Despite growing health concerns and little government oversight, the use of sweeteners in processed foods and drinks has exploded over the past decade, an EWG analysis shows.
Using data from Food Scores, our searchable database of more than 80,000 foods, EWG found that between 2013 and 2022, the use of sweeteners has gone up:
- by more than 600 percent in baby food.
- by more than 400 percent in snacks, cookies and candy, with sweeteners appearing on product labels nearly 25,000 times in 2022.
- by more than 400 percent in beverages.
- by more than 400 percent in frozen foods.
Perhaps most striking, the use of sweeteners has increased over 700 percent since 2013 in diet and nutrition foods, which are often marketed as “healthy,” as people search for alternatives to sugar.
There are several types of sweeteners – sugars and sugar-based sweeteners, sugar alcohols, artificial sweeteners and naturally derived low-calorie sweeteners. Those that are synthetic may originate in a lab or derive from natural ingredients synthesized for use as commercial ingredients in food and beverages.
Inadequate regulatory oversight
Few of these sweeteners, which are often found in products marketed to children, have ever been reviewed for safety by the Food and Drug Administration. And most of the sweeteners that have been reviewed by the FDA have not been reviewed for many decades.
Using FDA data, EWG found that only 10 of 44 sweeteners were thoroughly reviewed for safety by the FDA before entering the food supply.
Other sweeteners entered the marketplace through a loophole that allows chemical companies manufacturing the sweeteners to deem them “generally recognized as safe,” or GRAS. While the FDA subsequently “affirmed” that some of these sweeteners are safe, nine of them – including allulose, erythritol and stevia – have only been reviewed for safety by industry scientists.
Few of these sweeteners have been double-checked for safety by the FDA in recent decades. Of the 44 sweeteners EWG investigated, the FDA has taken no action on 34 since 2000. For some sweeteners, the pace of review has been even slower. Several sweeteners, including sorbitol, mannitol, xylitol, glycerin and maltol, have not been reviewed by the FDA since 1977 .
History of FDA sweeteners approvals
|
Name |
Most recent FDA action |
Approval pathway |
|
Synthetic |
||
|
Acesulfame potassium |
2003 |
Food additive petition |
|
Advantame |
2014 |
Food additive petition |
|
Allulose (d-allulose, psicose) |
2023 |
GRAS, industry-determined |
|
Aspartame |
1996 |
Food additive petition |
|
Neotame |
2002 |
Food additive petition |
|
Saccharin, ammonium salt |
1977 |
GRAS, then approved on interim basis |
|
Saccharin |
1977 |
GRAS, then approved on interim basis |
|
Saccharin, calcium salt |
1977 |
GRAS, then approved on interim basis |
|
Saccharin, sodium salt |
1977 |
GRAS, then approved on interim basis |
|
Sucralose |
1998 |
Food additive petition |
|
Lactitol |
1996 |
GRAS, industry-determined |
|
Erythritol |
2019 |
GRAS, industry-determined |
|
Isomalt (made by hydrogenation of sucrose treated with enzymes) |
1996 |
GRAS, industry-determined |
|
Maltitol (made by hydrogenation of maltose) |
1996 |
GRAS, industry-determined |
|
Hydrogenated glucose syrups (HGS) (sugar alcohol mixture made by hydrogenation of glucose syrup) |
1996 |
GRAS, industry-determined |
|
Hydrogenated Starch Hydrolysates (HSH) (sugar alcohol mixture made by hydrogenation of corn starch) (polyglycitol is a type of HSH) |
1996 |
GRAS, industry-determined |
|
D-Sorbitol (found naturally, made by hydrogenation of glucose) |
1977 |
GRAS, affirmed |
|
Mannitol (occurs naturally, made by hydrogenation of glucose) |
1977 |
GRAS, then approved on interim basis |
|
Xylitol (occurs naturally, made commercially by hydrogenation of d-xylose) |
1977 |
Food additive petition |
|
Glycerin, synthetic |
1977 |
Food additive petition |
|
Non-Synthetic |
||
|
Fructooligosaccharides (FOS) |
2022 |
GRAS, industry-determined |
|
Licorice extract powder (Glycyrrhiza Spp.) |
1985 |
GRAS, affirmed |
|
Steviol glycosides (different types exist, including stevioside, rebaudioside A, rebaudioside D, rebaudioside M, enzyme-modified steviol glycosides) |
2022 |
GRAS, industry-determined |
|
Monk fruit (luo han guo extract, SGFE) |
2015 |
GRAS, industry-determined |
|
D-Xylose (neotame) |
1979 |
GRAS, industry-determined |
|
Thaumatin (I and II) |
2020 |
GRAS, industry-determined |
|
Caramel |
1977 |
GRAS, affirmed |
|
Corn syrup (glucose syrup made with corn) |
1988 |
GRAS, affirmed |
|
Dextrin |
1983 |
GRAS, affirmed |
|
Dextrose (corn sugar) |
1988 |
GRAS, affirmed |
|
Glycerin |
1977 |
GRAS, affirmed |
|
High-fructose corn syrup |
1996 |
GRAS, affirmed |
|
Invert sugar |
1988 |
GRAS, affirmed |
|
Lactose |
1977 |
Regulation |
|
Lactose, hydrolyzed |
1977 |
Regulation |
|
Levulose (fructose) |
NA |
Likely GRAS |
|
Maltodextrin |
1983 |
GRAS, affirmed |
|
Maltol |
1977 |
GRAS, industry-determined |
|
Maltose |
1977 |
Regulation |
|
Malt syrup (malt extract) |
1983 |
GRAS, affirmed |
|
Molasses (saccharum officinarum L.) |
1977 |
GRAS, affirmed |
|
Sucrose (cane or beet sugar) |
1988 |
GRAS, affirmed |
|
Sucrose liquid (sucrose dissolved in water) |
1988 |
GRAS, affirmed |
|
Tapioca starch |
1977 |
GRAS, affirmed |
|
D-tagatose |
2021 |
GRAS, industry-determined |
Rising use of synthetic sweeteners
Twenty of the 44 sweeteners EWG investigated are synthetic.
Of these 20 synthetic sweeteners, 15 have not been reviewed for safety since 2000. Only eight received a full FDA review; the rest were introduced to the marketplace through the GRAS loophole.
Using data from Food Scores on synthetic sweeteners, EWG found between 2013 and 2022, their use increased:
- by more than 300 percent in snacks, cookies, and candy.
- by more than 600 percent in beverages.
- by more than 800 percent in frozen foods.
- by more than 900 percent in diet and nutrition foods
Once largely limited to diet foods and beverages and tabletop packets, synthetic and other non-sugar sweeteners are now commonly added to foods like bread, cereal, yogurt, oatmeal, condiments, salad dressings, dairy products and snack bars. This is partly because of an increased desire to lower sugar consumption as the public becomes more aware of its effect on health.
The number of foods and beverages that contain multiple sweeteners has also gone up.
The share of non-sugar sweeteners that have been linked to health harms but avoided FDA reassessment has also increased in some categories. For example, the sweeteners aspartame, acesulfame potassium and sucralose together made up just under one-third of all sweeteners in beverages in 2013. Their share of all sweeteners in beverages rose to 39 percent in 2022.
Slideshow: Sweeteners by grocery store aisle (click to expand chart)
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Source: Food Scores database
Potential health risks of sweeteners
The lack of post-market review of sweeteners is particularly troubling in light of conflicting evidence regarding the safety of sweeteners, particularly sweeteners that are synthetic.
In March, the World Health Organization advised against the use of non-sugar sweeteners. This followed an analysis of 283 studies that found long-term use of artificial sweetener may be harmful.
Individual studies have drawn similar conclusions. One found links between the three most common artificial sweeteners – aspartame, acesulfame potassium and sucralose – and cardiovascular disease. It also found connections between aspartame and acesulfame potassium and cancer risk. The International Agency for Research on Cancer has also listed aspartame as a possible carcinogen.
Common sugar alcohols—which contain neither alcohol nor sugar but are usually synthetically produced – include erythritol and sorbitol. They are often added to foods also sweetened with the natural sugar substitutes monk fruit and stevia. One study suggested that higher levels in the body of erythritol, which occurs naturally at low levels, may lead to increased cancer risk. Another study found a link between erythritol consumption and cardiovascular disease.
Other sweeteners, including sucralose, have been connected to detrimental changes in the gut microbiome. A healthy gut microbiome supports a strong immune system, as well as heart and brain health. One study found sucralose can transform into sucralose-6-acetate in the gut, a chemical that can damage DNA, increase the risk of cancer and lead to other health problems, like a leaky gut and inflammation.
Non-sugar sweeteners may also affect the nervous system. Since sugar substitutes, particularly artificial sweeteners, can be hundreds of times sweeter than sugar, despite containing fewer calories, they can cause taste receptors to signal the brain to expect a large influx of calories. The result is confusion and stronger sugar cravings, creating a vicious loop that leads to even higher sweetener intake.
Our knowledge of the potential health risks of non-sugar sweeteners is still developing, but the research already shows more than enough evidence to warrant a reassessment of sweeteners’ safety.
FDA’s duty to ensure food safety
For a food additive to be safe, the FDA must determine scientists find with “reasonable certainty” that it is “not harmful under the conditions of its intended use.”
The law also states that if an additive has been classified as GRAS, new information may require the FDA to reconsider its status.
Many sweeteners are found in food and beverages and consumed at rates that may not have been anticipated when they were approved decades ago. This increase in non-sugar sweeteners in our diets should lead the FDA to reconsider how they may harm our health. The FDA’s responsibility for ensuring that food additives are safe does not end after they enter the marketplace.
The FDA’s decades-long failure to review sweeteners’ safety extends to other food chemicals. Because the agency lacks a system of post-market review, it has not reassessed the safety of many other food additives and chemicals.
The FDA has recognized it should reassess the safety of food ingredients as new information becomes available, and has shown a desire to create a “more modernized, systemic” post-market reassessment of food substances. But agency officials have so far failed to take action.
