Are artificial sweeteners permitted on a keto diet?
In an ideal world, you would completely break your need for sweet foods, but this is a tall order if you’re dealing with obesity, diabetes, metabolic syndrome, or another cardiometabolic health issue. Artificial sweeteners like sucralose, aspartame, and saccharin, will be less problematic for you than regular sugar or other caloric sweeteners like honey, molasses, agave, and maple syrup. In my two decades of helping people lose weight and reverse chronic illnesses like diabetes, I’ve seen thousands of patients use these sweeteners without adverse effects on their health or weight. If you follow a keto diet without needing anything sweet, great, but if you can’t, then including artificial sweeteners can make a ketogenic or low-sugar strategy much easier to stick with over the long term. That’s what you want: something you can do for the rest of your life, not just until your next vacation or class reunion or some other event you want to look and feel good for. Look and feel good every day for yourself and your loved ones.
Sugar alcohols and other low-carb and no-carb sweeteners like erythritol, xylitol, stevia, allulose, and monk fruit are also permitted. Remember, however, you don’t subtract sugar alcohols if you’re using the total carb method of carb counting, which I recommend. Read labels and count the sugar alcohol carbohydrates toward your total for the day. What this will do is put a limit on the artificial sweeteners. I recall a patient who did not count the sugar alcohols as part of the total carbs and she came in a few weeks into the program complaining of having diarrhea. After some detective work, I figured out she was having over 20 packets of sucralose every day. After stopping this artificial sweetener, her diarrhea ceased. In typical daily usage, artificial sweeteners are fine, but I think it’s best to count them as part of your total carbohydrate intake.
What about the concerns about the risks of artificial sweeteners?
Some people read that artificial sweeteners are even worse than sugar. Honestly, I’m not worried based on the pre-clinical research that has been done. Pre-clinical means that the research is done in test tubes or mice or rats, in observational human studies, or in a very focused area of human research, like the gut microbiome. As a human-focused researcher, I just can’t get worried about this kind of information yet. If you have a sensitivity – like a headache from aspartame – then don’t have it! Sometimes I even wonder if the sugar industry spreads this information to get people to go back to sugar.
What about natural sweeteners?
Avoid them. They contain sugar and glucose. Sweeteners that are considered “natural,” like maple syrup, molasses, honey, and agave nectar, contain small amounts of nutrients, but ultimately they’re still just concentrated sources of sugar. If you have obesity or are living with a condition caused by or exacerbated by high blood sugar or insulin, the wallop of sugar these sweeteners deliver overshadows the minuscule amount of nutrients they provide – nutrients that you can get in higher amounts from other foods without the hit to your blood sugar. If you prefer to avoid artificial sweeteners and you are metabolically healthy, small amounts of these natural calorie-containing sweeteners can fit into your diet.
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