Cutting excess sugar from your diet can be extremely beneficial, as sugar overload has been linked to health problems such as diabetes and obesity. But if you're turning to a sugar substitute to get your fix, you may be in for a not-so-sweet surprise - some sugar-free substances may negatively affect your health.  Consider the following pros and cons of five popular sweeteners:

Aspartame
Better known by the brand names Equal® and NutraSweet, aspartame is an artificial sweetener found in many foods and beverages. It's roughly 200 times sweeter than sugar, low in calories and does not promote tooth decay.

Aspartame has generated a great deal of controversy since its initial approval in 1974. Some claim the ingredients (specifically the amino acids aspartate and glutamate) may act as an "excitotoxin," overstimulating and potentially damaging neurons in the brain.

While there is very limited conclusive research regarding specific risks, there are certain individuals who should avoid aspartame, including those with phenylketonuria (a genetic disorder) and advanced liver disease, as well as pregnant women (because their bodies cannot metabolize phenylalanine, a compound found in aspartame). Others may experience aspartame sensitivity, which can trigger headaches, dizziness and nausea.

Sucralose
Delivering up to six times the sweetness of sugar with no calories, sucralose is now found in many "diet" beverages and foods in the form of Splenda®. Although it's made from sugar molecules, sucralose is not natural - it's actually the result of several chemical modifications. These modifications prevent your body from metabolizing sucralose, keeping the caloric content at zero. 

Although the long-term effects of sucralose consumption in humans is still unknown, several short-term effects have been observed in rats. One study in the Journal of Toxicology and Environmental Health involved male rats who were fed Splenda® for 12 weeks¹. After 12 weeks, researchers discovered a significant reduction in beneficial bacteria within the gut, as well as an increased level of P-glycoprotein, a substance that can interfere with the absorption and effectiveness of medication.  

Stevia
Natural stevia sweeteners are generally derived from the leaves of Stevia rebaudiana, a plant native to south and central America. The extract of this plant produces a unique taste that is up to 300 times sweeter than sugar, although some products may have a slightly bitter flavor.

Stevia may be especially beneficial for those with blood sugar concerns. A study recently published in Appetite concluded that, when compared with sucrose and aspartame, those who ate meals sweetened with stevia experienced a significant decrease in post-meal insulin levels².

Xylitol
Found naturally in some fruits and vegetables, xylitol is a sugar alcohol commonly used in sugar-free gum and candies. Xylitol tastes very similar to sugar and can be used to sweeten beverages, baked goods and other foods.

Dentists are particularly impressed with xylitol due to its ability to reduce the prevalence of cavity-causing bacteria within the mouth. A recent study showed that chewing gum with xylitol significantly reduced levels of mutans streptococci (a strain of bacteria linked to tooth decay) in the mouth³. Researchers also noted that this affect was still measurable up to 30 days after consumption of xylitol.

Be advised, however, that xylitol can be extremely toxic to dogs, even in small amounts.

Honey
This naturally sweet substance is produced by bees using the nectar from flowering plants. Although raw honey contains calories, it also provides beneficial nutrients, including vitamins, minerals, amino acids and antioxidants. Honey also possesses anti-bacterial properties, and may have a soothing effect on the stomach.

Due to its caloric content and potential to contribute to cavity formation, honey should be used sparingly. However, just a small amount of this viscous and flavorful substance may be more than enough to satisfy your sweet tooth.

Conclusion
Stevia appears to be one of the best sweeteners available today; however, more research is needed to clarify its safety.

I suggest limiting your intake of sugar (including honey), as well as limiting your overall intake of sugar-free sweeteners.  Try to consume unprocessed food as much as possible; processed food and beverages often contain added sugars and many other unhealthy ingredients. To satisfy your occasional craving for a sweet sensation, I recommend eating more fresh fruit.

As always, to your health,
David N. Ilfeld, M.D.

Now for me Personally, I've been using Stevia for almost 2 years and I love it! It does take a bit to get use too. 5 drops is like 1 teaspoon of sugar.