Safety and Efficacy of Stevia and Aspartame

Introduction to Sweetener Safety

The American Academy of Pediatrics confirms that stevia has no contraindications, while aspartame is contraindicated in patients with phenylketonuria due to phenylalanine content 1, 2, 3
Aspartame has reported cases of thrombocytopenia associated with use 1, 2, 3

Aspartame contains 4 kcal/g, though minimal amounts used provide essentially no calories, and is 180 times sweeter than sucrose 1
Stevia has zero calories and is 200-400 times sweeter than sucrose 1, 2
Stevia is stable when heated, unlike some other sweeteners, and is designated as GRAS (Generally Recognized As Safe) 1, 4

The FDA underwent more rigorous premarket approval for aspartame, with over 100 safety studies, while stevia was accepted under the less stringent GRAS notification process in 2015 1, 2, 3
The American Diabetes Association confirms non-nutritive sweeteners, including aspartame and stevia, are safe when consumed within FDA-established acceptable daily intake levels 5, 6
Both sweeteners are safe alternatives to sugar for reducing caloric intake in the general population 5, 6, 7

The American Diabetes Association recommends that diabetic patients can use both aspartame and stevia as acceptable sugar substitutes 5, 6
Stevia may be preferable for children with phenylketonuria due to aspartame's contraindication in this population 1, 3
Aspartame can be consumed in moderation during pregnancy, adhering to acceptable daily intake levels, while stevia has no specific pregnancy contraindications 1, 8

Recent evidence suggests potential concerns with all artificial and non-nutritive sweeteners, including possible impacts on gut microbiota, cognitive processes, and metabolic hormones 7, 9
The American Heart Association suggests using non-nutritive sweeteners, including aspartame and stevia, as an intermediate step to reduce sugar-sweetened beverage consumption, and subsequently reducing all sweetener use to prevent potential long-term metabolic effects 7