Do Artificial Sweeteners Cause an Insulin Spike?

The notion that artificial sweeteners (and sweet tastes in general) might produce an insulin response is one of those murky memes that winds itself around the blogs, but it’s never stated one way or the other with any sort of confidence. I briefly mentioned the possibility of non-caloric sweeteners influencing satiety hormones in last week’s diet soda post, and a number of you guys mentioned the same thing. Still, I’ve never seen unequivocal evidence that this is the case.

This whole idea first came to my attention some time ago when my dog Buddha got into a bottle of “alternative sleep assists” which contained, among other things, 5 HTP (version of l-tryptophan) and xylitol (sugar alcohol). Long story short, dogs can’t take xylitol because it causes a spike in insulin, which then severely depletes blood glucose. Buddha got past this with a trip to the vet’s at 10:30 Sunday night (thanks, Dr. Dean). But it occurred to me that the same effect might be seen in humans, which is why I pose the question today…

Do artificial sweeteners induce insulin secretion (perhaps via cephalic phase insulin release, which is sort of the body’s preemptive strike against foods that will require insulin to deal with)?

One of the reasons a definitive answer is rarely given is that the question is improperly framed. Artificial sweeteners is not a monolithic entity. There are multiple types of sweeteners, all of them chemically distinct from each other. A more useful question would be “What effect does [specific artificial sweetener goes here] have on insulin?” So let’s go around the circle and ask.

Does aspartame (aka Equal and Nutrasweet) affect insulin?

Aspartame is pretty gross stuff, what with its awful taste and hordes of people who get terrible reactions from consuming it, but that’s not what we’re interested in today. Luckily, there is a good amount of research explaining what, if any, effect aspartame has on insulin secretion.

One study found that protein produced a significant insulin response, while aspartame had no effect on insulin levels.

Another also found that aspartame had no effect on the insulin response in humans, whether alone or combined with carbohydrates.

Another earlier study (full PDF) examined the effects of aspartame on prolactin, cortisol, growth hormone, insulin, and blood glucose levels and found it had none. The authors used the same amount of aspartame you’d find in a standard artificially-sweetened drink but were unable to record any significant hormonal alterations.

A study of forty-eight healthy volunteers found no evidence that aspartame has an effect on insulin levels.

Overall, the evidence seems to suggest little, if any, effect on insulin secretion as a result of tasting or consuming aspartame.

Does saccharin (aka Sweet’N Low) affect insulin?

Although saccharin has lingered in obscurity and consumer banishment (who ever really picks Sweet ‘n’ Low, anyway?) for most of the last couple decades (until recently when the EPA dubbed it safe for human consumption), there is some research on its effects on insulin.

In one study, fasted human subjects swished around eight different taste solutions for 45 seconds, and then spat them out. No swallowing. Only the sucrose and saccharin solutions activated a cephalic phase insulin release.

On the other hand, another study using humans found the opposite: swishing and spitting sweet solutions (even caloric ones using sucrose) did not elicit CPIR, while another study found that neither saccharin nor aspartame influenced insulin secretion in both fasted diabetics and non-diabetics (although aspartame-fed subjects had slightly higher insulin levels than the control and saccharin groups, this was physiologically irrelevant given the steady blood glucose levels).

The evidence for saccharin’s effect on insulin is mixed, but either way, it doesn’t appear to have too big of an impact in real world terms.

Does acesulfame K (aka Sunett and Sweet One) affect insulin?

In one study, researchers found that direct transfusions of acesulfame K increased insulin secretion in rats in a dose-dependent fashion. The same researchers performed an in vitro study, subjecting isolated rat pancreatic islets to acesulfame K solutions, and found that the artificial sweetener was an independent actor on insulin secretion. Both indicate that there is some effect, but it’s difficult to draw any conclusions from in vitro rat studies using isolated pancreatic cells or in vivo rat studies using direct transfusions of sweeteners (as opposed to oral dosing).

Another study using isolated pancreatic cells found that only those artificial sweeteners with a bitter aftertaste (acesulfame K, saccharin, stevia, and cyclamate) augmented the insulin response in the presence of glucose. Aspartame, which does not have a bitter aftertaste, did not affect insulin. Note, though, that this was an in vitro study using isolated cells and that the presence of glucose was a prerequisite for insulin secretion. Of course, dieters slurping down artificial sweeteners do it during meals, most of which tend to feature large amounts of glucose.

Acesulfame K appears to affect insulin levels, although this effect has only been shown in contrived settings – either in the presence of glucose in isolated cells (in vitro), in isolated cells in without glucose (in vitro), or by direct transfusions without the presence of glucose (in vivo). We haven’t seen people orally taking acesulfame K in a fasted state and having an insulin response. Yet.

Does sucralose (aka Splenda) affect insulin?

Sucralose activates the sweet receptors in taste buds, and some in vitro studies have shown that sucralose can stimulate the release of incretin hormones, which increase the secretion of insulin, via the sweet taste receptors in enteroendocrine cells (located in the gut). An in vivo study of sucralose infusions into the gut, however, showed that it does not stimulate the incretin hormones GLP-1 or GIP, does not release insulin, and does not slow gastric emptying.

Another in vivo study, this time using healthy human subjects, got similar results: oral dosing of sucralose did not induce a cephalic insulin response, nor did it affect GLP-1. Not even appetite was affected.

The commercial version of sucralose, Splenda, is cut with dextrose as a bulking agent. Dextrose is essentially glucose, which certainly elicits an insulin response, so there’s definitely the potential for a slight insulin response to Splenda, but there’s not much if any evidence that sucralose has an independent in vivo effect on insulin.

Recently, a review of in vivo studies concluded that “low-energy sweeteners” do not have any of the effects on insulin, appetite, or blood glucose predicted by “in vitro, in situ, or knockout studies in animals.” As far as the clinical studies go, I think I’d have to agree. Am I going to use the stuff? No; there are other potential negative effects to artificial sweetener usage, including gut flora disturbances, the promotion of psychological dependencies on sweets, and long term safety issues, but I think it’s important to be clear on where the science lies. So far as I can tell, according to the literature there isn’t an appreciable insulin effect from most sweeteners.

Still, some people anecdotally report an effect. As Jimmy Moore says, “The bottom line is to check your own blood sugar response and see how it impacts YOU.” Word. If you need to know (and most people don’t), testing yourself would be the way to do it.

Let me know if I’ve missed something, or come up short in my analysis. There’s a lot of stuff out there and it’s possible that I’ve overlooked something. And as always, I’d love to hear about your personal experiences with artificial sweeteners, especially regarding their effect on your weight loss/gain, insulin, appetite, and dietary success/failure. Let me know in the comment section!

P.S. If you’re new here and aren’t sure what all the fuss over insulin is about start here: The Definitive Guide to Insulin, Blood Sugar and Type 2 Diabetes (and you’ll understand it)

About the Author

Mark Sisson is the founder of Mark’s Daily Apple, godfather to the Primal food and lifestyle movement, and the New York Times bestselling author of The Keto Reset Diet. His latest book is Keto for Life, where he discusses how he combines the keto diet with a Primal lifestyle for optimal health and longevity. Mark is the author of numerous other books as well, including The Primal Blueprint, which was credited with turbocharging the growth of the primal/paleo movement back in 2009. After spending three decades researching and educating folks on why food is the key component to achieving and maintaining optimal wellness, Mark launched Primal Kitchen, a real-food company that creates Primal/paleo, keto, and Whole30-friendly kitchen staples.

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194 thoughts on “Do Artificial Sweeteners Cause an Insulin Spike?”

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  1. Before going primal, I used splenda in everything. I would get so used to that insanely sweet taste that I would slowly add more and more splenda to my food (yogurt, cottage cheese, baking, etc) until I was just buying the big bags of granulated splenda and dumping it on top of my food with cinnamon. Since I switched to the PB lifestyle, I have kicked splenda completely and have gained a new appreciation for all the flavors of full fat yogurt, cottage cheese, and coconut milk.

    Also, another drawback that I experienced with Splenda was its effects on overeating. Before BP I had a bad case of binge eating disorder, and I think that Splenda was at the root of my disorder. The sweetness messed something up in my mind or body that caused me to get all hopped up on sweet and ignore my body’s cues for satiety.

    Personally, I have to avoid the stuff or I lose it. Only plants and animals for me.

    1. I am suffering from Binge Eating disorder and i always thought there was no ‘cure’..

      but just kicking out sugar and sweetners did it for you?

      1. Sabrina, I also have an eating disorder and have found the same thing with artificial sweeteners. Sweets go right to the “reward center” of the brain and it is so hard to stop eating them. Kicking the sugar habit REALLY helped me stop bingeing.

      2. It was that easy for me. Ever since I kicked the carbs and splenda 4 months ago, I haven’t binged one time.

      3. There are specific “trigger foods” for different people. Generally it’s something sweet or commercially produced. If people with these disorders stay away from them they will not have the triggers to start binging. Plus, it’s really hard to eat an entire 1/4th of a cow at one seating. They’d be stuffed way before they did a lot of damage.

    2. I applaud your effort to kick all those artificial sweeterners, i think they are absolute garbage, and powerful neuro-toxins.
      Long time ago i read something pertaining to artifical sweetners and how they triggered, blood sugar levels in the body, in short i read that they affect the appestat, a region of the hypothalamus that triggers appetite. And how also the second the body tastes something sweet thru the receptors and gustatory glands in the tongue mainly, in short that body will release insuling to put to work all that sweet material. I was my understanding that the seconds this happens the body is fooled into believing that sugar has entereed the body (blood stream)
      Ruben videoblog

      1. >Long time ago i read something pertaining to artifical sweetners and how they triggered, blood sugar levels in the body, in short i read that they affect the appestat, a region of the hypothalamus that triggers appetite.

        Nice, except that this is invalidated by just about all the information in the article.

        1. The way that noncaloric sweeteners (at least artifical ones, I don’t know if it’s been tested with stevia) affect appetite is more subtle than what this article discusses. Binding to sweetness GPCRs still sends a message to brain, and when that *fails* to be followed by glucose delivery (and I guess, associated insulin spike) it essentially teaches the brain that sweetness doesn’t mean nutrition, which increases appetite with a delay of hours to days. I’m at work so I can’t link to sources right now, but look for a study involving rats and isocaloric yogurt drinks with artificial or sugar sweetener. I’m told by my neuroscience major partner that this has been replicated in humans too and the effect is actually pretty large.

      2. No. They are NOT neurotoxins. Don’t use words you don’t understand to make your bs claims sound “scientific”.

        1. I’d ask my very excellent doctor about artificial sweeteners being metabolic disrupters and he said not to worry about it. I consume a lot of them, for possible emotional reasons. I don’t drink, don’t smoke and exercise: my weight is what it is at 52, and, stable. I don’t want to keep reading all this inconclusive small scale research. Let us know when you really know about insulin/artificial sweeteners correlation.

    3. AGREED!……I have had the same experience. I now get instant headaches with the use of sucralose. (not worth even looking at the stuff) Aspartame leaves me craving, xylotol has a cold sharp taste and is a catalyst for a binge.
      However, I can tolerate a bit of stevia in my starbucks. I have found that finding and eating foods how God made them has worked “swimmingly” for me.

    4. I really feel the need to “pile on” here. I used to use sweeteners like splenda all of the time, tons of sugar and diet soda. And I would always say “I don’t know why I never feel full.”

      I started college in 2004 and finished December 2008. I went from 178-245. After 2 years of full time employment later I was 277 January 3rd 2011. I got that heavy WHILE counting calories. I couldn’t stop eating and was totally out of control.
      I would forget to pay attention while eating and not realize I’m full till I realize I’m choking down what’s in front of me.

      I started eating paleo/primal/4hb January 3rd of this year. I weighed 273 then, and weigh 256 right now.

      I feel fuller while eating, and actually get that feeling of “when” to slow down or stop eating. It happened at the end of my first week completely changing my diet. I was so confused and shocked and happy and overwhelmed I nearly cried.

      I’ve been at this for just over a month and I’m finally not hungry all the time. I haven’t slept this well in (literally) years. I had no problem shoveling my driveway. My scar like stretch marks have been visibly reduced already.

      1. Hiya – what do you mean by primal/4hb? I know the paleo diet…

        1. I’m guessing he means “4 Hour Body”, in which Tim Ferris talks about a “slow carb” diet that is largely primal, with some exceptions.

    5. Ok, so I’m not the only one binging after using splenda. I started using this about 1 year ago or so. I started developing a binge issue in October. This is so not like me. I have always eaten healthy, and never had any issue with food what so ever. It gradually got worse until today where I binge every day (sometimes several times a day). I have looked for several causes until today, when I thought Splenda might be a cause. Binging is so not like me, I thought there has to be an external source, and I think it’s what I’m putting in my body. For me, it took a while to begin to binge, or I didn’t notice the gradual increase of food. I have gained 10 lbs in the last year by the way. I’m going to see if I can return the last 2 large bags I bought.
      Thank you for sharing your experiences ladies and gentlemen. I never would have been able to catch on to this without your input and the above article. I hope this is the cause of my binging, because it is so unhealthy for my body to eat so unnecessarily, and I need it to end. I’ll cut the splenda out and see if it fixes the issue, besides it sounds like it’s unhealthy anyway.

    6. Agree with what you are saying, the article is about artificial sweetener and insulin level, it would have been better if you could have added something of your experience to help others, instead of letting us know of how you got addicted to sweetness.

    7. agreed. splenda made me gain weight on binge eating. before that i didn’t at all, even though i was bingeing (which is freaky i know). i too think it’s the “reward centre” thing which may rewire the brain.
      i’m perfectly healthy and fine now, but i wouldn’t touch splenda or aspartarme with a ten foot pole

      1. PB is short for Primal Blueprint it’s anawesome book by Mark Sisson

    8. Also don’t touch anything fat-free or low-fat dairy. Skim milk is used to make pigs gain weight. Their body realizes something is missing from the milk so they try to compensate by eating more. Gluten also makes people eat an estimated 400 calories more a day when it is eaten. I’ve noticed if I even touch it through a wheat contaminated soy sauce I become insatiably hungry. Such a careful line to walk …

      1. Perhaps one of the most unfounded comments currently on the interwebs.

        1. Petter you may have too much time on your hands to know all of the inter web comments at this time. LOL

          I read comments all the time too because though sometimes they are nonsense they usually state more about the state of the planet, humans and human world views than the articles published.

          Trolls are annoying though because when you are looking for information below a thought imposed there are a ton of comments with no purpose; insults(esp. between world views), noise makers for the sake of making noise OR to distract from the real information that is coming forth that could help humans in similar situations. HMM … progress anyone?

    9. Yes.. Sweeteners do not activate Insulin.. So you do not have that momentary satisfaction..

      And splenda has a small amount of Sugar, thus it *does trigger* it.

      Basically, Diat Coke Is fine.. if you drink it alone, or preffrably, with water.

      Filling your stomach will satisfy you, but insulin will remain unaffected.

    1. Stevia is not mentioned here because it is not an “artificial” sweetener.

      1. I’d like to see an article comparing them all. Because stevia ‘artificial’ or not, is still processed.

        1. Agreed. I am a big stevia fan and would really like to know if it causes problems with my insulin levels.

        2. Anything you eat is processed. If you cut your steak, it’s processed. It was processed before then actually, since cows don’t come pre-sliced.

          Words are slippery at the best of times but using imprecise language doesn’t exactly help.

        3. There’s something up with Stevia. Every time I’ve tried it I get massive stomach cramps.

          … and every once in a while I find it in the cupboard and forget that fact and experience it all over again.

          1. Most stevia has erythritol. I get severe lethargy from this .

      2. Well, it’s sweet without being sugar. That meets some of the criteria of being “artificially sweet”. 😛

        1. I love Stevia and you don’t have to buy processed stevia. You can grow it as an herb in your garden as I do and then use the dried leaves to complement your foods, I like it in tea or yogurt crushed up.

          1. I tried that, it tastes terrible to me, just couldn’t get used to the “grass” taste. However, 100 pure organic stevia powder, with no additives (seems expensive because you get very little, but you only only a teeny tiny bit) may be an option. I haved wondered how they get it to be white and still call it organic. Assumably they use a natural source to remove the green color and worse the flavor.

  2. “alternative sleep assists” – doesn’t sound very primal. 🙂

    What is it, exactly?

    1. My wife was going through menopause and wanted to try an herbal remedy to help her sleep when the hot flashes were hitting hard. She tried a few, including this. She used the stuff once or twice and abandoned it.

      1. Talk about transparency! I’m always blown away by your honesty and integrity (primal fuel introduction discussion anyone?). Grok on!

      2. Has she tried valerian root tincture? That knocks everyone out and gives them a long peaceful slumber but the herb smells like dirty feet. Red clover and a few other herbs for females (blue cohash for one) might calm the hot flashes.

        Just a thought.

        1. I like the valerian as well… when I’m having sleep issues I’ll take melatonin AND valerian and the valerian seems to help with quality of sleep, and sleeping deeper.

          But yes, smells AND TASTES like dirty gym socks.

          I made my hubs take it once when he had vertigo and he was disgusted. 🙂

        2. I think you might’ve meant Black Cohosh – I used it for several months while my hormones were settling down & it nearly saved my sanity. Darn hot flashes!

        3. fyi
          Valerian is less likely to help ‘Type A’ persons. It has the opposite effect.

        4. Anyone considering taking natural remedies should consult a professional. Black and blue cohosh, for instance, can bring on labor and cause a miscarriage. Generally not a problem for someone who is peri-menopausal, I know. I’m just sayin’, natural remedies can also have unwanted side-effects.

  3. I used to be able to use splenda with lots of things, namely my coffee or tea, but now, I have a box of it sitting in my kitchen that I haven’t touched in months. If I really want something sweet, I’d rather use honey than put all those chemicals in my body! At some point it just came down to my picking natural (with calories, insulin bla bla) than the zero calorie chemical crap.

  4. Even if they don’t cause an insulin response, any kind of sweetener will keep the body used to sweet tastes, and in my opinion, make the whole process of switching to eating real foods more difficult. I’ve noticed that clients I work with who use any sweetener, even stevia, in moderate to large amounts, take longer to get past the initial carb cravings, because they are still used to the taste.

    1. I agree. If I chew gum that has artificial sweeteners, or eat sugar free candy, I just start to want real honest to god sugar.

      I also feel like I get an insulin response when chewing gum. I haven’t tested that with a blood glucose meter, but it sure feels like it.

    2. I absolutely agree. I don’t use completely ‘artificial’ sweeteners, just stevia or erythlitol, or dates, yet the cravings are still there. The more I indulge, the more I crave. It’s gotten so bad that now I had to ask my family to hide my blender (one of my favourite treats is cashewnut butter blended with erythritol, vanilla, and coconut flakes and maybe a bit of coconut oil), cocoa powder, stevia,erythritol, even the coconut flakes. As of Monday, I am quitting all forms of sweeteners, except for cinnamon. I also won’t blend my foods anymore and will quit high sugar fruits like bananas as well, because even they can trigger a binge in me – how crazy is that??

  5. Do these studies actually report what happens in your brain after you ingest artificial sweeteners? I imagine the sweeteners’ effect on the “sweet receptors” in the brain and the subsequent instructions to your organs are the bigger problem. People are probably “sweet receptor” junkies as much as they are measureable-insulin-spike junkies. If they are this kind of junkie, they will keep going back to an artificial sweetener or natural one on the same kind of roller coaster. And the idea of a swish and spit test seems ridiculous. The real effects of this kind of ingestion happen when this stuff runs through your intestines and gets processed in your stomach. I don’t need to have contact with very many overweight and/or moody Diet Coke drinkers to keep me off of the stuff.

  6. Humans and dogs and cats all process things differently. What may not be poison to a human can be lethal to a dog think chocolate. Also, their bodies do thinks that ours don’t like cats make their own vitimin C where human can’t.

    So, any test done on an animal other than a human we should view it with a grain of salt and understand that it may not really apply to us humans. All we really now for sure is that those animals in the test had a certian response.

    I think it is best to stick with something that has not been over processed or made by man when deciding to put it in your mouth. That said it can be hard to avoid the occasional sweet. When that does happen I go for the real thing.

  7. 8 years ago i was using artificial sweeteners for my oatmeal. when i cut it and replaced it with fruit, my energy levels increased , my mood has changed. Since last year i even cut the oatmeal and went 99.9% primal. so happy..even my teeth problems gone away since i am not getting any sugar at all.

  8. Good info Mark! I don’t see any that would be an acceptable substitute for the life we’ve taken on. Better to play it safe if you can and do without. Now that I’ve gone through all the issues with taking processed foods and sugars out of my diet, I don’t think I would want to experiment with them to see which ones didn’t have any insulin effects on me. LOL.

  9. did you know that if you leave Equal in piles near where ants are invading your house, they will carry it back to their nests and kill off the whole colony… food for thought!

      1. Great! I’ve been wondering what to do with that bag of Equal! haha

  10. You briefly mentioned xylitol in the first paragraph in regards insulin spikes in dogs, have you found it has a similar effect on humans. And how about other sugar alcohols, ie, malitol, erythritol? Anybody?

    1. I use xylitol in moderation. also it is in my chewing gum it is great. It is natural (made from Birch Trees) I have noticed no ill effects from it. It is not good for dogs though.

    2. I like xylitol in my toothpaste, but didn’t like it as a diet supplement, I feel that it interfered with my normal gut flora, probably killing or inhibiting them, so I stopped eating it. Also, it is expensive, so I figured a little real sugar is better.

  11. As a Type 1 diabetic Primal 2 yrs-
    For me-
    absolutely no effect on my BGs at all -Stevia -nil not one bit

  12. Oh good grief, people. I’m tired of the holier-than-thou attitude about artificial sweeteners. If they cause you trouble, then abandon them, but don’t make it sound like those of us who use them are somehow “unnatural”. We use a liquid form of sucralose that we buy on-line (therefore, no dextrose, no carbs). One drop on our morning coffee or tea and that’s it. We have been doing low-carb/Primal/Paleo long enough to have absolutely NO cravings for carbs anymore. No binging, no problems.
    Thanks, Mark, for the word on these. People try to make these out to be the devil in disguise. My opinion is, no harm, no foul. Everybody is different.

    1. Great reply, I was in danger of being severely brainwashed just reading the replies in this topic, it’s great being careful with regards to your health and what you eat, but obsessiveness isn’t a great state of mind! For me I think sucralose is one of the safer sweeteners. i don’t react as badly to it as acesulfame k and aspartame in whey protein products.

    2. Thanks. I would have to agree. I’m a bodybuilder and have cut out sugar and simple carbs completely out of my diet for the past year. I don’t miss it and I never really have a craving. But it’s nice in the evening to down a protein shake with a little sucralose in it as a dessert treat. I never feel a spike or a low after so I know it’s not affecting my blood sugar at all.

  13. um actually I pick sweet and low over any other kind of artificial sweetener (which is often if I’m getting tea or coffee out, because it takes a lot less artificial sweetener than sugar)

    Why? it has the least aftertaste, and its just what I’ve always used. I can’t stand splenda in anything – even using it myself in proper amounts (As opposed to the over sweetened diet drinks) it has the worst aftertaste of all of them, despite the fact it isn’t supposed to have one…

    1. I’ve always used sweet n low too, and have tried just about every other sweetner and most just don’t do it. Stevia is fine in cold things, but in coffee…BLEH~ Can’t do it, it’s MUCH more bitter than S&L. I figure it this way…Saccharin has been around longer than most of the others, and I just can’t find that much negative press about it, especially when in comparison to Aspartame! Until I find something natural that actually tastes good in coffee, I’ll do my little pink packets~

  14. Mark,
    Considering the cephalic phase insulin response occurs due to a majority of reasons – sight, smell and even thought – is it really a bad thing to have some insulin response from sweeteners? Sure, this is no reason to dump half a dozen Splenda’s in your morning coffee, but a rare pack or two when getting used to the low carb thing might be more beneficial to folks. What do you think?

    Make no mistake… I hate those bastards and would rather eat honey if I wanted something sweet.

  15. Makes me wonder if that Now Foods Xylitol Toothpaste is jacking my insulin every morning/night.

  16. “The commercial version of sucralose, Splenda, is cut with dextrose as a bulking agent.”
    In the UK, Splenda Granular is cut with maltodextrin. One teaspoonful weighs 0.5g and contains 2kcal. Splenda tabs are cut with ~30mg lactose.

    1. Thanks Nigel, I wanted to highlight the point as well that most of the things (particularly products) discussed tend to be very American specific. For instance, HFCS is not at all used commonly in other countries like Australia, and neither is diet ‘soda’ marketed to people as something that assists in weight loss (as was implied in the diet soda post). Along the same lines, artificial sweeteners are also not marketed as such (eg no ads on tv, maybe in womens’ magazines).

      The reason I bring it up is because a lot of the advice on here seems just a tad alarmist, and seems to be to deter people from relying on these sweeteners and on diet sodas for weight loss. There are some of us here who use both of these things occasionally (eg diet coke/ coke zero/ xylitol/ equal once or twice a week) with no ill effects at all. And at such a low frequency of consumption, I would rather drink a can of coke zero/ diet coke than one of regular coke with about 9 teaspoons of sugar…. the insulin spike from that would wollop the one from diet coke.

  17. According to Gary Taubes, in his book “Good Calories, Bad Calories,” there was a study conducted by Stylianos Nicolaidis
    which demonstrated that rats will secrete insulin in response to a sweet taste, regardless if it’s real sugar or a no calorie sugar substitute, implying that the body responds to the perceived taste of sweetness by releasing insulin. This study is compared to Pavlov’s dogs, which would salivate at the sound of a bell, which was associated with feeding time. Our bodies are capable of similar responses. So, Nicolaidis suggested that the release of insulin is “pre-adaptive”, meaning our bodies anticipate the effects of a meal or particular food and so prepare the body regardless of its caloric nutrients.
    I apologize that my version of the book is digital, so I don’t have proper page numbers and can’t figure out what chapter this is, but if anyone is more clever than I, the Kindle page is: 8,878-86 out of 13,715

      1. You are just full of perceptive comments, aren’t you?

        Yes, any sweet food can cause this reaction. However, these foods are not being ingested under the assumption that they are doing nothing to our bodies. People have been sold on these chemical sweeteners- liquid or powder- as completely care free sweetness. If they have some effect on insulin, then they are not really what they are claimed to be. This is on top of the known and suspected problems and toxicity of these sweet chemicals.

        1. I meant ANY food, not just sweet ones… “our bodies anticipate the effects of a meal.” And most of the “chemicals” are not toxic. That’s the point. Just labeling a substance as toxic doesn’t make it so.

  18. Sylvie wrote: “demonstrated that rats … implying that the body responds to the perceived taste of sweetness by releasing insulin.” Which suggests henceforward that rats should avoid sweeteners, yes? {tee hee hee!}

    Mark, I decided a month or so ago to stop all use of Splenda (liquid Sweetzfree — no carbs at all) in the hopes of seeing a drop in my pre-diabetic blood sugar. No such effect yet.

    I did find at first that when I’d sit to a meal, my reaction was: “I CRAVE my sweet drink.” (I used Wyler’s brand of strawberry “koolaid” – but I have never found it to make me crave anything except my strawberry drink.) (I also use a small amount of Splenda in my morning coffee, with 1 TBLS cream and 1/4 cup of unsweetened almond milk.)

    I switched to drinking water with (1/4 to 1/3 cup) lemon juice (not from concentrate) — but ended up putting two drops of the Splenda in that too. But it’s good to know I can go back to my strawberry drink, once I’ve made sure the Splenda isn’t affecting my blood glucose. Thanks!

    1. You’ll get more of an insulin response from cream then you will splenda.

  19. Yeah I’m inclined to agree with Sylvie above. If you eat enough Splenda in one dose, I think it does have an affect. For the first time since I began the challenge three weeks ago, I decided to have a sugar free dessert. It was a kiddie Rita’s ice sugar free cherry.
    1.) It tasted crazy sweet to me for sugar free, but this is because I haven’t been eating my usual sugar laden garbage I’m guessing. 2.) Shortly after consuming this I felt so bad almost like low blood sugar. It was if my body reacted to the sugar free like sugar.
    Luckily it subsided after a few hours of feeling yucky. Also, I think they use a lot in the SF ice because it’s listed as having 30g of carbs on the internet. That’s a lot of splenda for 30g of carbs, and I think that it would influence your insulin at that high of a sweetness level.
    Needless to say, I’m going back to my 2 ounces of dark chocolate or fruit if I need a sweet fix.

  20. I use sweetener in my coffee and its a noname brand. The ingredients just say dextrose. Is that the worst one to use cuz mark said “Dextrose is essentially glucose, which certainly elicits an insulin response,”????

    1. I reckon that quote from Mark you post there is pretty much saying dextrose is going to have an effect, but it’s up to you whether that’s something you want. Keep in mind that a lot of the artificial sweeteners aren’t tested, so one being labeled as toxic and another not might simply be that the second one doesn’t have data on it.
      Maybe go by how you feel when you drink it?

      1. Dextrose is a glucose polymer. Glucose is what every cell in your body runs on. You should be able to digest it very easily (not as sweet as sucrose, which contains fructose, or fructose) but so can your gut bacteria, heh heh. Taken alone, it will cause a BG spike.

  21. We’ve been using xylitol cause of it’s purported (and now observed) benefits with discouraging tooth decay (have a 3 year old) and my question is – is xylitol considered an artificial sweetener? it’s derived from the woody stems of plants – birch trees, corn stalks – and it’s an extraction process – not “naturally” occurring (but then sugar cane is extracted too i guess…) technically it’s a “sugar alcohol” and has a GI of 7 rather than sugar at about 100 – OK, so – it “feels” pretty clean to use it, no jitters or nausea- however i notice that there is still a sweet craving i occasionally get that xylitol does satisfy –

    Since going primal – i have had increasingly intense reactions to falling off the wagon – i used to be able to down a whole bag of potato chips no prob(yes , i know) and now when i have just a big bowl i get nauseous and have that empty-gut kinda feeling (unpleasant) – and xylitol muffins or whatever does NOT do this – i am assuming that the chips (starch quick into sugars) are spiking insulin while xylitol just is not? mind f*ck or real??

    1. Xylitol has, iirc, 2kCal/g, so it has half the caloric density of carbohydrates. It is usually well tolerated but all of the sugar alcohols may have laxative/IBS effects in susceptible individuals.

      Xylitol is protective of teeth when swished around in the mouth (as in xylitol gums or toothpastes). One reason is that destructive oral bacteria cannot consume xylitol for fuel and thus starve out. I can’t fathom what eating xylitol in food would do for you except to reduce caloric density & possibly cause unpleasant gut problems if you are prone to that sort of thing.

      If you are concerned for your little one’s teeth, vitamins A, D, K, and Calcium should be on your mind. Sources include cod liver oil and milk. There are lots of controversies about milk, which does vary in micronutrient content. Nevertheless, even with the problems with the US milk supply, a recent study showed that milk-drinking children had better bone density compared to children who did not drink milk.

      IMO, whole milk from pastured cows or goats is best for children. Children should never receive raw milk–severe gastrointestinal upset and death are among the risks. (Children also do not “need” raw milk as, unlike most adults, they produce plenty of lactase in their guts. Some children, due to genetics, do drop off in lactase production around 7/8 years and kefir or yogurt can be substituted. These fermented products contain much less lactose than milk.) There is also a claim that certain breeds of cows provide more healthful milk than others. That’s the perfectionist approach; I’d say that USDA A+D fortified whole milk is “good enough” for dental health, if that’s your concern. (That said, I personally won’t buy any milk from cows fed rBGH. At the very least, it’s cruel, and the use of it hurts small dairies the most.)

      1. “Children should never receive raw milk”

        Nonsense. Absolute garbage. Children have been happily consuming raw dairy products for as long as homo sapiens sapiens has been consuming dairy products.

        Choose a clean, safe, fully pastured source from a producer you trust. Ask for the lab reports or have it tested yourself if you’re concerned. But don’t deprive your children of the benefits of healthy, grass-pastured raw milk due to this kind of alarmist nonsense.

  22. I think part of the reason why this is talked about also is due to the fact that a lot of artificial sweetener packets include somewheres around a gram of maltodextrin which if i am not mistaken is a starch aka a carb, no? So if you are putting 3 or 4 (i have seen some people put seriously like 10) packets in your morning coffee that will have some kind of impact on your insulin levels!

    1. Yep, which is why Dr. Bernstein, the diabetes expert, recommends liquid sweeteners or tablets.

        1. That are basically inert. Many “natural” substances are certainly not so. What’s your point?

    2. But notice no frucktose. That last word may be misspelled. Perhaps the “r” should be dropped?!

      1. No, it’s the “k” that should be dropped… as well as the poor attempt at a joke…

  23. Hi Mark…I love coming to your page every day and reading about the primal lifestyle, which I try to do to the best of my ability because I truly do think it is a healthy way of living. However, I’m in college and the 50 plus food trucks on campus are sometimes too enticing to resist…mmm crepe truck…but thats not why I’m writing this. I merely have a question about Grok. My question is this: You state that pre agricultural revolution, we were a rapidly evolving species (namely our brains were evolving and growing) Now, you say, post AR, because of grains and wheat and ultimately sugar, we have slowed down this evolutionary process. Based on the mounds and mounds of evidence you bring forth, I can appreciate and mostly agree with your theory. (You yourself can admit it still is only a theory) However, it seems to me you are very focused on only biological evolution, and not what some (and I) may call “cultural evolution”, as in how we have evolved socially to interact with other humans. This undoubtedly is something that should be noted, because Grok and his mates certainly did not interact with one another the same way people did in Greece or even today. (Im on the interwebs and all writing this!) So, finally, what I want to ask is, isn’t it just as likely that at the dawn of the Ag. Revolution, we did not only have a major shift in our diet, but a major shift with our culture…and this, just as the diet, had an effect on our minds. No longer did we have to develop our brains to outsmart prey and catch or scavenge for dinner. Now that we could grow our own food, this need to evolve mentally wasnt as necessary, not on a dietary level, but because our daily lives shifted to more of an inter-personal level. It is merely a question, and I’m sure you are more than capable of a response. Thank you so much for your website and time.

  24. So what do those going Primal use as a sweetener? Sugar? Or nothing, no sweetener? Sounds like there’s nothing wrong with these artificial ones (except that they taste bad and prevent you from eating real food and drinking water). Just curious.

  25. We use Truvia the majority of the time, mostly in coffee or tea and occasionally use Splenda. But that’s maybe 1/2 a packet if nothing else is available, and something needs a bit of sweet to make it taste better.

  26. I gave up artificial sweetners after being on it between the ages of 4-35. The doctors back in the 1970’s told my parents that I was “allergic” to sugar which is actually impossible since sugar has no protein to be allergic to. As it turns out, I had related symptoms of Celiac disease that was only just diagnosed 3 years ago. I ended my love of artificial sweetners when I came down with something that has been termed “splenda flu” on the internet (headaches, joint aches, fever) I gave up splenda and all other artificial sweetners and never looked back. I use honey, sugar in the raw, and a little agave. If you are going to consume something sweet then just own it already. A teaspoon of honey or sugar only has about 4-9 grams of carbs in it. You can’t get around that sweets are not good for you. There is no magical way around it. Please also note that many people with Celiacs Disease report allergic reactions to stevia for some reason. So, not too sure about stevia being all that good for you either. Good luck picking your poison!

    1. I get migraines from stevia–didn’t know there was a connection with celiac! I have been on a gluten free diet for several years with much improvement

    2. I agree about being weary about stevia. It is not good to assume that something that is natural is good for you. Marijuana and tobacco are natural and plant derived, and these are NOT good for you. Many “natural, plant derived” substances are poisonous. I’m sure stevia is fine in moderation, but lets just not assume is has no harmful effects just because it comes from a plant.

      1. Marijuana is a plant thats NOT good for you??? Im sorry for you… Especially since you put it into the same category at Cigarettes which are loaded with chemicals, have no medicinal benefits at all and are reponsibile for millions of deaths! Please do some research about it before just posting. Give concrete evidence its bad…

  27. Before going primal I drank 2 cans of soda at lunch and dinner. I switched to primal and I couldn’t stop having that sweet drink with my lunch and dinner so I made fresh squeezed lemonade with Stevia. I now only drink lemonade with dinner, hopefully in a couple more weeks I will be strictly water and away from artificial sweeteners altogether.

  28. If any study showed bad affects from Splenda, it is due to the dextrose they use as a filler.

    I only use liquid Splenda that is pure Sucralose and nothing else. Thus for a 12 oz glass of limeade that is very bitter, I only need to use two drops of Splenda.

    The brand of liquid Splenda i recommend is Sweetzfree. You can buy it on the internet. A 1 oz bottle lasts me 3 months.

  29. Mark,
    Great post!
    Obviously, you sort through a ton of research and evidence to put together a post such as this. It seems that many studies contradict one another. I was wondering how you critique all of these papers and studies. Specifically, I would be interested to see the demographics of the study participants as well as the methods employed. There are so many confounding variables that aren’t always apparent in an abstract.

  30. Here’s an interesting thing about Splenda/sucralose. A few years ago there was a paper published in Nature or Science (I don’t have the ref off the top of my head) wherein they had successfully sequenced the first human “microbiome.” That is, they basically scraped the GI lining of some poor grad student (actually I think they’re n was like 3 or something) and they sequenced every bit of DNA in there to find out what kinds of microbes normally inhabit the GI tract and then figure out what they’re doing metabolically.

    There was one result that was immediately striking to me, but which the authors of the paper didn’t appreciate, nor do I think anyone has picked up on this yet–there were de-cholorinase genes they picked up. The thing that prevents both us and the bacteria from metabolizing that sucralose is the presence of the chloride groups on the sugar backbone. Well, if you’re a bacteria and you get an enzyme that can cleave those pesky chlorines off, you suddenly have yourself a unique resource that you can metabolize and your competitors in the GI tract can’t.

    The question then is whether these bugs are doing this intra- or extracellularly. If they’re secreting dechlorinating enzymes extracellularly, then there is some leakage obviously into our own cells. The authors did point out that some 10-15% (by their estimates) of our caloric energy was provided via interaction with our bacterial commensals (although, again, not necessarily by making Splenda metabolically available to us).

    Most people tend to forget (or never knew to begin with) that they have more microbial cells in and/on their body then human cells–so we can’t ignore their impact (though the problem is that we’re still in our infancy scientifically in understanding what exactly that impact is). The bottom line is that bacteria can evolve clever ways to extract energy out of just about anything (they’ve had 4 billion years to figure this out). We can make up all these compounds to trick our body and metabolism, but those are potential food sources for bacteria and they’re going to find ways to metabolize that stuff. And so depending on how efficient they are at it, how much of said resource you’re consuming, etc., it wouldn’t surprise me to find people thinking they’re adding no calories in a soda or whatnot, and actually getting some energy via microbial metabolism.

    So it’d be interesting to look at the insulin responses of people who habitually have high levels of artificial sweetners in their diet vs various other populations. My guess is that in cases like the poster above who used to “pour” the Splenda over everything (I used to be guilty of buying those big bags of Splenda and using tons of it too…), you’re going to select for commensal GI flora that can turn it into real sugar and you’re potentially looking at some of that leaking into your own cells.

    As an aside, in response to Gabrielle above, yes, you can have an allergic reaction to sugar. One of the fundamental steps of the innate immune system is to react to little bits of bacterial polysaccharides (most bacteria are covered in “coats” of long chains of sugars, sometimes with amino groups, lipids, etc thrown in). I’m being technical here–I’ve never heard of anyone having an immune response against a mono- or di-saccharide because, that would be a pretty lethal condition (though we do see conditions autoimmune conditions where we make antibodies against our own DNA, so I suppose anything is possible). But could your immune system mistake some longer chain polysaccharide from a dietary source for a bacterial one and lead to an inflammatory response–certainly. So thus, you could be allergic to sugars, although if they’re glommed together in a chain, it would technically be more like a starch allergy, and well, I don’t think I need to tell anyone posting here about that process. I’m just saying there is a very small possibility your immune system could go haywire and get activated over smaller chains of polysaccharide than we might see from say your typical grain.

  31. My dad’s been suffering from diabetes since 8 years ago. He’s already undergoing dialysis twice a week due to his renal problem as a complication. I just hope the medical society get better researches about all these stuff including artificial sweeteners.

  32. Testing your blood to determine effect has been mentioned several times however unless you are checking for insulin testing is not germaine to this discussion, right? Nobody is suggesting that artificial sweeteners raise your blood sugar, just your insulin. Theoretically if there is an effect a diet soda would lower blood glucose and potentially create hypoglycemia in a normal person? now if you are choking down bun-less cheese burgers and bacon cakes with a diet soda, an insulin increase would not be a good thing.

    I test my blood regularly (not diabetic just interested to see what food does to the blood)may have to experiment and see what turns up.

    Thoughts about testing and insulin response?

    1. Well – it seems like if a certain substance caused an insulin response, then blood glucose would necessarily go down. Is that right?

    2. It IS possible to test insulin levels, but not in an at-home monitoring system that I am aware of. Now THAT would be cool. Let’s make it and get rich! 🙂

  33. Mark,

    I highly recommend for you to check out the book The Hormone Diet by Natasha Turner. The book covers the affects of artificial sweeteners on our hormones – especially on the sensitivity of insulin. Those guys are terrible for you, really. If you’re going to use any art. sweets. stick to stevia. But yeah, check out the book, it changed my mind – and now I’m studying hormones at Harvard 🙂


  34. I was surprised that you didn’t mention stevia , but nice post , thanx mark but i don’t know about this “Does sucralose (aka Sucralose) affect insulin?”

  35. Since going Primal in February of 2010 I’ve lost 104 lbs. I’ve eliminated grains and sweets except for rare occasions but the one thing I havent been able to kick is Coke Zero. From personal testimony it must not be having much of an effect on insulin because of the weight loss. I’m sure though I should kick it for some other reason.

  36. Mark any comments on whey low? In their info they state it causes no insulin spikes.

  37. Since I gave up artificial sweeteners my goiter has gotten much better.

  38. I gave up artificial sweeteners almost 6 years ago in response to side effects-like headaches, dizziness, and even panic attacks- that they were causing me. Granted I was having a fairly large dose of them, along the lines of 4-5 20 oz diet sodas a day. All symptoms stopped within a week of cutting all artificial sweeteners.

    I am also suspicious of stevia, I wish there was more info on what that does to a body, or if the body anticipates something sweet and reacts as it does with articial ones.

  39. I use xylitol in the only sweetened food I have which is my daily coffee. 2 cups per day with a spoonful of xylitol in each. I don’t do primal baked goodies and find fruit (which I eat rarely) to be enough to settle any desire for sweet food.
    It doesn’t induce cravings and I have it in such small amounts that I really don’t worry about it.

  40. Hey Mark, I’m just wondering about the Purdue University study that came out a couple of years ago linking artificial sweeteners to weight gain. Where would that fit into all of this? Are you thinking that it’s not insulin secretion, and rather another mechanism that could be behind this weight gain, such as psychological dependence/lessened insulin response to other sugars/??? Just curious as to your thoughts. 🙂

    1. As Dr. Eades states time and again, correlation is not causation, and there was no hard evidence presented, only weasel words such as “suggests,” “suspect,” “might,” etc. And the study was done on rats. Another one using a few fat people relied on self-reporting. More than likely, they were consuming loads of refined carbs along with the diet soda.

  41. Seems to be a lot of Primal folks out there who still dable in artificial sweeteners. I can understand the appeal as well as the intense cravings, however I would like to offer encouragement, as others have, to just try to cut out all of the sweet stuff. Give it a few weeks and see what happens.

    The only sweetened food I consume, now that I am Primal, is 85% cocoa or higher dark chocolate. Chocolate has always been my weakness. Just out of curiosity, I helped myself to a Hershey’s milk chocolate kiss at work. I almost had to spit it out it tasted so disgusting to me. My taste for sweet has become so sensitive after only about 5 months of living Primal that I not only don’t crave sweet, I don’t like it.

    And as a few others have pointed out, I can taste and appreciate other flavors more now.

    I know I’ve never had as strong as sweet tooth as some but I’ve never been disgusted by sweets before now. I have to think that with a little hard work and a system of alternative rewards in place, most people could experience a similar effect.

    1. @fritzy. Agreed. I no longer like the taste of those sweet things I used to like. The only sweetener I have is stevia, and I only have that in my morning coffee and in my whey protein shakes (and even then in only very small quantities). I tried a piece of milk chocolate a few months back and had the same sensation, not only because of the sweetness but also because of the milk.

  42. I had a feeling it was going to turn out this way and I’m ashamed I didn’t do my own homework on the subject.

    I had been saying for a while that if they *have* found an association between artificial sweeteners and insulin spikes, either it was going to be that cephalic response thing, or it was going to be from the bulking agent, which is usually either dextrose or maltodextrin or both–and both are sugars. Nice to know someone bothered conducting studies that controlled for the bulking agents.

  43. By the way, I don’t have trouble with artificial sweeteners in the sense of them making me eat badly. (I don’t think aspartame agrees with me, and I hate the taste of saccharin, though.) But I usually favor savory snacks over sweet, and only want a sweet treat every now and again. I do want my coffee sweetened, but I have maybe two cups a day. (Kicking caffeine is on the agenda, I just haven’t gotten around to it yet. Kind of nervous at the prospect, actually, as I suffer from various types of headaches.)

    For the record, I am disgusted by sugar-sweetened foods now. They are too sweet for me *even though I am still using Splenda.* Although Splenda does taste very close to sugar because it’s really nothing more than a chlorinated sucrose molecule, it apparently doesn’t taste close enough. So it’s not a sure thing that you won’t lose your taste for sugar just because you are still tasting things that are sweet.

    Also, I have long had an appreciation for herbs and spices, and I was eating brown rice before it became cool and trendy, because I liked that taste better than the white rice as well. I have a fairly sharp sense of taste, unblunted by my liking for sweetened coffee.

    So it’s not a sure thing that X behavior will produce Y result or that everybody who likes sweet stuff has some kind of eating disorder. I don’t believe *all* things are OK in moderation, but occasional sweetness *is* part of our evolutionary experience. So unless it’s really messing you up to taste something sweet now and again, don’t guilt-trip yourself to death about it.

  44. Back when I was drinking huge amounts of iced tea and sweetening it with Sweet N Low, I noticed that I got hungry all over again after drinking it, even if I’d just eaten half a chicken for dinner.

    I am not sure if other artificial sweeteners did this to me, because I don’t remember testing them this way.

    I have at times gotten a headache when using Equal, so I don’t use anything else but either saccharin or stevia.

    I can get away with a little bit of iced tea and pure saccharin (Necta-Sweet tablets) but note that Sweet N Low (and lots of the others) are “cut” with maltodextrin, dextrose, and other “nutritive” sweeteners etc.

    Sugar alcohols can give humans diarrhea. I once bought and ate some Girl Scout cookies with xylitol in them, and it was just like using Ex-Lax and about as prompt.

    I like stevia. I like the taste of the white powder better than green powder, but I just ordered some green powder to get used to, and also some tablets for iced tea when I’m out and about.

    I think that for some people, caffeine can affect blood sugar and insulin levels also.

    The problem for me, and for other people, is that if you use enough of any kind of sweetener, you risk stirring up sweet cravings again.

    1. If you buy high quality xylitol, it does not induce diarrhea. I had the same problem with the cheap xylitol, ie Now Brand at $9 a bag, but then I was introduced to The Ultimate Sweetener Brand, $18, and it never bothers me.

      I use Stevia as well.

  45. I think in general artificial food is non-beneficial and artificial sweeteners are linked to cancer. that said, I do chew sugarless gum. I am VERY sensitive to sugars and carbs but I have no apparent and immediate impacts from gum.

  46. I love coffee and don’t use sugar but I can’t go so far as to drink it black. I always choose sweet and low because saccharine passes through your body unchanged while Equal breaks down into 3 different compounds. There is no evidence that these 3 compounds hurt you but not enough study has been done yet.

  47. In light of how most research is conducted today, you have faith in a VA/Nutrasweet sponsored study? Really? I’d bet dollars to artificially sweetened donuts that a real researcher with no conflict of interest would prove otherwise.

  48. This was a great article.

    I bet the first few days without artificial sweetness are tough, but once you’re over that first hump it gets easier.

    I might give it a try. BUT, I really like protein shakes. I know I know, Grok never had access to shakes. But they’re really convenient for an on-the-go gym junkie. Maybe this could be my ONLY source of sweetness.

  49. if it tastes sweet, I will overeat.

    I’ve tried them all, and my belief is that if you have hyperinsulinemia, meaning reactive insulin, sweets from any source will trigger insulin.

  50. I’ve been interested in this question so thank you for this article.

    It seems to me, however, that in the big picture, whether or not we get even a small insulin response from artificial sweeteners doesn’t really matter. That is because protein intake has shown to cause insulin response, sometimes a very large response in the case of whey for example. So whether or not you cut out all sources of sugar or sweeteners you still are getting ample insulin response on a paleo diet.

    Is this line of thinking correct? If not, please correct me, as this has always been a point of confusion for me regarding avoiding sugars because of the insulin response. Thanks.

    1. dave…i’m with you on that. i don’t think insulin is a bad guy at all. an insulin spike isn’t a dangerous thing either (in healthy people) …therefore…insulin isn’t dangerous…we actually need it of course (diabetics). what we don’t want to do…is damage our metabolism so that the insulin doesn’t do its job. that’s the danger. you’re right, protein and dairy have considerable insulin responses…but that doesn’t make them unhealthy. just like it seems some primative cultures could eat a lot of stachy tubers (glucose) and avoid western disease. they would obviously have had an insulin response but a healthy one. the things that damage this are fructose, n-6 veg/seed oils, wheat. i’ve read some evidence that insulin is more than just for shuttling glucose into cells, that it also acts as a brake to stop your liver from producing ketones or releasing stored glycogen in the presence of glucose. this makes sense if you think about ketoacidosis and can even help explain hyperglycemia in type 2 diabetics. (blood sugar is high and not only is it not being lowered by absorption to cells but your own body is keeping it higher by still releasing glycogen as it hasn’t gotten the message). i’m like mark…i don’t eat fake sugars…but that would be the case regardless of what the insulin response is. i’m curious to hear what others have to say on this…as i’ve been trying to piece this theory together in my mind for some time. i believe mark has touched on some of these aspects before (like the insulin response to dairy).

      1. the healthy skeptic has just written a good piece suggesting that avoiding disease is about more than just keeping one macronutrient low etc. that it’s certain types of each macronutrient that damage your metabolism (and insulin response). similar information can be found in various places here on mda of course.

        that said…there are probably still benefits to low carb for your daily life than just whether or not “safe” carbs can lead you to disease…at least in my mind.

  51. In her book Kiss Your Dentist Goodbye Dr. Ellie Phillips discusses the research supporting protective effect of xylitol against caries.

    1. I managed to reverse a cavity using Dr. Ellie’s simple, inexpensive protocol – my dentist called it “magic”!

  52. I simply cannot eat sweets of any kind; they tend to trigger a binge. Except for those small amount of carbs found in raw foods such as vegetables, I simply must avoid all carbs with emphasis on sweet flavors. I even avoid fruit.

  53. In 2009, I was on an extended backpacking trip with my husband. I brought some of those electrolyte hydration tablets that you add to water. They are sweetened with sorbitol and acesulfame K. After drinking part of my water with the tablet, my blood sugar crashed horribly. My legs were so shaky that I had to sit down.

    My husband, who isn’t afraid of artificial sweeteners, took the rest of my water and the same thing happened to him.

    Never again.

  54. I have a very serious Coke Zero addiction. I drink about 7 a day. I know it’s bad for me to have that much and the caffiene is probably just as bad for me as the chemicals. But whatevs, I am cool with the risks for the enjoyment of drinking Coke Zero.

    I switched to a lowcarb diet four months ago and have lost 30 pounds effortlessly. I have only 10 more pounds to go and I’ll be back to my size 4 high school weight.

    I would say that if I can drink 7 Coke Zeros a day and still loose weight it’s probably not a big deal insulin wise.

    Also I tried to give it up fearly it was causing an insulin response and I gained 3 pounds during the time I was not drinking Coke Zero and lost the three pounds immediately after starting to drink it again. This may be related to the stress of withdrawal though.

  55. After seeing the ‘Sweet Misery’ documentary, no need to even consider aspartame anymore.

    What would be interesting is, to compare these 0 calorie sweeteners:

    Stevia (SweetLeaf, Skoopz, etc)

    Chicory Root / Vitamin C
    ( )

    Whey Sugar (

    Monk Fruit / luo han guo extract ( )

    Sugar Alcohols ( Xylitol, Erythritol , etc) (, etc)

    and maybe even fructose, honey, and agave, all of which have calories, but are said to not have much an effect on blood sugar.

  56. I was invited to a lunch meeting with few professors from Sweden and Iceland the other day. They showed me results from studies they had done on artificial sweeteners and even though you keep reading blogs from people saying they are going to spike your insulin, give you cancer and what not their results could not confirm any of this. They even told me about a German study on aspartame where they tried to induce cancer in rats over 12 months with dosage so high that a person could never consume the same amount in 9 months the results… cancer, no problems, nothing!

    I’m just one of those people that I don’t believe the hype, show me the studies and I’ll change my mind until then, artificial sweeteners are not going to kill anyone 😉

  57. ugh… if it’s “artificial”, simulated or whatever, I just don’t eat it. If I want sugar, I use sucanat. I put some in my coffee. I use honey, molasses, or maple syrup in some cooking applications. Once in a while stevia in a beverage. That’s all. I’ve used tom’s toothpast for years, so I know how sweetened all the others are (yuk!)

  58. Mark would having one diet coke can a day be a problem? if this was the only soft drink i had…

    Im thinking about going Primal but im still not sure if i can do it. I have everything low caloric, including yogurt, cordial, butter etc.. im worried this is my problem with staying a big girl.. i have always been a big girl since i was little. im looking into my hormones and have always been insomniac, I seem to do well if i count calories but its a lot of work to concentrate on. But the weight comes back as i do like my chocolate and abit of a drink. i know i sound like i want something without doing it properly. i believe you only live once so you should enjoy it.. however i do want to be healthy. Im so confused on what is wrong & right … between carbs, low calories, sweeteners & proper fat.. im LOST

  59. I read once that just thinking about food would bring a response.I use equal and see no effects from it.I think people just have to listen to their body and adjust.I think all the posts about sodas,well i think cokes and such encourage cancer by being acidic.I still have a diet coke once in a while as a treat.(you must remember the old leaving a penny in coke and see it slowly disolve with time thing)soda pop just isnt good for you.regular non diet soda has just an incredible amount of sugar in it.

  60. The responses here could make a very nice study on why people believe anecdotal research vs real studies when it suits their belief structure. Thanks for trying Mark!

  61. So I’m going to have to give up my diet coke-a-day addiction (and crystal light addiction)… Ok, but what is the best choice to add to my morning coffee and afternoon tea as I try to cut it down to less and less until I acquire a taste for no sweetener at all?

  62. I didn’t see alot, if any, DIABETICS posting here.
    I am a Diabetic, Insulin-dependent, and I use SPLENDA daily. I can tell you that it does not effect my Insulin levels and I do glucose finger-sticks daily also……
    For me, SPLENDA, is he best sweetner on the market!

  63. Thanks for a very informative article, and to all those who mae comments

  64. This is an old thread but this topic is pretty interesting to me and I think my experience is different from the majority so I thought I’d post it.

    I am a low carb guy and have been for quite awhile. I also was a Diet Pepsi junkie and drank a lot of the stuff (around 250 ounces a day – not a typo). With lunch (salad with chicken and pork, pico de gallo, a little hot sauce and cheese) I’d typically have 100 oz of Diet Pepsi and I notice I’d be nearly passing out from a lack of energy an hour later. So I eventually quit the Diet Pepsi and switched to iced tea.

    The results were that my desire to sleep after lunch stopped occurring immediately and I ended up losing 14 lbs of fat and gained 6 lbs of lean muscle mass in 6 weeks. This was roughly 4 months ago and any cravings I had for sweet tasting beverages has completely gone away.

    Unfortunately I didn’t have my glucose meter back then so I don’t have any test results to see if I was experiencing a crash in blood sugar levels. I’m thinking of doing a test of this but it’s hard to raise any enthusiasm for the project since I’ve been so good since then and don’t want to mess up my success.

    So my personal experience is that large amounts of Diet Pepsi were doing something to me as my energy levels and weight changed as soon as I ditched the stuff. Whether it was the DP is impossible to say but it was the only thing that changed during this time period so I’m not certain what else it could be.

  65. I get cold sores from all all artificial sweeteners apart from xyilitol and Stevia.

  66. Quoting Jimmy Moore in this otherwise well-written, informative article?? EPIC fail, dude. If Jimmy had any real clue, he wouldn’t have been on essentially the same diet since 2004 – still expecting some magically different result. Jimmy Moore is NOT paleo – he’s just adopted it to make money.

  67. We recently took my 11 yr old daughter and I off sweeteners. We have been off sugar for quite awhile and increased our artifical sweeteners. They created a huge Binge Eating Disorder in my daughter as well as affected her attention in school. I am in more control of my eating in recent years but think artifical sweeteners have been part of the problem all along in my binge eating disorder and bulimia. It;s really amazing actually-I didn’t believe the pediatrician but have now witnessed it first hand!

  68. Okay, once and for all, anything that even potentially causes insulin secretion to go UP will/should cause blood glucose to go DOWN. Because that is what insulin does!
    So to do “as Jimmy Moore says” and “check your own blood sugar response [to a given artificial sweetener] and see how it impacts YOU,” in the text of this article is probably not going to tell you much about the insulinogenicity of any given artificial sweetener unless you consume it by itself. Because all the other macronutrients we eat cause variable degrees of insulin secretion (carbs from fruit and vegetable sources, especially).
    So the popular idea that I read on paleo opinion sites all the time that artificial sweeteners cause “blood sugar” to go up are barking up the wrong tree! The only blood sugar we can measure outside of a research lab is glucose. And glucose does not go up in response to insulin secretion; only the consumption of glucose or starches or sugars that are converted to glucose in the body (amylose, fructose, et al.), none of which these artificial sweeteners are proported to do – they are proported to stimulate insulin secretion – DIFFERENT.
    If you’re going to talk about the science of this stuff, please get it right 🙂

    1. * … fructose, etc.

      ‘et al.’ corresponds to personnel. (Brown, Jones, Smith et al.)

  69. I see several of these commenters are worried about artificial sweetener chemicals in their bodies but have no problem with drinking their coffee which is also full of chemicals. In fact it is reported that coffee has at least 200 carcinogens in its make up. perhaps worrying about the mountain instead of the mole hill would be more appropriate. Artificial sweeteners may be bad, coffee Way bad.

  70. I have slightly elevated blood sugar so I monitor it each morning when I wake up. I have a pretty good feel for what it should be each morning based on what I ate the previous day and how late at night I ate.

    However, once in a while I’ll forget to check my blood sugar until after I drink some coffee. I use either saccharin or xylitol in my coffee.

    I find that either one of these sweeteners will raise my blood sugar slightly – maybe 20 or 30 points. Not as much effect as a meal but there is definitely a small change in blood sugar from each sweetener.

    But, then again, maybe it’s the coffee that’s making the change. Hard to be certain.

  71. I have hypoglycemia. It is usually not a problem. I am not even that careful about what I eat. However, if I drink a diet soda, regardless of when I ate last, my blood sugar bottoms out in less than an hour. It makes me hungry enough to be nauseous every time. Perhaps it does not cause an insulin spike. Whatever the reason, the effect on blood sugar is very strong.

  72. I am a diabetic. I do not know if maybe it is some sort of allergic reaction or not but anything with aspartame makes my blood sugar soar. When I ran out of my insulin I could see 100 point spike after aspartame that would last all day. I do not have any reaction to Splenda (as of now).

  73. I’m doing the low carb diet, so, when I drink something, I use sweeteners. Of course, I prefer sugar than sweeteners, maybe, this point also helps our desire for eating sweets (as the sweeteners are not so good, you will not very interested in their consumption). Anyway, even eating sweeteners some times (not often), I’ve been loosing a lot of pounds.

  74. What a crock! The only non-sugar sweeteners that impact blood glucose and creates an insulin response are “sugar alcohols” like sorbitol, mannitol, and xylitol, and fructose. Less of an impact than sugar, but still significant. How do I know this? I’m a Type 1 diabetic on an insulin pump. I could drink only Diet Coke all day long and my glucose would be stable. And I have done this once in a while on busy days where I was concentrating on something and put off eating. If it rose, that would mean I would need to pump some insulin to offset it. Protein doesn’t produce an insulin response either, that’s why diabetics are encouraged to focus on meat and green veggies to keep our carb levels and insulin requirements low. Stop the panic! Artificial sweeteners are very helpful for controlling blood glucose and supporting weight loss, so I’m sick and tired of people trying to bash aspartame in particular, which has been clinically tested to death in double-blind studies by every developed country, and continually found to be safe except for those with specific genetic blood conditions. I have consumed at least 35,000 cans of diet soda over the last 30 years of having diabetes, and I’m in very good shape, thanks very much.

  75. Mark, I have a question that came up after I read your comments about Splenda. I work in a lab and have access to free lab work. I want to drink a splenda flavored drink and then have my insulin level drawn and my blood sugar checked. I would do this several times and also have it drawn after drinking plain water. I need to know how long after I drink the Splenda or the water should I wait before having blood drawn? I can’t find an answer anywhere. Does your pancreas shoot it out immediately after ingestion, or does it take thirty minutes for optimal rise? Please tell me what you think or know about this. I really enjoy cooking with splenda and drinking water sweetened with Splenda. I use the liquid splenda which bypasses the problem of the dextrose filler. Thanks

  76. All you guys blaming binge eating on Splenda are out of your minds. As a bodybuilder, I am a HUGE advocate of Splenda.

    One of the most rewarding things you can treat yourself at the end of a hard day in the gym and office is a cup of calorie free lemonade or fruit punch.

    When I cut right before summer last year from 10% BF to 7% BF eating ~1200 calories a day as a 180lb male and the only thing entering my mouth was alternating chicken breasts and protein powder throughout the day, I gave myself 80 calories to drink a cup of KOOL-AID if I really earned it that day. Such a SWEET reward and was a huge motivator to keep feeding away on chicken all day long.

    Let me tell you, the fact that now I can drink that same kool-aid with 0 calories is an even better feeling, now I can put those extra 80-100 ‘kool-aid calories’ to better use with some barbeque sauce for my chicken next summer.

    Stop binging, and stop blaming splenda – your issues are psychological and much deeper than that.

  77. I am from Brazil, and here we are lucky to have all sweeteners in liquid form (plus, cyclamate is legal here). This means they are diluted in distilled water (so, no extra carbs from maltodextrin, lactose or whatever), distributed in small flasks, and you put a few drops of the solution on whatever you want to sweeten. We have the powder as well, but most people prefer the liquid because it’s more practical. The only problem is that the only affordable ones are those based on the saccharin/cyclamate combo, which I can’t tolerate because of the bitter aftertaste. All others are outrageously expensive here, especially sucralose (about $5 USD for a 2-fl. oz. flask, less than $1 for a similar saccharin/cyclamate flask).

    What about stevia? Not very popular after Lydia Rodarte-Quayle, I suppose, but some people love it. Others, however, find it strongly bitter and very little sweet (if at all), and that includes me. Yuck!

  78. I don’t know about insulin releases, but both my wife and I are type 2 diabetics, she can control hers by diet, I inject 35 units of N morning and night. Now to the saccharin. We both test 4 times a day, in the morning after 8 hr fast the 2 hrs after each meal. Sometimes we have coffee in the morning anywhere from an hour to 10 minutes before testing. My wife has coffee every morning and I skip slot. That’s what got my attention. The wife’s sugar is high almost every day (120-170). Mine on the mornings I have coffee runs about the same as the wife’s. We use great value sweetner, saccharin according to the packaging, no creamer or flavoring. Now I tried the coffee without anything except the water, wife says no way, for about a week and my blood glucose levels stay below 110 every day. At the end of the week I returned to using the sweetner and the bgl went right back to 173. This is not the most scientific study by any means, but it convinced me. Like the man said test yourself.

  79. Just to pose a question that is slightly off topic, I am a recovering alcoholic and throughout recovery you here both sides that it is a genetic disorder and that it is curable. Since I started going primal I have very little urge to drink however from past experiences I know what happens after the first one.. which I believe is to be attributed to the sugar content, depending on what is consumed control is still a concept until the carbs start breaking down which I believe turns straight into glucose. However even being pretty much carb/ sugar free..

    While writing this I think I answered the questionI was trying to ask which was why sometimes do you get strong cravings for those bakery section goodies in the grocery store. Something to think of for myself now is to remember what I consumed within the last 24 hours. What I had approximately 6 hours prior to these cravings was pretty high in both sugar and carbs.

  80. I stands to reason that mere faux sweeteners provoke no insulin response, since even the most common in-nature sweetener—which is fructose—would the more likely bring about an insulin-spike in spite of its very low glycemic index. Which of course it doesn’t.

    I see so many comments here that it’s likely it’s already been pointed out.

  81. I use 100% pure sucralose (no dextrose) in my home brewed iced ceylon tea, so I probably have consumed around 0.2mg or 0.3cc of the pure stuff each day for the past 10 years. the fact that it’s use encourages me to keep regularly hydrated and sugar free, far outweighs any potential impact it may have from my tongue receptors confusing my intestinal flora production – LOL. at middle age my blood work and digestion are fine, i have not caught a cold in years, while my diet has been paleo, which helps me keep my BMI under 26 even during a generally sedentary lifestyle.

    New science studies come out all the time, and online news services love to make headlines that attract page-hits. when the hype dust settles, you really need to READ how small these trail samples are. the low percentage of negative and often inconclusive results can not dispel the huge benefits using one of the better artificial substitute may have on your diet and health. the posts here that claim using sweeteners increases your sugar cravings are purely anecdotal, and IMHO more due to that individuals carb withdrawal (it’s a real thing) than what sweetener they used.

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  83. It’s cute how you mention that there’s only anecdotal reports of insulin repsonces at the end, but talk about the “nasty stuff” aspartame is as though it were backed by anything more than mommy blogging contrarianism.

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  85. you didn’t mention “Stevia” ? Do you know if it spikes insulin? thank you for this article

  86. I have started the keto diet a week ago. My question is does taking polyethylene glycol 3350 affect my fast in the morning? I need it for a regular bowel movements but just wondered if it may throw me out of ketosis when I fast in the morning until early afternoon?

    1. I had the same question. Based on the information I found, polyethylene glycol will not throw you out of ketosis as it is non-metabolized and therefore has no calories. In fact, I was able to find recommendations of this product for those with constipation on ketogenic diets.

  87. I’ve been Keto for a few months now and had started a 24 hr fast. I drank a black coffee, tested my blood sugar at 9:30 am and it was 78. Ran around, did errands and I grabbed a Diet Coke about 2 pm. I drank 10 oz and 30 minutes later tested my blood sugar and it was 127! That was all I had had all day besides a dogleg black coffee and plain water. I also had a rather long weight lose stall and cut all diet drinks including Mio and reduced sweetener that I cooked with. I started losing weight again almost immediately. I realized this is all just anecdotal information however I have experimented pretty extensively on my own body and diet and have concluded that for me sweeteners do indeed mess with my blood sugar.

  88. For some reason when ever I have anything with artificial sweeteners I develop the same symptoms as if I was hypoglycemic. This has happened to me my entire life. Now that I am older I can check my blood sugar levels when this happens. My blood glucose levels are always normal but the symptoms are clearly the exact same symptoms as hypoglycemia. Has anyone else ever heard of this. I am an obese person and would like to lose weight, but can drink or eat anything “diet” I have brought this up to many doctors and none have heard of it. They usually say it is probably something else causing the reaction. It has happened enough in my life that I”m 100% certain that this is the cause. An example is I just tried doing a cleans, but wanted to keep my protein levels up. I’m doing this with a nutritionist. For the first 3 days I was horribly sick with hypoglycemic symptoms but the lowest my blood glucose levels got was 109. It turned out that the vanilla protein shake I was using has artificial sweetness in it. I switched protein drinks and now I feel fine.

  89. Thank you for this post, I appreciate the scientific references.

    The comments show the poor state of scientific education in this country. Further, it’s clear that this issue is like a religion and that people don’t want to be confronted with facts. Instead they have their beliefs and no amount of facts will get them to change their minds.

  90. The studies cited don’t always support the statements made in this article.

  91. It seems people react differently to sucralose. My morning glucose levels are usually between 80 and 90. I took an
    energy cocktail sweetened with sucralose and 40 minutes later my glucose spiked to 183! that is quite a spike.

  92. My question still remains. Does Stevia cause an increase of insulin when we taste it? Does the brain immediately interpret the sweet taste as sugar? Is my belly fat increasing because of Stevia even though I eat a very low carb diet?