Table of E-numbers for sweeteners and their relative sweetness (reference: sucrose = 1)
E-number Additive Relative sweetness
E420 Sorbitol 0.5-1
E421 Mannitol 0.7
E950 Acesulfame K 200
E951 Aspartame 180-200
E952 Ciclamate 30
E953 lsomalt 0,5
E954 Saccharin 300
E955 Sucralose 600
E957 Thaumatin 2,000-3,000
E959 Neohesperidine DC 1900
E960a Steviol glycosides
from Stevia		 200-400
E960b Enzymatically produced
steviol glycosides		 200-400
E960c Glucosylated steviol glycosides 200-400
E961 Neotame 7,000-13,000
E962 Salt of aspartame-acesulfame 350
E964 Polyglycitol syrup 0.4-0.9
E965 Maltitol 1
E966 Lactitol 0.5
E967 Xylitol 1
E968 Erythritol 0.6-0.8
E969 Advantame 20,000

There are differences between the sweeteners authorized in the European Union and those approved in the United States, where only six are permitted, or in the United Kingdom, which allows eight.[4][13]

Health effects

Based on current scientific evidence, the sweeteners in use today are considered safe for the general population, including pregnant women.[7] However, some should be limited or avoided in specific health conditions.

  • Aspartame should be avoided by individuals with phenylketonuria (PKU), as it contains phenylalanine, an amino acid they cannot metabolize.[14]
  • Polyols, which occur naturally in many fruits and vegetables, may have a laxative effect if consumed in large quantities. When they make up more than 10% of a product, labeling regulations require a statement that excessive consumption may cause laxative effects.[13] Limiting polyols is also one of the recommendations of the low-FODMAP diet, often prescribed for individuals with irritable bowel syndrome (IBS).[15]
  • Research on the relationship between sweeteners, weight management, and obesity prevention has produced contradictory results, although there is no evidence that sweeteners increase appetite.[7][16][17]
  • As a precaution, sweeteners should not be given to children under two years of age.[18]
  • Because high sugar intake increases the risk of tooth decay, replacing sugar with sweeteners, provided no sugar is present in the food, reduces this risk.[13][19]

Importantly, there is no evidence that sweeteners cause cancer.[20]

References

  1. ^ a b c Commission Regulation (EU) No 1129/2011 of 11 November 2011 amending Annex II to Regulation (EC) No 1333/2008 of the European Parliament and of the Council by establishing a Union list of food additives. https://eur-lex.europa.eu/eli/reg/2011/1129/2013-11-21
  2. ^ a b EFSA. Sweeteners. Last reviewed date: 4 July 2025.
  3. ^ National Agricultural Library – USDA | Sweeteners.
  4. ^ a b c U.S. Food and Drug Administration. Aspartame and other sweeteners in food. https://www.fda.gov/food/food-additives-petitions/aspartame-and-other-sweeteners-food. Content current as of: 02/27/2025.
  5. ^ Ziesenitz S.C. Authorised EU health claim for fructose in foods, nutrients and food ingredients with authorised EU health claims: Volume 2, 2015 doi:1016/B978-1-78242-382-9.00011-6
  6. ^ Food Standards Agency. Approved additives and E Numbers. Last updated: 16 July 2025.
  7. ^ a b c Rios-Leyvraz M. and Montez J. Health effects of the use of non-sugar sweeteners: a systematic review and meta-analysis. World Health Organization 2022. https://www.who.int/publications/i/item/9789240046429
  8. ^ Borrego F. and Montijano H. Neohesperidin Dihydrochalcone. In: Nabors LO (ed). Alternative Sweeteners. Marcel Dekker, Inc, New York, USA, 2001.
  9. ^ Fry J.C. 3 – Natural low-calorie sweeteners. Editor(s): David Baines, Richard Seal. In Woodhead Publishing Series in Food Science, Technology and Nutrition, Natural Food Additives, Ingredients and Flavourings. Woodhead Publishing. 2012:41-75. doi:10.1533/9780857095725.1.41
  10. ^ Martău G.A., Coman V., Vodnar D.C. Recent advances in the biotechnological production of erythritol and mannitol. Crit Rev Biotechnol 2020;40(5):608-622. doi:10.1080/07388551.2020.1751057
  11. ^ EFSA Panel on Food Additives and Flavourings (FAF). Castle L., Andreassen M., Aquilina G., et al. Re-evaluation of saccharin and its sodium, potassium and calcium salts (E 954) as food additives. EFSA J 2024;22(11):e9044. doi:10.2903/j.efsa.2024.9044
  12. ^ Wee M., Tan V., Forde C. A comparison of psychophysical dose-response behaviour across 16 sweeteners. Nutrients 2018;10(11):1632. doi:10.3390/nu10111632
  13. ^ a b c NHS. The truth about sweeteners. Page last reviewed: 20 February 2023 https://www.nhs.uk/live-well/eat-well/food-types/are-sweeteners-safe/
  14. ^ Newbould E., Pinto A., Evans S., Ford S., O’Driscoll M., Ashmore C., Daly A., MacDonald A. Accidental consumption of aspartame in phenylketonuria: patient experiences. Nutrients 2021;13(2):707. doi:10.3390/nu13020707
  15. ^ Shepherd S.J., Parker F.C., Muir J.G., Gibson P.R. Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence. Clin Gastroenterol Hepatol 2008;6:765-71.doi:1016/j.cgh.2008.02.058
  16. ^ Roberts J.R. The paradox of artificial sweeteners in managing obesity. Curr Gastroenterol Rep 2015;17(1):423. doi:1007/s11894-014-0423-z
  17. ^ Te Morenga L., Mallard S., Mann J. Dietary sugars and body weight: systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 2012;346:e7492. doi:1136/bmj.e7492
  18. ^ Baker-Smith C.M., de Ferranti S.D., Cochran W.J. COMMITTEE ON NUTRITION, SECTION ON GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION. The use of nonnutritive sweeteners in children. Pediatrics 2019;144(5):e20192765. doi:10.1542/peds.2019-2765
  19. ^ EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific opinion on the substantiation of health claims related to the sugar replacers xylitol, sorbitol, mannitol, maltitol, lactitol, isomalt, erythritol, D-tagatose, isomaltulose, sucralose and polydextrose and maintenance of tooth mineralisation by decreasing tooth demineralisation, and reduction of post-prandial glycaemic responses pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2011;9(4):2076. doi:10.2903/j.efsa.2011.2076
  20. ^ National Cancer Institute. Artificial sweeteners and cancer. https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet

Biochemistry and metabolism