Understanding Sucralose: A Comprehensive Guide to Health Risks
Sucralose, most commonly known as Splenda, is the most popular artificial sweetener in the U.S. It's used in over 6,000 food products, as well as toothpastes and medicines. In the last 10 years, the use of sucralose and other artificial sweeteners in products across the grocery store has ballooned.
The FDA approved sucralose in 1998 for use in 15 food categories, and then one year later as a sweetener—despite the fact that of the over 100 studies submitted on behalf of sucralose to the FDA, none involved humans and most were short-term and not publicly published.
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The FDA has not reevaluated the authorization of sucralose in the nearly 30 years since, despite a growing body of research sounding the alarm on the alternative sweetener.
Sucralose is an artificial sweetener made through a chemical process, in which three hydroxl groups in sugar are replaced with chlorine atoms. It was discovered in 1976 and introduced most broadly in the U.S. in 1998 through Splenda.
Sucralose is zero calories, but Splenda contains dextrose and maltodextrin, which add a negligible amount of calories—especially since sucralose, which is up to 600 times as sweet as sugar, is often used sparingly.
Sucralose, like many sugar substitutes, can cause gastrointestinal upset, with symptoms ranging from bloating and gas to diarrhea, so folks with bowel diseases may also find it flares up symptoms. Studies have also shown that regular consumption of sucralose reduces the number of 'good bacteria' in the gut.
Daily sucralose intake, warns the Women's Health Network, could be a migraine trigger. It may also reduce the absorption of therapeutic drugs treating cancer and heart disease, making them less effective.
'There are not any instances that I would recommend incorporating sucralose into a diet, as there are no real nutritional benefits and there are some potentially negative effects,' Susan Kamin, RD, CDN, CHC and team clinician and midlife health specialist at Wise and Well, told Flow Space. 'That being said, if someone occasionally consumes sucralose in small quantities, it is not likely to be a problem.'
While studies have cast doubt on the claim that sucralose doesn't break down in the digestive system, more than 85 percent of sucralose is excreted without metabolizing or accumulating in the body. For that reason, sucralose consumed in very limited amounts may not be harmful—but regular consumption has been shown in studies to have adverse effects.
There is debate over the framing of sugar substitutes like sucralose as a tool for weight loss. While products made with sucralose may be marketed as 'sugar-free' and 'low-calorie,' the World Health Organization (WHO) in 2023 advised against using 'non-sugar sweeteners' for weight management.
A 2025 study by the Keck School of Medicine at the University of Southern California, funded in part by the National Institutes of Health (NIH), found that sucralose altered brain activity—increasing hunger and appetite—and did not create the physical sense of fullness that sugar brings to the body after consumption. Women were more greatly affected than men, according to the findings.
'[Artificial sweeteners] rewire your taste buds and set you up for cravings,' Kamin explained. 'The body gets a dopamine hit every time we consume sweet foods, and naturally craves more. Our bodies also intuitively expect calories to accompany sweet foods. When there are no calories, the body continues to look for them and that also leads to cravings.'
Kamin recommends that her patients use more natural sugar substitutes for weight management. 'There are better alternatives on the market,' she asserted—including allulose, monk fruit, and stevia. No matter what sweetener you use, from sugar to stevia, Kamin also emphasized that she believes 'all things in moderation to be the best approach' to managing your diet.
'To the extent possible, we should be consuming whole, minimally processed foods,' Kamin explained. 'Sucralose is often found in highly processed foods, which should be consumed judiciously. I truly believe that food is a pleasure to be enjoyed. I would much rather see someone fully enjoy, without guilt, a real sugar sweetened treat on occasion, than consuming artificially sweetened yogurts, diet sodas or cookies on a regular basis.'
A 2023 study published in the Journal of Toxicology and Environmental Health, Part B and done with support from the Engineering Foundation at North Carolina State University found that sucralose-6-acetate, a compound produced in the gut after sucralose consumption, is 'genotoxic.' When a substance is 'genotoxic,' it breaks up DNA.
The NC State study found that sucralose itself, as well as sucralose-6-acetate, can damage tissues lining the wall of the gut, making it permeable and causing 'leaky gut.' This can interfere with the body's ability to flush out its system, resulting in matter entering into the bloodstream that typically is excreted and increasing your risk of inflammatory bowel disease (IBD) and/or chronic liver disease.
Researchers also found that exposure to sucralose-6-acetate in gut cells could increase oxidative stress, inflammation and cancer risk.
'To put this in context,' corresponding author and biomedical engineering professor Susan Schiffman asserted in a press release about the study, 'the European Food Safety Authority has a threshold of toxicological concern for all genotoxic substances of 0.15 micrograms per person per day. Our work suggests that the trace amounts of sucralose-6-acetate in a single, daily sucralose-sweetened drink exceed that threshold.'
Other studies have found that sucralose is associated with an increased risk for cardiovascular disease, stroke and heart disease, and potentially elevated blood sugar—increasing the risk of type 2 diabetes, heart disease and stroke.
Kamin urged women in midlife to heed these warnings and keep artificial sweetener consumption to a minimum.
'Women in midlife are facing unique health challenges,' she explained. 'As their sex hormones are dropping, there is a profound impact on gut, metabolic, brain, cardiovascular and bone health. Therefore, it is imperative that they make a conscious effort to focus on a whole food diet. Most foods that contain sucralose will crowd out the more nutritious options and prevent optimization of the macro and micronutrients needed most at this stage of life.'
Artificial sweeteners are often marketed as safe sugar substitutes for people with diabetes, but studies on sucralose reveal mixed results, particularly for people with severe obesity and those who do not regularly consume sucralose—all of whom may see a blood sugar spike after consuming sucralose.
'A higher intake of artificial sweeteners can lead to a decrease in insulin sensitivity, which is important because insulin is responsible for regulating blood sugar,' Kamin added. 'Dysregulated blood sugar can lead to an increased risk of obesity, metabolic syndrome and type 2 diabetes.'
After the NC State study was released, Schiffman called for more studies into the safety and regulation of sucralose.
'If nothing else,' she added, 'I encourage people to avoid products containing sucralose. It's something you should not be eating.'
The Mayo Clinic also recommends using sugar substitutes like sucralose 'for a short time, or every once in a while,' and to cut back on everyday consumption. The Women's Health Network advises pregnant women, children and teens to avoid them altogether.
That may be particularly true if you're using sucralose in baked goods. At high temperatures, sucralose begins to break down and interact with other ingredients. When combined during the heating process with glycerol, which is found in fat molecules, sucralose produces chloropropanols—substances that may increase cancer risk. For recipes that go above 350°F (175°C), sucralose may not be the safest sweetener to use.
All that said, the anxiety of trying to eliminate sucralose entirely from your diet may not be worth the effort. Neither is worrying about whether we made choices previously that we're now learning carried more risk than we believed.
'We cannot undo the food choices we have made in the past, so limiting consumption of artificial sweeteners like sucralose and focusing on better choices moving forward is the best option,' Kamim said. 'The body is highly dynamic and is constantly renewing every cell, so there is always an opportunity to improve overall health.'
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