A dietitian (and newsletter subscriber 🙂) recently asked me:
(BTW, I love hearing from you—please keep the questions coming!)
This reader is right. In a past newsletter about sparkling water, I wrote:
Here’s why…
Artificial sweeteners have been shown to disrupt the gut microbiota.
This can trigger a chain reaction: dysbiosis → increased intestinal permeability→ inflammation → metabolic changes and chronic disease.
The 2024 review, Exploring the Long-Term Effect of Artificial Sweeteners on Metabolic Health, dives deeper into this series of events.
Even a quick skim is worth it for the figures and tables.
This information alone is enough for me to steer patients away from Splenda and other artificial sweeteners.
But there’s more…
As the use of artificial sweeteners has grown over the years, IBD rates have also climbed, and some epidemiological studies suggest a link—though we don’t have proof of cause and effect.
Though most IBD nutrition guidelines don’t address artificial sweeteners, the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD) recommends limiting them to reduce the risk of flares in both Crohn’s disease and ulcerative colitis.
Many of my patients report gas, bloating, diarrhea, and/or abdominal pain when they consume these sweeteners, which lines up with findings from a 2024 study associating artificial sweeteners with GI symptoms in a large group of people with IBS (not IBD).
All this said, context matters.
One of my patients eats a mostly Mediterranean-style diet but enjoys a daily teaspoon of Splenda in her coffee.
Because her overall dietary pattern is high quality, and her relationship with food is rocky, I’ve chosen to leave it, at least for now.
A quick note on resources: The International Food Information Council (IFIC) offers a variety of user-friendly, accessible fact sheets on sweeteners, but much of their funding comes from food and beverage companies.
A 2022 analysis found that the IFIC tends to promote industry interests and downplay independent evidence—so I recommend reviewing their materials with caution.
👉 Takeaway: Evidence isn’t definitive, but encouraging people with IBD to limit artificial sweeteners is a sound, practical approach.
