# Sweeteners and sugar alcohols: what applies, who tolerates what

The substances in this article are approved in the EU, and within their ADI values the authorities do not expect harm.[^2] Long-term effects are not fully settled, though,[^2] and tolerance is a separate question: what one person handles well gives another a stomach ache.[^25]

## In short

- Sweeteners like aspartame or sucralose are very sweet and provide almost no calories. Sugar substitutes like xylitol or sorbitol are sugar alcohols with fewer calories than sugar.[^1]
- Sweeteners have ADI values. If you stay below them, today's assessments do not expect harm. That is no licence for any amount.[^2]
- Phenylketonuria is the clear exception: the ADI of aspartame does not apply to people who have it, and they should avoid it.[^4][^5]
- Sugar alcohols can cause bloating and diarrhoea, with IBS already at smaller amounts.[^25]
- Xylitol is dangerous for dogs.[^27]

## Two groups that are often mixed up

The EU has approved 19 sweetening substances. Eleven are non-nutritive sweeteners, eight are sugar substitutes.[^1]

|  | Sweeteners | Sugar substitutes |
| --- | --- | --- |
| What they are | Chemically very different, often much sweeter than sugar | Sugar alcohols, also called polyols, usually less sweet than sugar[^1] |
| Energy | Almost none | 2.4 kcal per gram for labelling, erythritol 0 kcal[^14] |

The pack says “with sweetener(s)” or “with sugar(s) and sweetener(s)”, and the substance is in the ingredients list.[^14]

## Sweeteners at a glance

The ADI is the amount per kilogram of body weight that, according to the assessment, can be consumed every day for a lifetime without expecting harm.[^1]

| Substance | What it is | ADI and status |
| --- | --- | --- |
| Aspartame (E 951) | Breaks down completely in the gut into phenylalanine, aspartic acid and methanol[^18] | 40 mg. EFSA 2013, no reason for a change in the 2026 assessment of E 962[^4][^6] |
| Acesulfame K (E 950) | A sweetener often mixed with others | 15 mg. Newly set by EFSA in 2025, before that 9 mg[^7] |
| Saccharin (E 954) | One of the five most used sweeteners | 9 mg. Newly set by EFSA in 2024, before that 5 mg[^8] |
| Sucralose (E 955) | Contains chlorine, which matters when heated[^10] | 15 mg. EFSA 2026: no change needed[^9] |
| Cyclamate (E 952) | Often mixed with saccharin | 7 mg as cyclamic acid, value from 2000. EFSA's re-evaluation is running[^3][^11] |
| Steviol glycosides (E 960a–d) | Extracted from the leaves of the stevia plant, now also made in other ways[^1][^3] | 4 mg, counted as steviol. EFSA 2010, checked in 2024 and not raised[^12] |

Sweeteners are mainly found in table-top sweeteners and soft drinks, also in sweets, dairy products and toothpaste, often several at once.[^2]

In EFSA's estimates, intake of acesulfame K, saccharin and sucralose was below the ADI in all population groups.[^7][^8][^9]

## Sugar substitutes at a glance

| Substance | What it is | ADI and status |
| --- | --- | --- |
| Erythritol (E 968) | About 60 to 80% as sweet as sugar, also occurs in fruit and fermented foods[^25] | 0.5 g. EFSA 2023, derived from studies on diarrhoea. Estimated intake was above the ADI, and people with high intake may get symptoms[^13] |
| Xylitol (E 967) | About as sweet as sugar, also occurs in fruit, berries and oats[^25] | No numerical value, re-evaluation running |
| Sorbitol (E 420) | About 50 to 70% as sweet as sugar, also occurs in apples, pears, peaches and apricots[^25] | No numerical value, re-evaluation running |
| Maltitol (E 965) | About 75 to 90% as sweet as sugar, manufactured[^25] | No numerical value, re-evaluation running |

Xylitol, sorbitol and maltitol have no numerical value, and EFSA's re-evaluation is running.[^2][^3] They are often found in sugar-free chewing gum and sweets, in ice cream, syrup and jam without added sugar.[^25]

## What “approved” means and what it doesn't

The sources do not support a blanket “harmless”. To be exact: approved sweeteners count as safe as long as the ADI values are kept, across all foods together. Most studies show no adverse health effects. For a final assessment the data are not enough for the BfR, partly because studies mainly look at diet drinks and real intake may be higher.[^2]

For scale, WHO calculates: with 200 to 300 mg of aspartame per can, an adult of 70 kg would need more than 9 to 14 cans a day to exceed the ADI, with no other sources.[^17] That is an order of magnitude, not a guide value.

Animal studies on mixtures of several sweeteners are missing. Whether effects add up is neither shown nor ruled out.[^1]

**Do not heat sucralose strongly.** Above 120 °C it can break down, and chlorinated substances can form that may be harmful to health.[^10] EFSA could not rule this out for heating at home.[^9] The BfR advises against baking or frying food containing sucralose and suggests adding it only after heating.[^10]

## What is being debated

- **WHO guideline 2023.** WHO advises against using sweeteners for weight control or to lower disease risks. Its review found no long-term benefit for body fat and signs of more type 2 diabetes, cardiovascular disease and mortality with long use. The recommendation is only conditional because these links may be distorted. It does not apply to people with diabetes or to sugar alcohols.[^16]
- **Aspartame and cancer.** In 2023, IARC classified aspartame as possibly carcinogenic (Group 2B). For humans it relied on three studies on sweetened drinks and liver cancer, in which chance, bias and confounding could not be ruled out. The expert committee JECFA saw no convincing evidence of harm in the same year and confirmed the ADI.[^18] The IARC classification shows how strong the evidence is, not how high the risk is at a given amount. That is what JECFA assesses.[^17]
- **Erythritol and the heart.** In a study of 1,157 people undergoing cardiac assessment, confirmed in groups of 2,149 and 833, high blood levels of erythritol went along with more heart attacks, strokes and deaths within 3 years.[^19] In 10 healthy people who drank 30 g, platelets reacted more strongly afterwards. The authors name the small number and the short duration as limits.[^20] The body also makes erythritol itself,[^29] and according to EFSA the data do not show a causal link with erythritol in food.[^13]
- **Gut and blood sugar.** In a trial of 120 healthy adults, four sweeteners changed gut bacteria within 2 weeks, and saccharin and sucralose impaired blood sugar responses. Differences between people were large, and what this means for health is open.[^21] The SWEET study of 341 adults saw other changes in gut bacteria after 1 year and no differences in heart and metabolic values.[^24] The BfR cannot say clearly whether sweeteners affect gut flora to a clinically relevant degree.[^2]
- **Large observational studies.** In the French NutriNet-Santé cohort of about 100,000 adults, more sweetener went along with somewhat more cancer and cardiovascular disease.[^22][^23] That shows a link, not a cause. The authors themselves name selection of participants, confounding and reverse causality as limits.[^22]

## Sweeteners and weight loss

The sources do not agree here. According to the BfR, sweetener instead of sugar can support weight loss within a programme with fewer calories and behaviour change. Without such a programme the data allow no statement.[^2] In the SWEET study, the group that replaced sugar-rich products kept somewhat more of its weight loss after a year.[^24] WHO sees no long-term benefit for body fat.[^16]

The EU list has no approved claim on body weight for sugar replacers.[^15] So we do not say that sweeteners help you lose weight. They are one way to eat less sugar if you like sweet things. You do not have to, and water and unsweetened tea stay the simplest choice.[^28]

## Who doesn't tolerate what well

| When | Concerns | What applies |
| --- | --- | --- |
| Phenylketonuria | Aspartame (E 951), aspartame-acesulfame salt (E 962) | **Avoid.** The ADI does not apply to people with this condition, who need a strict low-phenylalanine diet.[^4][^5] The pack says “contains aspartame (a source of phenylalanine)” or “contains a source of phenylalanine”[^14] |
| Sensitive stomach | Sugar alcohols | They can cause bloating, abdominal pain and diarrhoea. From 10% added sugar alcohols the pack must say “excessive consumption may produce laxative effects”[^14][^25] |
| IBS | Mainly sorbitol and mannitol, often studied together with fructose | Symptoms appear at smaller amounts than in healthy people. There is no fixed limit[^25] |
| Dog at home | Xylitol | **Dangerous for dogs.** Blood sugar can fall sharply within 10 to 60 minutes. If a dog has eaten xylitol, go to a vet or animal hospital at once[^27] |

In healthy adults, about 10 g of sorbitol a day usually causes mild symptoms, about 20 g stronger ones.[^25] For xylitol, a review gives about 0.3 g per kilogram of body weight as a single portion without laxative effect. It acts sooner in drinks than in solid food.[^26] For erythritol, the amount without diarrhoea in studies was 0.5 g per kilogram.[^13] These are study values, not recommendations.

**If sugar alcohols don't agree with you:** sweeteners are not sugar alcohols and don't fall under this warning.[^14] Erythritol is well absorbed and caused fewer symptoms in healthy people than others, though data on IBS are missing.[^25]

Diarrhoea is a side effect and has nothing to do with losing weight. It can upset the electrolyte balance.[^13] If symptoms persist, read [when to get medical advice](https://kostenlos-abnehmen.de/en/wissen/aerztlicher-rat).

## Pregnancy, children and diabetes

- **Pregnancy and breastfeeding:** According to the BfR, possible effects cannot be estimated because studies are few and inconsistent.[^2] That is neither an all-clear nor a warning. If in doubt, talk to your doctor or midwife.
- **Children:** Data are limited.[^2] The ADI is per kilogram of body weight, so children get close to it sooner. For erythritol, estimated intake was highest in children.[^13]
- **Diabetes:** The WHO guideline excludes people with diabetes.[^16] The US society ADA puts water first and names sweeteners as a replacement for sugar-sweetened products, in moderation and for the short term.[^28] Most studies reviewed by the BfR showed no negative effect on blood sugar.[^2]

## What may be said in the EU

The EU list approves these claims for sugar replacers. Here they are word for word with their condition:[^15]

| Approved claim | Condition |
| --- | --- |
| “Consumption of foods/drinks containing [name of sugar replacer] instead of sugar induces a lower blood glucose rise after their consumption compared to sugar-containing foods/drinks” | The replacement must lower the sugar content by at least the share that applies to the claim “reduced” |
| “Consumption of foods/drinks containing [name of sugar replacer] instead of sugar contributes to the maintenance of tooth mineralisation” | Consumption must not lower plaque pH below 5.7 during and up to 30 minutes after it[^15] |

Both claims compare with sugar. They don't say that a food lowers blood sugar or repairs teeth. We recommend no products.

## Sources

[^1]: [BfR: Sweeteners in food, questions and answers, as of 23 Oct 2026](https://www.bfr.bund.de/en/service/frequently-asked-questions/topic/sweeteners-in-food-selected-questions-and-answers/)
[^2]: [BfR: Opinion 004/2023 on sweeteners (German)](https://doi.org/10.17590/20230207-070309)
[^3]: [EFSA: Sweeteners, as of 27 Oct 2026](https://www.efsa.europa.eu/en/topics/topic/sweeteners)
[^4]: [EFSA: Aspartame, as of 10 Sep 2026](https://www.efsa.europa.eu/en/topics/topic/aspartame)
[^5]: [BfR: Communication 062/2026 on aspartame](https://www.bfr.bund.de/en/notification/re-assessment-of-aspartame-as-a-food-additive/)
[^6]: [EFSA: Re-evaluation of E 962, 2026](https://efsa.onlinelibrary.wiley.com/doi/10.2903/j.efsa.2026.10259)
[^7]: [EFSA: Re-evaluation of E 950, 2025](https://www.efsa.europa.eu/en/plain-language-summary/re-evaluation-acesulfame-k-e-950-food-additive)
[^8]: [EFSA: Re-evaluation of E 954, 2024](https://www.efsa.europa.eu/en/plain-language-summary/re-evaluation-saccharin-and-its-sodium-potassium-and-calcium-salts-e-954)
[^9]: [EFSA: Re-evaluation of E 955, 2026](https://www.efsa.europa.eu/en/plain-language-summary/re-evaluation-sucralose-e-955-food-additive)
[^10]: [BfR: Communication 015/2026 on sucralose](https://www.bfr.bund.de/en/notification/sucralose-heating-above-120c-can-produce-substances-that-are-harmful-to-health/)
[^11]: [SCF: Revised opinion on cyclamic acid, 2000](https://food.ec.europa.eu/system/files/2020-12/sci-com_scf_out53_en.pdf)
[^12]: [EFSA: Steviol glycosides (E 960a–d), 2024](https://pmc.ncbi.nlm.nih.gov/articles/PMC11533382/)
[^13]: [EFSA: Re-evaluation of E 968, 2023](https://pmc.ncbi.nlm.nih.gov/articles/PMC10731997/)
[^14]: [Regulation (EU) 1169/2011, version of 1 Apr 2025](https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:02011R1169-20250401)
[^15]: [Regulation (EU) 432/2012, version of 19 Aug 2024](https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:02012R0432-20240819)
[^16]: [WHO: Guideline on sweeteners, news of 15 May 2023](https://www.who.int/news/item/15-05-2023-who-advises-not-to-use-non-sugar-sweeteners-for-weight-control-in-newly-released-guideline)
[^17]: [WHO: Aspartame, news of 14 Jul 2023](https://www.who.int/news/item/14-07-2023-aspartame-hazard-and-risk-assessment-results-released)
[^18]: [IARC and JECFA: Summary of findings on aspartame, 2023](https://cdn.who.int/media/docs/default-source/nutrition-and-food-safety/jecfa-summary-of-findings-aspartame.pdf)
[^19]: [Witkowski et al.: Erythritol and cardiovascular event risk. Nat Med 2023](https://pubmed.ncbi.nlm.nih.gov/36849732/)
[^20]: [Witkowski et al.: Erythritol and platelet reactivity. ATVB 2024](https://pmc.ncbi.nlm.nih.gov/articles/PMC11338701/)
[^21]: [Suez et al.: Non-nutritive sweeteners and glucose tolerance. Cell 2022](https://pubmed.ncbi.nlm.nih.gov/35987213/)
[^22]: [Debras et al.: Sweeteners and cancer risk. PLoS Med 2022](https://pubmed.ncbi.nlm.nih.gov/35324894/)
[^23]: [Debras et al.: Sweeteners and cardiovascular diseases. BMJ 2022](https://pubmed.ncbi.nlm.nih.gov/36638072/)
[^24]: [Pang et al.: The SWEET study. Nat Metab 2025](https://pubmed.ncbi.nlm.nih.gov/41057614/)
[^25]: [Lenhart, Chey: Polyols and irritable bowel syndrome. Adv Nutr 2017](https://pmc.ncbi.nlm.nih.gov/articles/PMC5508768/)
[^26]: [Mäkinen: Sugar alcohols and gastrointestinal disturbances. Int J Dent 2016](https://pmc.ncbi.nlm.nih.gov/articles/PMC5093271/)
[^27]: [FDA: Paws Off Xylitol](https://www.fda.gov/consumers/consumer-updates/paws-xylitol-its-dangerous-dogs)
[^28]: [ADA: Standards of Care in Diabetes 2026, section 5](https://diabetesjournals.org/care/article/49/Supplement_1/S89/163932/5-Facilitating-Positive-Health-Behaviors-and-Well)
[^29]: [Heianza et al.: The POUNDS Lost trial. Int J Obes 2026](https://pubmed.ncbi.nlm.nih.gov/42477477/)

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Last updated: November 2026. This is general information and not medical advice.

Original article: https://kostenlos-abnehmen.de/en/wissen/suessstoffe