The Truth About Sugar Substitutes

 Nutrition By Jill Carnahan, MDJanuary 25, 2021

sugar vs artificial sweeteners

Stroll down the aisles of just about any grocery store and you’re bound to see a plethora of products claiming to be “sugar-free” or “low-sugar.” These products claim to cater to “health conscious” individuals looking to cut back on their sugar intake without having to give up their sweet tooth. 

These sugar substitutes play on consumers’ trust that “sugar-free” also means “healthy” and that these highly palatable sweet-tasting treats come without any of the negative side effects of sugar. But as they say, when something sounds too good to be true, it usually is. 

So, today we’re going to dive into two of the most popular sugar substitutes – artificial sweeteners and sugar alcohols. We’ll look at exactly what these sugar swap-ins are, how they affect your body, and whether or not they’re truly safe. 

What Are Artificial Sweeteners?

Artificial sweeteners are technically defined as a type of food additive or chemical designed to duplicate the taste of sugar while contributing virtually zero calories. But how exactly are the chemicals in artificial sweeteners able to satisfy your sweet tooth minus the calories?

Artificial sweeteners are composed of molecules that essentially mimic sugar – allowing them to bind to the receptors on your tastebuds that signal to your brain that you’re tasting something sweet.1 And while these molecules are similar enough to sugar to taste sweet, they’re not quite similar enough for your body to be able to break them down into a significant amount of calories.

Artificial sweeteners are also sometimes referred to as “high-intensity sweeteners” thanks to their concentrated dose of sweetness – often being hundreds of times sweeter than table sugar. That means it requires a much smaller amount of artificial sweeteners than sugar to achieve the same amount of flavor. 

What Are Some Examples of Artificial Sweeteners?

Some common artificial sweeteners that you’ll find both as stand-alone sweeteners and on the ingredients list of many “diet” food and beverages include:2

  • Aspartame: also sold as Equal or Nutrasweet
  • Acesulfame potassium: also sold as Sweet One or Sunnet
  • Saccharin: also sold as Sweet N’ Low, or NectaSweet
  • Sucralose: also sold as Splenda

This artificial sweeteners list is not comprehensive – these are simply the ones you’re most likely to come across. 

While these artificial sweeteners may be approved for use by the FDA and commonly sold in products that you can find at just about any grocery store, these tasty chemicals have another side that’s not so sweet.

Possible Health Side Effects of Artificial Sweeteners 

While these artificial sugar swap-ins have some sweet-sounding names, the question is – are artificial sweeteners safe? Research has revealed that artificial sweeteners may:3,4,5

  • Disrupt gut health: Since your body can’t break down artificial sweeteners, these compounds can wreak havoc on your gut health – decimating beneficial gut flora, promoting “bad” bacterial overgrowth, and damaging the integrity of your gut lining.
  • Interfere with satiety hormones: Our brains are wired to crave sweet food – so the more sweet-tasting food you eat, the more your brain signals you to eat. Providing your body with the ultra-sweetness of artificial sweeteners without the calories can interfere with the hormones that tell your brain when you’re full and it’s time to stop eating.
  • Imbalance blood sugar and insulin levels: Artificial sweeteners have been shown to dysregulate blood sugar and insulin levels – leading to an increased risk of insulin resistance and Type 2 diabetes.
  • Cause weight gain: Although it may seem counterintuitive that a “diet” food causes weight gain, it’s the truth. Thanks to artificial sweeteners’ ability to damage gut health, disrupt satiety hormones, and increase insulin resistance, these sugar substitutes have been directly linked with weight gain and an increased risk of obesity.

So, are artificial sweeteners bad for you? Much of the research out there indicates that yes, these sugar substitutes aren’t so healthy after all. Artificial sweeteners may operate under the guise of being healthier than sugar, but as it turns out, the effects of these chemicals are just as bad, if not worse, than sugar. 

Are Sugar Alcohols Considered Artificial Sweeteners?

Sugar alcohols and artificial sweeteners are not one and the same. While artificial sweeteners are compounds composed of synthetically made chemicals, sugar alcohols have an entirely different molecular structure that’s also capable of binding to your “sweet” receptors.

Sugar alcohols are naturally found in some fruits and veggies and they can also be manufactured by processing regular sugar. They are considered a type of carbohydrate, with a chemical structure that resembles sugar, but also contains an alcohol molecule – hence their name. Sugar alcohols also differ from artificial sweeteners in that they contain calories – typically about half the amount of calories as regular sugar.

You’ve likely seen sugar alcohols in sugar-free gum, toothpaste, and many diet or reduced-sugar foods.

What Are Some Examples of Sugar Alcohols?

Some of the most commonly found types of sugar alcohols include:

  • Erythritol
  • Malitol
  • Mannitol
  • Sorbitol
  • Xylitol

Now let’s take a look at whether or not these sweeteners have any negative side effects.

Is Sugar Alcohol Bad for You? The Side Effects

Considering that sugar alcohols occur in nature, our bodies are more well equipped to break these sweeteners down in comparison to the chemical-laden compounds that make up artificial sweeteners. But that doesn’t mean these sweet-tasting molecules don’t have a sour side. Sugar alcohols can be not-so-great primarily for 2 reasons.6,7

  • Sugar alcohols are not “sugar-free”: While these sugar alternatives are often marketed as “sugar-free,” this is misleading. Sugar alcohols do in fact contain calories and cause fluctuations in your blood sugar. This is particularly important if you struggle with diabetes, obesity, or other metabolic disorders, because this marketing can deceive people into thinking they can essentially eat unlimited amounts of sugar alcohols without consequences.
  • Sugar alcohols can be hard on your gut: Your body can’t completely digest sugar alcohols. So when you consume them frequently, or in large amounts, it can disrupt the delicate balance of your digestive tract – leading to imbalanced bacterial overgrowth, gas, bloating, and other digestive issues. 

While sugar alcohols can certainly be a safer alternative to artificial sweeteners they still can have some not-so-sweet effects on your health. Now that might leave you wondering – well then what exactly is a healthy alternative to sugar?

So, What Is the Safest Sugar Substitute?

When approaching this question from a functional medicine standpoint, the answer to this is a little more complicated than simply choosing the healthier option between alternative sweeteners and sugar alcohols. If you’re truly looking to reduce your sugar consumption in order to address a health issue or optimize your well-being, it requires a “big-picture” approach – so here’s what I recommend:

  • Retrain your tastebuds: If you’re frequently chowing down on sweet-tasting foods, you can all but guarantee that you’ll crave more and more of that concentrated dose of sweetness to feel satisfied. But cutting back on these hyper-palatable foods can essentially set a new baseline for your tastebuds – allowing them to adjust and get that same satisfaction from less intense flavors.    
  • Focus on whole-food, natural sugars: As you retrain your tastebuds, you’ll be able to get a similar intensity of sweetness with less. Try focusing on naturally occurring sugars like those found in fruit, raw honey, or pure maple syrup. While these sugars are all-natural and certainly healthier than table sugar or sugar substitutes, it’s still important to be mindful of exactly how much of these naturally occurring sugars you’re consuming.
  • Fill in any nutrient gaps: Sometimes cravings can be triggered by nutrient deficiencies. So filling in any nutrient gaps by having a well-rounded healthy diet and taking supplements can ensure you’re not missing out on any important nutrients that could be throwing your cravings out of whack. You can head over to my online store to check out my full line of top-notch supplements. You can even get 10% off your first order by clicking right here.
  • Try other natural sweeteners: Artificial sweeteners and sugar alcohols aren’t the only sugar substitutes. If you need a touch of sweetness, you can try occasionally using natural sweeteners like stevia or monk fruit.
  • Keep unnatural sweeteners to a minimum: It can be unrealistic (and stressful) to expect yourself to never ingest unnatural sweeteners. But making intentional choices and keeping these unnatural sugar swap-ins to a minimum can go a long way in protecting your health.

Addressing the issue of cutting back on sugar and finding healthier alternatives from a functional medicine standpoint means addressing the root cause and coming up with a comprehensive plan to support and enhance your health.

When It Comes to Your Health, You Are Your Own Best Advocate

Both artificial sweeteners and sugar alcohols can have side effects that can put a damper on your health. But cutting back on sugar and avoiding unnatural sweeteners doesn’t mean you can never have these things. Occasionally splurging and treating yourself to a sugary sweet dessert or intermittently having small amounts of unnatural sugar substitutes is not going to hurt you in the long run. It’s all about the “big-picture” and creating an overall healthy lifestyle you can stick to and enjoy.

If you’re looking to take your health to the next level by cutting back on sugar, changing your diet, or adopting some new healthy habits, remember that you are your own best advocate. Your day-to-day choices about how you eat, move, sleep, and think are the foundation of a healthy life. And I’m dedicated to supporting you in any way I can. 

So if you enjoyed this article and want to learn more about how you can prioritize your health, my blog is chock-full of resources for you. And if you want to take it even deeper, you can sign up for my newsletter to get all my best tips and advice delivered straight to your inbox. All you have to do is enter your name and email address in the form below.

Now it’s time to hear from you. Were you surprised to learn about the not-so-sweet side effects of artificial sweeteners and sugar alcohols? What steps are you taking to be intentional about your sugar intake? Leave your questions and thoughts in the comments below!   


  1. Mechanisms for Sweetness (
  2. Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States | FDA
  3. Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials (
  4. Low-Calorie Sweeteners | The Nutrition Source | Harvard T.H. Chan School of Public Health
  5. Artificial sweeteners as a sugar substitute: Are they really safe? (
  6. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals (
  7. Sugar Alcohols: American Diabetes Association®

These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease.   The information in this article is not intended to replace any recommendations or relationship with your physician.  Please review references sited at end of article for scientific support of any claims made.

COVID-19: A Wake-up Call to Boost Your Immune System

Bobbie Delsasso, RDH,BSMarch 26, 2020

What a turbulent time this is – office staff on furloughs or laid off, dentists scrambling to settle payment arrangements for their offices, hospital workers fighting for supplies, and general indecision about the fate of our futures. Our way of life in the United States is vastly different than it was just 2 weeks ago. We are all having to adjust to a “new normal.” For most people, the new normal is developing at home.

With such a contagious disease like COVID-19 possibly inflicting half our population, whether mildly, asymptomatically, or intensely, nothing is more important than your immune system.

COVID-19 is your official warning call to strengthen your immune system and eat healthy, plant-based foods.

With the impact on the medical and dental world, if you are like most people, your stress levels are currently in the red zone. The danger light is flashing and now is the time to put out the fire! Stress is a killer, right along with COVID-19.

It is very difficult to interpret the reality of what’s going on through the myriad of text and articles being pushed every day into emails, social media, and the news. The best reality you can have right now is the reality that we must get healthy, and stay healthy, so we can fight viruses and other diseases naturally and won’t need to rely on broken systems to heal us. We can heal ourselves right now and we do this by strengthening our own immune systems.

What many people don’t realize is that immune support starts in your gut. And if your gut is out of balance, you’re more susceptible to disease. The immune system plays a pivotal role in overall health. In short, the gut is the body’s first line of defense that keeps us healthy. Switching up your diet to include less meats – and more vegetables, grains, and fruits, is one of the best strategies to naturally support your immune system health. Because we don’t always get the immune support we need from our food, supplements can be an essential part of achieving gut balance. Probiotics, Beta-glucan, and selenium, along with the most important basics – Vitamin C, D, and zinc, are a few of the unique, very powerful immune supporting supplements. These supplements, along with quality sleep and plant-based nutrition, is what we can do right now to build our immunity to not just this virus, but all disease – even heart disease, diabetes, strokes, and more.

Bobbie DelSasso, RDH, BS

Bobbie graduated from Marquette University College of Dentistry in 1979 with a Bachelor’s degree in Dental Hygiene and currently works one day a week for a Periodontal Practice she managed for over 25 years. A lecturer, writer, speaker, past event coordinator for a Seattle Study Club  and executive coach to dentists in Illinois, Bobbie has developed a passion for total health she shares with her commitment to AAOSH. She is a founding member of AAOSH, member of ISDHS, Speaking Consulting Network member and Executive Director of AAOSH.

Exploration of the Human Mouth: Bacterial Colonies Do Present Dangers

© Ezume Images / Adobe Stock / Courtesy Today’s RDH

The human mouth is a sodden ecosystem housing billions of microorganisms − mostly bacteria − burrowing in our gingiva, living within plaque, and surviving on our tongues. Dental plaque and the surface of the tongue are among the densest microbial habitats on Earth.In fact, 100 billion organisms exist per gram of plaque.1 Scientists have unveiled over 700 different species that colonize in our oral cavities. While some of these bacteria are part of a normal flora, others can become problematic to the overall health.

While this information doesn’t seem very profound to most of the dental world, to the average patient, this is surmounting. We loyally educate our patients on the importance of proper oral hygiene without fail. But do we actually comprehend the complexity of the oral microbiome? Delving a smidge deeper into the fascinating details of the human mouth is actually very intriguing and astonishing.

Colonial Expansion

Jessica Mark Welch of the Marine Biological Laboratory in Woods Hole, Mass., and Gary Borisy and Floyd Dewhirst of the Forsyth Institute in Cambridge, Mass., call the human mouth a varied and ordered ecosystem and have studied the bacteria found here with great intensity.By studying mouth-related bacteria, they are able to gain a better comprehension of how bacteria organize themselves in other ecosystems in the world.

Welch comments, “We expected more big wads of bacteria, and it was really surprising to see how organized they are and how they work together.”1

Collectively, they have discovered that bacteria colonizes into nine different sites within the oral cavity (tongue, buccal mucosa, tonsils, keratinized gingiva, throat, tonsils, saliva, supragingival plaque, subgingival plaque, and palate). This research has concluded that bacteria structure differently by creating vastly different communities in each of the nine sites. For example, despite the fact the tongue contacts the hard palate often, these two sites have completely separate variations of bacterial communities. If a swab was taken from just one site, it is with 100% certainty that the site could be identified solely on the bacterial community found in that location.

Who’s Who in Bacteria

While some bacteria in the mouth are necessary for metabolism and absorption of the nutrients, there are others that can inflict harm. Bacteria have multiple personalities and, depending on the host, can behave differently. For example, bacteria in plaque can be more resistant to antibiotics and turn on parts of their metabolism only in this biofilm. Interestingly enough, dental biofilm is comprised mostly of DNA.

Corynebacteria is the bacteria believed to extract the calcium from saliva, creating the calculus that dental hygienists so diligently remove. This cone-shaped, slow-growing bacterium colonizes on the hard surface of the teeth by gluing themselves to the enamel. This bacterium is also the foundation of the communities they help other organisms inhabit. In other words, they are the oak tree of the forest.

Streptococcus alone is a harmless bacterium; however, when fed sugar, it can create carious lesions by forming lactic acid. If these bacteria get in our bloodstream, they can contribute to heart disease. When Streptococcus is attached to Fusobacterium nucleatum, it can invade the immune system by entering through the cheek cells. Research has discovered that this is a commonly found cell in colon cancer, the second leading cause of cancer death in the U.S.2

Streptoccus mutans are transferred to babies and children most often from their mothers during birth or shortly thereafter. However, one study concludes that these caries-causing bacteria are also transmitted from peers. Children frequently interacting with other children may contract these bacteria from one another. Forty percent of the subjects included in this study did not share S. mutan strains with their mothers, which leaves open the possibility this bacterium was contracted elsewhere.3

Close Contact

Several articles have been shared across the walls of social media in reaction to this particular subject. While a child is most likely already harboring bacteria contracted from their mothers or other family and friends, it still is certainly wise to avoid kissing a child directly on the lips. One case that instilled fear in many parent’s minds was that of 18-day old Mariana Swift, who died from viral meningitis caused by HSV type 1.

Herpes simplex type 1 is commonly at fault for creating cold sores. Both of Mariana’s parents tested negative for HSV Type 1, leaving the assumption that this virus was transmitted by a kiss from a close family or friend. There is only a 10% chance of HSV contraction after birth.4 However, maybe that margin is still dangerous enough to avoid any possible chance of shared bacteria.

Because the oral cavity is characterized by a stable environment, any imbalance allows for oral disease such as periodontal disease. Porphyromonas gingivalis is a commonly known bacteria contributed to periodontal disease. This periodontopathic bacterium was found in 85.75% of subgingival plaque samples from patients with chronic periodontitis.Researchers have also found a strong link between this particular bacteria and Alzheimer’s disease. A study revealed that Alzheimer patients with chronic periodontitis (CP) had a notable decline in cognition compared to those who did not have CP.6

I simply couldn’t go without mentioning our furry friend’s mouths. Again, social media has been home to the commonly shared article that discourages sloppy kisses from dogs. While this decision is personal, it should be noted that comparing human to canine mouths is like comparing apples to oranges.

While humans’ and dogs’ mouths are equally inhabited by vast arrays of bacteria, some of which are the same, it should be mentioned that the bacteria in a dog’s mouth is not zoonotic. However, if your pooch is fed a raw diet, you do have an increased risk of Salmonella infection.7 And if your furry friend makes a habit of snacking in the litter box, then you have a higher probability of contracting E. Coli.

The human mouth is truly remarkable, and the bacteria that call it home are equally substantial. As researchers learn more about the bacteria in the oral cavity, health-care professionals can better educate and treat patients. Afterall, the mouth is the gateway to the human body.

10 things that weaken the immune system

In light of the present COVID-19 pandemic, immune system health has come to the forefront of peoples’ minds.

Everyone wants to know, “how can I maintain a strong immune system that is less susceptible to infection?”

Our immune systems are ancient and amazingly complex – built to keep our bodies functioning through a lifetime of challenges presented by foreign invaders.

However, our modern, convenience-laden world has presented a number of new challenges to our main line of defense. 

Here are 10 commonly-encountered immune busters. Steering clear of them may be good advice in order to ensure your immune system has all the resources it needs to protect you.

1. Stress, anxiety, panic

When we are stressed, our bodies tell our nervous systems and stress hormones that it is time to act. Our hypothalamus informs the adrenal glands to produce more hormones, adrenaline and as well as cortisol, and release them into the bloodstream. Experiments where adrenaline is given intravenously shows it decreases magnesium as well as calcium, potassium, and sodium. This proves that when you are in a revved-up state and burning adrenaline, you are also burning off magnesium.

And, because studies have found that magnesium has a strong relationship with the immune system, you’ll want to restore your body’s magnesium levels to keep the immune system working properly.

2. Inadequate sleep 

According to the National Sleep Foundation, even though sleeping more isn’t likely to help you avoid getting sick, missing precious hours of sleep could weaken your immune system, leaving you more susceptible to infection.

3. Yeast Overgrowth

Yeast overgrowth is a major immune suppressant because yeast produces 178 different yeast toxins that, once released, have to be eliminated from the body.

All of the work the body undertakes to expel the toxins uses up nutrients and takes energy away from other body functions, especially the immune system.

Start by eliminating foods that feed yeast so they will begin to starve (eg. high-sugar fruits, sugar, grains that contain gluten, nuts, caffeine).

4. Fast food and junk food

According to research out of Germany, the immune system reacts similarly to a high fat, high calorie fast-food diet as it does to a bacterial infection. And, this hyperreactivity can persist long after switching to a healthy diet. Therefore, the sooner these foods are eliminated, the better.

5. GMO-based foods

Genetically modified organisms place a burden on the immune system. Our immune system has developed and evolved over thousands of years. When we introduce a genetically modified food to the immune system, it doesn’t recognize the language of “genetically modified” and, as a result, identifies it as foreign and executes an immune response.

The source of many vegetable oils – corn, soybean, cottonseed, palm, rapeseed, safflower, etc. – are highly genetically modified foods. These oils are in many processed foods, so watch out for them in the ingredient listing.

6. Foods containing MSG

Research indicates that eating foods containing MSG can cause unwanted changes to your thymus and spleen, both of which are key players in your immune function. (Both your thymus and your spleen create lymphocytes, which take out foreign invaders; your spleen also makes antibodies that help keep you well.)

7. Sodas

The chemicals in soft drinks can wreak havoc on gut bacteria. This is problematic because there is a lot of interaction between the body’s immune system and bacteria in the gut.

A recent study done involving diet soda and gut bacteria found that consuming diet soda may cause harmful damage to your body’s microbiome. The digestive and intestinal tracts are filled with good bacteria that keep the body healthy. 

8. Overdoing caffeine

When caffeine is consumed in moderation, up to 400 mgs of caffeine (roughly 3 – 4 cups of brewed coffee) it can have some positive effects on inflammation, and antioxidants in coffee can even help prevent some cancers, heart disease, diabetes, osteoporosis and neurological diseases.

However, too much caffeine can decrease the ability of our immune system to fight infections as well as remove damaged or abnormal cells. Studies also show women and men who drink large amounts of caffeine release higher levels of the stress hormone cortisol in response to physical and mental stress. 

9. Smoking

Smoking suppresses immune cells. Cigarette smoke contains more than 4,000 toxins, most of which can irritate or kill cells in the body, according to the Centers for Disease Control. Smoking alters the number of various immune cells and impairs the functioning of others.  It may even turn the immune system against the body’s own cells.

As a result of these changes, smokers are more likely to catch several types of infectious diseases, including respiratory infections, flu and even gum disease. When smokers quit, their immune activity begins to improve within 30 days.

10. Alcohol

There is significant evidence that alcohol disrupts immune system function. These disruptions can impair the body’s ability to defend against infection.

Alcohol alters the numbers and relative abundances of microbes in the gut microbiome, an extensive community of microorganisms in the intestine that aid in normal gut function. These organisms affect the maturation and function of the immune system. Alcohol disrupts communication between these organisms and the intestinal immune system.