Does sugar-free mean healthy?

Sugar-free and diet foods have become increasingly popular as more people look to reduce sugar and calorie intake for health reasons. Foods labeled as sugar-free or diet imply they are healthier options by removing sugar entirely or reducing the sugar and calorie content. But does simply removing or reducing sugar automatically make a food healthy? Here we take a deeper look at what sugar-free really means, the pros and cons of sugar substitutes, and whether sugar-free foods are truly healthier options.

What does “sugar-free” mean?

The U.S. Food and Drug Administration (FDA) has specific guidelines for when a food can be labeled as sugar-free:

  • Less than 0.5 grams of sugar per reference amount customarily consumed (RACC) and per labeled serving
  • No ingredients that contain sugar, such as juice or dry fruit

This means a sugar-free food must have virtually no sugar content from any source, not just added sugars. However, sugar-free foods can still contain carbohydrates and calories. They may also contain sugar alcohols or artificial sweeteners to replace the sweetness of sugar while keeping calorie and carbohydrate content low.

Common sugar substitutes in sugar-free foods include:

  • Acesulfame potassium (Ace-K)
  • Advantame
  • Aspartame
  • Neotame
  • Saccharin
  • Sucralose
  • Sugar alcohols like erythritol, maltitol, and sorbitol

So in summary, a sugar-free food contains virtually no sugar but frequently contains sugar substitutes and other carbohydrates or calories. Simply having no sugar does not automatically make it low calorie or nutritious.

Are sugar substitutes healthier than sugar?

Sugar substitutes like artificial sweeteners and sugar alcohols were developed to provide the sweetness of sugar without the calories. But despite being labeled “natural,” sweeteners like stevia and sugar alcohols are still processed and do not exist in their whole form in nature. Here we review some of the pros and cons of common sugar substitutes:

Artificial sweeteners

  • Pros: Provide intense sweetness at virtually no calories. FDA approved versions (like aspartame and sucralose) have been extensively studied and deemed safe for human consumption.
  • Cons: Associated with negative effects on gut bacteria and metabolism in some studies. Still trigger sweet taste receptors and may increase cravings for sugary foods. Safety concerns over neurological effects and cancer risk, though currently inconclusive.

Sugar alcohols

  • Pros: Contain fewer calories than sugar, are not fully absorbed by the body, and do not spike blood sugar levels. Derived from natural sources like fruits and vegetables.
  • Cons: Most have a laxative effect if consumed in large amounts. Also can trigger sweet taste receptors and cravings like artificial sweeteners. Less sweet than sugar so larger amounts are needed.


  • Pros: Derived from the natural stevia plant. Has no calories and does not raise blood sugar. Does not have a laxative effect.
  • Cons: Often highly processed and mixed with additives to mask bitter aftertaste. Safety concerns still being researched, including effects on kidneys, fertility, and diabetes management.

While sugar substitutes provide a way to reduce sugar and calorie intake, their health impacts are still being researched, with some potential concerns. Moderation is key when incorporating sugar substitutes into a diet.

Do sugar-free foods promote weight loss?

One of the main reasons people choose sugar-free foods is to reduce calorie intake for weight loss or maintenance. Sugar-free foods and beverages typically contain:

  • 0 grams of sugar per serving
  • Very few or no calories
  • Low carbohydrate content

This seems like it would equate to effortless weight loss. But does consuming sugar-free foods actually contribute to losing or maintaining a healthy weight long-term? Let’s review what the science says:

Short-term studies

Some studies have shown sugar-free foods can help reduce body weight and fat over a 6 month period:

  • In one study, adults drinking sugar-free beverages for 6 months lost 1.3 kg compared to the control group.[1]
  • Another 6 month study found people drinking sugar-free beverages lost 2.5% of body weight compared to 0.7% in the sugar-sweetened beverage group.[2]

So in the short-term (6 months or less), consuming sugar-free foods instead of sugary versions appears beneficial for weight loss.

Longer-term studies

But longer-term studies looking at 1 year or beyond have shown mixed results:

  • A 1 year study found no difference in weight between people drinking regular or sugar-free beverages.[3]
  • A different 1 year study found people drinking sugar-free beverages gained less weight than the regular soda group.[4]
  • A 10 year study found daily consumption of diet beverages was linked to increased risk of obesity and metabolic syndrome.[5]

Overall the most extensive reviews have found insufficient evidence that nonnutritive sweeteners like artificial sweeteners and sugar alcohols help prevent weight gain or promote weight loss in the long run.[6]

Potential concerns with sugar-free foods

While sugar-free foods may seem like an easy way to reduce sugar and calories from your diet, there are some potential drawbacks to watch out for:

May stimulate appetite

Even though they don’t contain sugar, artificial sweeteners and sugar alcohols found in sugar-free foods still activate the sweet taste receptors. This may increase appetite and cravings, leading to overeating.[7]

Gut health and glycemic impacts

Sugar substitutes may negatively impact gut bacteria linked to health and metabolism. Artificial sweeteners also appear to disrupt glycemic responses to meals, contributing to glucose intolerance.[8]

Lack of nutrients

Since sugar-free foods focus on removing or replacing sugar, they often lack beneficial nutrients like protein, fiber, vitamins, and minerals. This can lead to nutrient deficiencies if you rely too heavily on sugar-free processed foods.

May contain other additives

To improve flavor and texture, sugar-free products often contain additives like thickeners, emulsifiers, and artificial flavors or preservatives that may have their own health impacts.

Safety concerns

While regulatory bodies have approved artificial sweeteners and sugar alcohols as safe, some studies have linked them to neurological issues, cancer risk, kidney problems, and more. The long-term safety is still inconclusive.[9]

Tips for choosing healthy sugar-free foods

Simply going sugar-free does not guarantee health or weight loss benefits. But you can make informed choices by keeping these tips in mind:

  • Opt for whole foods like fruits, vegetables, nuts, dairy, eggs, meat, fish, and grains. Avoid heavily processed snack foods even if sugar-free.
  • Check the ingredient list for artificial sweeteners, sugar alcohols, and additives. Choose options with the fewest additives.
  • Look for sugar-free versions of foods you already eat to simply remove excess sugar, not add extra processed snacks.
  • Enjoy treats like sugar-free desserts occasionally as a substitute, not in addition to sugary versions.
  • Beware of sugar-free junk foods with minimal nutrition. Fiber, protein, and nutrients should come first.
  • Drink calorie-free beverages like water, seltzer, or unsweetened tea instead of sugar-sweetened beverages.

Following an overall healthy diet focused on whole foods rather than relying solely on sugar-free substitutes leads to the best health and weight outcomes.

Healthier sugar-free food swaps

Here are some easy food swaps to reduce sugar intake from an overall healthy diet:

Instead of… Choose sugar-free…
Candy Fresh fruit like berries
Ice cream Sugar-free gelatin
Sugary cereal Oatmeal with cinnamon and sliced fruit
Sugary soda Sparkling water with lemon
Sweetened yogurt Plain Greek yogurt with honey and nuts
Fruit juice Sliced fruit infused in water
Sugary coffee drinks Black coffee or coffee with a dash of milk

Choosing whole foods prepared with little added sugar ensures you get fiber, nutrients, protein, and healthy fats while avoiding empty sugar calories.

The bottom line

  • Sugar-free means a food contains less than 0.5g of sugar per serving.
  • Sugar substitutes like artificial sweeteners provide sweetness with few or no calories.
  • Sugar-free foods may help reduce calories and sugar intake but have mixed results for weight loss.
  • Consuming whole foods and healthy sugar-free swaps is better than relying solely on processed sugar-free snacks.
  • Sugar-free does not automatically mean healthy – check nutrition labels and ingredients for the whole picture.

Rather than focusing just on sugar-free claims, choose minimally processed foods with beneficial nutrients, fiber, protein, and healthy fats from whole food sources. Moderately incorporating sugar-free options can reduce excess sugar without relying solely on artificial or highly processed foods. An overall diet focused on whole, nutritious foods leads to the healthiest weight and well-being.


1. Tate DF, Turner-McGrievy G, Lyons E, et al. Replacing caloric beverages with water or diet beverages for weight loss in adults: main results of the Choose Healthy Options Consciously Everyday (CHOICE) randomized clinical trial. Am J Clin Nutr. 2012;95(3):555-563.

2. Peters JC, Wyatt HR, Foster GD, et al. The effects of water and non-nutritive sweetened beverages on weight loss during a 12-week weight loss treatment program. Obesity (Silver Spring). 2014;22(6):1415-1421.

3. de Ruyter JC, Olthof MR, Seidell JC, Katan MB. A trial of sugar-free or sugar-sweetened beverages and body weight in children. N Engl J Med. 2012;367(15):1397-1406.

4. Raben A, Vasilaras TH, Møller AC, Astrup A. Sucrose compared with artificial sweeteners: different effects on ad libitum food intake and body weight after 10 wk of supplementation in overweight subjects. Am J Clin Nutr. 2002;76(4):721-729.

5. Fowler SP, Williams K, Hazuda HP. Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. J Am Geriatr Soc. 2015;63(4):708-715.

6. Miller PE, Perez V. Low-calorie sweeteners and body weight and composition: a meta-analysis of randomized controlled trials and prospective cohort studies. Am J Clin Nutr. 2014;100(3):765-777.

7. Swithers SE, Davidson TL. A role for sweet taste: calorie predictive relations in energy regulation by rats. Behav Neurosci. 2008;122(1):161-173.

8. Nettleton JE, Reimer RA, Shearer J. Reshaping the gut microbiota: Impact of low calorie sweeteners and the link to insulin resistance? Physiol Behav. 2016;164(Pt B):488-493.

9. Whitehouse CR, Boullata J, McCauley LA. The potential toxicity of artificial sweeteners. AAOHN J. 2008;56(6):251-259.

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