No getting around it, we Americans have a sweet tooth. Most of us eat the equivalent of 20 teaspoons of sugar a day. True, you're probably not sucking on sugar cubes throughout the day, but you are probably downing more than your fair share of sugary cereals, snacks, sodas, ice cream .. and the list goes on and on.

Sugar substitutes are sweeteners that you use instead of regular table sugar (sucrose). Artificial sweeteners are just one type of sugar substitute.

Some manufacturers call their sweeteners "natural" even though they're processed or refined. Stevia preparations are one example. And some artificial sweeteners are derived from naturally occurring substances — sucralose comes from sugar.

Natural sweeteners are sugar substitutes that are often promoted as healthier options than sugar or other sugar substitutes. But even these "natural sweeteners" often undergo processing and refining.

Natural sweeteners that the FDA recognizes as generally safe include:

Fruit juices and nectars
Honey
Molasses
Maple syrup

Artificial sweeteners are synthetic sugar substitutes. But they may be derived from naturally occurring substances, such as herbs or sugar itself. Artificial sweeteners are also known as intense sweeteners because they are many times sweeter than sugar.

Artificial sweeteners are widely used in processed foods, including:

Soft drinks, powdered drink mixes, and other beverages
Baked goods
Candy
Puddings
Canned foods
Jams and jellies
Dairy products
Artificial sweeteners are also popular for home use. Some can even be used in baking or cooking.

Artificial sweeteners don't contribute to tooth decay and cavities. Artificial sweeteners may also help with:

Weight control. Artificial sweeteners have virtually no calories. In contrast, a teaspoon of sugar has about 16 calories — so a can of sweetened cola with 10 teaspoons of added sugar has about 160 calories. If you're trying to lose weight or prevent weight gain, products sweetened with artificial sweeteners may be an attractive option, although their effectiveness for long-term weight loss isn't clear.
Diabetes. Artificial sweeteners aren't carbohydrates. So unlike sugar, artificial sweeteners generally don't raise blood sugar levels. Ask your doctor or dietitian before using any sugar substitutes if you have diabetes.

Artificial sweeteners have been scrutinized intensely for decades.

Critics of artificial sweeteners say that they cause a variety of health problems, including cancer. That's large because of studies dating to the 1970s that linked the artificial sweetener saccharin to bladder cancer in laboratory rats. Because of those studies, saccharin once carried a label warning that it may be hazardous to your health.

Artificial sweeteners are regulated by the Food and Drug Administration (FDA) as food additives. They must be reviewed and approved by the FDA before being made available for sale.

Sometimes the FDA declares a substance "generally recognized as safe" (GRAS). Substances receive this designation if they meet either of these criteria:

Qualified professionals deem the substance safe for its intended use based on scientific data. Stevia preparations are an example of this type of GRAS designation.
The substances have such a lengthy history of common use in food that they're considered generally safe.
The FDA has established an acceptable daily intake (ADI) for each artificial sweetener. ADI is the maximum amount considered safe to consume each day throughout a lifetime. ADIs are set at very conservative levels.

When choosing sugar substitutes, it pays to be a savvy consumer. Artificial sweeteners and sugar substitutes can help with weight management. But they aren't a magic bullet and should be used only in moderation.

Food marketed as sugar-free isn't calorie-free, so it can still cause weight gain. Keep in mind that processed foods, which often contain sugar substitutes, generally don't offer the same health benefits as whole foods, such as fruits and vegetables.

© Mayo Clinic