DOI: Ukiya M, et al. Here are 8 ways food companies hide the sugar content of foods. It's about 100 to 300 times sweeter than table sugar, but it has no carbohydrates, calories, or artificial ingredients.. People with allergies to ragweed, chrysanthemums, marigolds or daisies should be careful when trying stevia, according to Tufts Medical Center Community Care. However, since stevia can have blood pressure and blood glucoselowering effects, as well as diuretic effects, those taking certain medications or who have certain health conditions should talk with their healthcare provider before consuming significant quantities of Stevia. This article explains what whole eating is and shares 11 simple ways clean up your. However, like all herbs, they have powerful side-effects. 2017;16(1):55. doi:10.1186/s12937-017-0278-x. (2019). However, as the research on stevia itself is limited, it's safe to say that incorporating this natural sweetener into your diet as a sugar substitute will likely yield greater benefits than risks. Since stevia is a plant-based extract, there's some possibility it can cause allergies or irritation in certain people. However, some products containing. Some stevia products contain added sugar alcohols that may cause unpleasant symptoms in individuals that are very sensitive to the chemicals. View abstract. October 4, 2021. Food Chem Toxicol 2008;46 Suppl 7:S83-91. Pope E, Koren G, Bozzo P. Sugar substitutes during pregnancy. The study notes that its compounds, stevioside and rebaudioside, are up to 200 times sweeter than sugar. View abstract. Prakash I, Dubois GE, Clos JF, et al. J.Agric.Food Chem. It is many times sweeter than sugar yet has virtually zero calories. Lohner S, Toews I, Meerpohl JJ. Centers for Disease Control and Prevention. Stevia is used as an artificial sweetener in many foods and beverages, such as tea and juices, and is likely safe for most people. Bactericidal activity of a fermented hot-water extract from Stevia rebaudiana Bertoni towards enterohemorrhagic Escherichia coli O157:H7 and other food-borne pathogenic bacteria. Food and Chemical Toxicology. But artificial sweeteners can help some people enjoy sweetness without excess calories. blood pressure conditions and medications. Additional information about high-intensity sweeteners permitted for use in food in the United States. 2. A review on the improvement of stevia [Stevia rebaudiana (Bertoni). However, the United States Food and Drug Administration (FDA) only consider high-purity steviol glycosides to be safe for human consumption currently. Common potentially harmful chemicals found in stevia products include: When consumed at low doses, purified stevia is generally not considered to pose health risks for pregnant people. View abstract. Your lithium dose might need to be changed. Both have pros and cons, but is one better for you? And according to a 2009 study, stevia leaf powder may help manage cholesterol. Adding stevia products to foods instead of sugar can lead to lower energy intake, the same study concludes. Phytother Res 2006;20:732-6. Cytotoxic and apoptosis-inducing activities of steviol and isosteviol derivatives against human cancer cell lines [Abstract]. All rights reserved. U.S. Food and Drug Administration, December 2008. Theres concern that raw stevia herb may harm your kidneys, reproductive system, and cardiovascular system. View abstract. Theres some evidence to suggest that stevia may help fight or prevent some types of cancer. While some studies have shown stevia can be used to manage diabetes and weight loss, a study published in July 2017 in Canadian Medical Association Journal showed that consuming nonnutritive sweeteners frequently may actually result in an increase in body mass index (BMI). Therapeutic Research Faculty 2020. Stevia leaves are about 200 times sweeter than traditional white sugar and people have used them for centuries as a sweetener and herbal supplement. Video of the Day The Science Behind Stevia Stevia, not to be confused with Splenda, is a sugar substitute sweetener that comes from the plant Stevia rebaudiana, which is native to South America. According to a 2012 study, a glycoside called stevioside found in stevia plants helps boost cancer cell death in a human breast cancer line. Overdosing with stevia may lead to tingling or numbness in your hands and feet, similar to the feeling of neuropathy, as well as a temporary loss in motor control. 2012;132(3):1121-1132. Many focus on how the gut and brain communicate. privacy practices. View abstract. Import Alert 45-06: Detention without Physical Examination of Stevia Leaves, Crude Extracts of Stevia Leaves and foods Containing Stevia Leaves and/or Stevia Extracts. Office of Regulatory Affairs. Planta Med 2005;71(2):108-113. Int J Dent. 4. In the United States, the Food and Drug Administration (FDA) allows the following sugar substitutes to be used: Other countries, such as those in the European Union, have more sugar substitute options than does the United States. ", Molecular and Cellular Endocrinology: "In Vitro Bioassay Investigations of the Endocrine Disrupting Potential of Steviol Glycosides and Their Metabolite Steviol, Components of the Natural Sweetener Stevia", Harvard Health: "Sweeteners: Time to Rethink Your Choices? It's also associated with several impressive. Some have no calories. As noted in the 2019 stevia study referenced above, indigenous people have safely used extracts from the stevia plant as sweetener for foods, . But limit or cut out sugar substitutes: Dietary guidelines for Americans say adults shouldn't give sugar substitutes to children under 2 years old. But other things people do, or healthy habits that people don't do, may be the cause of the higher risk. Sucralose can be especially carcinogenic (cancer-causing) when heated, so stevia may be a healthier option for baking. The amount of sugar alcohol that causes these symptoms varies from person to person. 1-15-2009;17(2):600-605. Some other potential side effects of stevia include allergic reactions. However, given the popularity of stevia, there are several large-scale, comprehensive studies working on the matter. Phytochemistry 2003;64:913-21. From wellcurve.in. People take stevia for obesity, high blood pressure, diabetes, and many. Geuns, J. M., Buyse, J., Vankeirsbilck, A., and Temme, E. H. Metabolism of stevioside by healthy subjects. Accessed Nov. 14, 2022. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. 2020;10(1). This article discusses the different forms of stevia and the side effects of this sugar alternative. But if you use it throughout the day, the carbs add up. Stevia, not to be confused with Splenda, is a sugar substitute sweetener that comes from the plant Stevia rebaudiana, which is native to South America. Monk fruit and stevia are the latest buzz-worthy candidates for your morning cup of coffee or tea. You can learn more about how we ensure our content is accurate and current by reading our. View abstract. These ingredients may get your tastebuds used to sweetness. Stevia (Pure Via, Truvia) Artificial sweeteners are also called sugar substitutes, low-calorie sweeteners or nonnutritive sweeteners. Stevia is a sugar substitute made from the leaves of the stevia plant. Stevia has a mild, licorice-like taste thats slightly bitter. View abstract. However, the ADI for steviol is 4 milligrams (mg) per kilogram body weight per day. Clin Ther 2003;25:2797-808. According to a 2020 review, "In addition to its hypoglycemic property, the stevia plant also exhibits antibacterial, anti-inflammatory, hypotensive, antiseptic, diuretic, anti-fertility and cardiotonic properties." Below are some of the main advantages associated with stevia use: 1. Takasaki, M., Konoshima, T., Kozuka, M., Tokuda, H., Takayasu, J., Nishino, H., Miyakoshi, M., Mizutani, K., and Lee, K. H. Cancer preventive agents. And it's best to use sugar substitutes for a short time, or just every once in a while. Remember that stevia is much sweeter than table sugar, so you wont need to use as much. J Nutr. Food Chem. FoodData Central. Government health agencies oversee ingredients that product-makers add to food. 2019; doi:10.1542/peds.2019-2765. 2014;60(11):1003-1005. If youre trying to lose weight, this aspect may be appealing. You can learn more about how we ensure our content is accurate and current by reading our. More recent studies, however, have concluded that stevia may help prevent kidney damage. In general, it is safest to take in small amounts of sugar substitutes. Indigenous people in South America have been using it as a sweetener for hundreds of years, according to a study published in May 2015 in Nutrition Today. It may also drop blood pressure too low or interact with medications that lower blood sugar. Some people are at an increased risk of developing side effects from regular stevia use. Whole foods, such as fruits and vegetables, usually have the best mix of nutrients for the body. In addition to its use as a natural sweetener, honey is used as an . Farhat G, Berset V, Moore L. Effects of Stevia Extract on Postprandial Glucose Response, Satiety and Energy Intake: A Three-Arm Crossover Trial. Stevia in its natural form hasnt. J Ethnopharmacol 1991;33:257-622. View abstract. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. A 2013 study carried out in a laboratory found that stevia reduced cyst growth in kidney cells. Accessed Nov. 14, 2022. Some studies suggest it may have anti-inflammatory properties, though more research is needed to determine the magnitude of this effect. Is this how abdominal fat leads to diabetes? A January 2015 study published in Food and Chemical Toxicology explained that there's little evidence to support that there is any link between allergic reactions and highly purified stevia extracts. Although stevia is considered safe for people with diabetes, brands that contain dextrose or maltodextrin should be treated with caution. Melis MS, Sainati AR. Check with your physician for additional information about side effects. U.S. Food and Drug Administration. Potential complications with the. Investigation of the antihypertensive effect of oral crude stevioside in patients with mild essential hypertension. Abudula, R., Jeppesen, P. B., Rolfsen, S. E., Xiao, J., and Hermansen, K. Rebaudioside A potently stimulates insulin secretion from isolated mouse islets: studies on the dose-, glucose-, and calcium-dependency. Review/update the J Ethnopharmacol 1999;67:157-61. Low-calorie sweeteners are often perceived as a healthful alternative to sugar, but a new study finds that they may actually increase fat formation. Honey is a sweet fluid made by honeybees using the nectar of flowering plants. View abstract. Sugar alcohols, stevia and luo han guo can cause bloating, gas and diarrhea. Other research is looking at long-term use of sugar substitutes and the gut. Verywell Health's content is for informational and educational purposes only. Heart failure: Could a low sodium diet sometimes do more harm than good? Farid A, Hesham M, El-Dewak M, Amin A. For A 150-pound person, this would amount to around 40 packets of stevia. Exp Biol Med (Maywood.) OTHER NAME(S): Azucacaa, Caa-He-, Ca-A-Jhei, Ca-A-Yupi, Capim Do. Other sugar substitutes called sugar alcohols are not as sweet as sugar. Read our. How sweet it is: All about sugar substitutes. Principles and methods for the risk assessment of chemicals. View abstract. In general, artificial sweeteners are safe in limited amounts for healthy people, including pregnant people. 2002;25(11):1488-1490. Effect of stevia extract intervention on lipid profile. However, some studies suggest that consuming nonnutritive sweeteners such as Stevia instead of sugar does not reduce overall calorie intake or blood sugar levels. Although hypersensitivity to sugar alcohol is rare, its symptoms can include: Several studies using rodent and human cell cultures have demonstrated the potential gastrointestinal benefits of steviol glycosides. Studies dating back to the 1970s linked the artificial sweetener saccharin to bladder cancer in rats. It could potentially help lower their blood sugar levels without excess insulin. View abstract. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment. 000252. Although stevia may help control blood sugar in people with diabetes, it was also once thought that long-term or heavy stevia consumption might cause hypoglycemia or low blood sugar. Allergic reactions. 2020;150(5):1126-1134. That includes soft drinks, candy and baked goods. U.S. Department of Agriculture. Boll.Soc Ital Biol Sper. Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. Is the ketogenic diet right for autoimmune conditions? Sucralose administered in feed, beginning prenatally through lifespan, induces hematopoietic neoplasias in male swiss mice. Factors that may increase the risk of stevia side effects include: There are many different types of steviol glycoside found in stevia, classified into five major groups. 2005-2023 Healthline Media a Red Ventures Company. Yasukawa, K., Kitanaka, S., and Seo, S. Inhibitory effect of stevioside on tumor promotion by 12-O-tetradecanoylphorbol-13-acetate in two-stage carcinogenesis in mouse skin. Saudi Pharmaceutical Journal. Know your limit for added sugars. Mutagenesis 1996;11:573-9. Klongpanichpak, S., Temcharoen, P., Toskulkao, C., Apibal, S., and Glinsukon, T. Lack of mutagenicity of stevioside and steviol in Salmonella typhimurium TA 98 and TA 100. Development of rebiana, a natural, non-caloric sweetener. Nutrition Journal. These are compounds extracted and refined from the leaves of the Stevia rebaudiana plant. Available at: https://www.cfsan.fda.gov/~rdb/opa-g252.html. But be aware of how sugar substitutes affect your food and drink choices. If you use stevia now and then, it may not be enough to impact your blood sugar. Another popular zero-calorie sweetener issucralose, sold under the brand name Splenda. 2. Tooth decay occurs when bacteria from sugar damage the teeth. Effect of Stevia rebaudiana on glucose tolerance in normal adult humans. U.S. Food and Drug Administration. Gardana, C., Simonetti, P., Canzi, E., Zanchi, R., and Pietta, P. Metabolism of stevioside and rebaudioside A from Stevia rebaudiana extracts by human microflora. Carbohydr.Res 6-1-2011;346(8):1057-1060. Koyama, E., Kitazawa, K., Ohori, Y., Izawa, O., Kakegawa, K., Fujino, A., and Ui, M. In vitro metabolism of the glycosidic sweeteners, stevia mixture and enzymatically modified stevia in human intestinal microflora. Stevia is safe for most people to use. Stevia made with Reb-A is safe to use in moderation during pregnancy. In general, experts need to do more studies to learn what long-term health effects sugar substitutes might have on children. Many sugar substitutes taste sweeter than sugar. To avoid stevia stomach upset, be careful before purchasing stevia products. Acesulfame potassium is an artificial sweetener. As a result, the FDA do not recognize stevia leaves and crude extracts as safe for consumption. A critical review of the genetic toxicity of steviol and steviol glycosides. Mayo Clinic. Stevia may also work as a better option than sugar for people wanting to maintain good oral health. Because of this, it takes only a small amount of artificial sweeteners to sweeten foods. Currently, there isnt enough evidence that whole-leaf stevia or crude stevia extract wont harm your pregnancy. However, to date, research is inconclusive. Planta Med 2001;67(9):796-799. Nutr Today. A double-blind placebo-controlled study of the effectiveness and tolerability of oral stevioside in human hypertension. Stevia is a zero-calorie sweetener extracted from the Stevia rebaudiana plant. Don't get tricked by these 3 heart-health myths, Get to know the new Nutrition Facts label, Nutrition rules that will fuel your workout, Nuts and your heart: Eating nuts for heart health. View abstract. EFSA Panel on Food Additives and Flavourings (FAF), Younes M, Aquilina G, et al. Stevia is often touted as a safe and healthy sugar substitute that can sweeten up foods without the negative health effects linked to refined sugar. M S, M P, E T, et al. 2017;41(3):450-457. Some people have allergic reactions to steviol glycosides that . Int J Clin Res Trials. Dizziness Some people have reported feeling dizzy after taking stevia. Plants that come from the Asteraceae family that have been known to cause allergies include ragweed and sunflower seeds. According to the Mayo Clinic, signs of allergic reaction may include: Tingling or itching in the mouth. Pezzuto JM, Compadre CM, Swanson SM, et al. This information may not fit your specific health circumstances. Healthline Media does not provide medical advice, diagnosis, or treatment. 2016;2016:5967907. Ashwell M. Stevia, Nature's Zero-Calorie Sustainable Sweetener: A New Player in the Fight Against Obesity. Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Stevia, also called Stevia rebaudiana, is a plant that is a member of the chrysanthemum family, a subgroup of the Asteraceae family (ragweed family). Some research on long-term, daily use of artificial sweeteners suggests a link to a higher risk of stroke, heart disease and death overall. However, the FDA has not approved stevia leaf and crude stevia extracts for use in food. Stevia in the Raw recommends replacing half the total amount of sugar in your recipe with their product. Rebecca Valdez is a registered dietitian nutritionist and nutrition communications consultant, passionate about food justice, equity, and sustainability. The Food and Drug Administration (FDA) considers stevia leaf extract safe for consumption, and it is unlikely to cause side effects in most people. Foods and drinks with aspartame can lead to serious health problems. All rights reserved. (2018). Stevia has a slightly bitter flavor that some people don't like. New research shows that artificial sweeteners may increase the risk of weight gain and, Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. Sucralose. Artificial sweeteners can be a short-term way to help some people lessen their use of sugar and lose or manage weight. Avicenna J Phytomed. While stevia is generally considered safe to be used in food and drink, some extracts of the plant have not been approved by the Food & Drug Administration (FDA). By Rebecca Valdez, MS, RDN Automatic detention of stevia leaves, extract of stevia leaves, and food containing stevia. Health effects of the use of non-sugar sweeteners. Geuns JM. Swithers SE. You might try to stay away from table sugar by using less processed sweeteners such as honey and molasses. Stevia can cause gastrointestinal side effects in some people, including gas, nausea, and bloating. https://www.uptodate.com/contents/search. 2019;11(12):3036. In fact, evidence is still inconclusive in many ways as to how stevia affects the body over time. Advertising revenue supports our not-for-profit mission. J Nutr Sci Vitaminol (Tokyo) 1995;41:105-13. Low blood sugar: Stevia has the potential to lower blood sugar (blood glucose), especially in those using it to replace sugar. Certain chemicals in stevia are commonly used as natural food sweeteners. 2020;10(2):118-127. Some stevia side effects include potentially making it harder to lose weight. Effects of stevioside on glucose transport activity in insulin-sensitive and insulin-resistant rat skeletal muscle. Effect of calcium and verapamil on renal function of rats during treatment with stevioside. Stevia During Pregnancy and Breastfeeding. Profiles Drug Subst Excip Relat Methodol. Consult your physician before using a product containing stevia. Added sugar can play a part in weight gain. Artificial sweeteners produce the counterintuitive effect of inducing metabolic derangements. Monk Fruit vs. Stevia: Which Sweetener Should You Use? It may seem strange that a highly refined product is considered safer than a natural one. Artificial sweeteners and other sugar substitutes. Sugar, particularly refined sugars, has been linked to countless health risks, including diabetes and heart disease. Side effects of stevia According to the International Stevia Council's website ( 10 ): "Based on the positive safety opinions of this sweetener, stevia leaf extracts are safe and harmless - like every other approved food." What does "based on the positive safety opinions" even mean? View abstract. Abdel-Aal RA, Abdel-Rahman MS, Al Bayoumi S, Ali LA. Biol Pharm Bull. In a preliminary 2017 study, rats with diets comprised of up to 3.5 percent stevia for 90 days presented no clinical symptoms and experienced no change in blood chemistry, cellular function, compensation, or appearance. Matsui M, Matsui K, Kawasaki Y, et al. J Nat Prod. Mkinen KK. In some people, stevia products made with sugar alcohols may cause digestive problems, such as bloating and diarrhea. Stevioside may also help decrease some mitochondrial pathways that help cancer grow. Food Chem Toxicol 2008;46 Suppl 7:S40-6. Numbness 8 Ways Food Companies Hide the Sugar Content of Foods, 11 Simple Ways to Focus on Whole Foods Instead of Clean Eating, Berberine A Powerful Supplement With Many Benefits, The Top Health Benefits of Prunes and Prune Juice, What to Know About Andrographis Supplements: Potential Benefits and Uses, Kerry Boyle D.Ac., M.S., L.Ac., Dipl. https://professional.diabetes.org/sites/professional.diabetes.org/files/pel/source/sugar_substitutes.pdf. View abstract. This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. How Does Stevia Compare to Other Zero-Calorie Sweeteners? Can ice cream really be healthy? Chronic administration of aqueous extract of Stevia rebaudiana in rats: renal effects. Stevia may cause mild digestive issues like nausea, according to Memorial Sloan Kettering Cancer Center. These products rarely cause side effects. Natural sweeteners in a human diet [Abstract]. Developmental toxicity of steviol, a metabolite of stevioside, in the hamster. Stevia may affect the transmission of nerve impulses to and from your central nervous system and may slow down nerve conduction velocity. Processed foods often contain a lot of sugar, yet it can be difficult to tell how much. 2016;22(1):7-17. In addition to some of stevia's touted benefits as a sugar substitute in helping people lose weight or improve diabetes management, it has been linked to a number of other potential health benefits, though these are still being explored further. Stevia stomach upset, however, may be a cause for concern. View abstract. They offer the sweetness of sugar without the calories. People who may be more likely to experience side effects from stevia include people taking medications to lower blood pressure or blood glucose or those diagnosed with: Stevia leaf extract is safe to consume when pregnant or breastfeeding. Part 8: Chemopreventive effects of stevioside and related compounds. Accessed Nov. 11, 2022. Drug Chem Toxicol 1998;21:207-22. Acceptable daily intakes aren't the same everywhere. Stevioside induced ROS-mediated apoptosis through mitochondrial pathway in human breast cancer cell line MCF-7 [Abstract]. For some people, it may raise blood sugar and insulin levels. mood swings Read more The 5 Best (and Worst) Sweeteners You Can Eat - Cleveland Clinic All rights reserved. Stevia is available in a few different forms. Can whole-grain foods lower blood pressure? information submitted for this request. muscle cramps. However, erythritol is better tolerated than most sugar alcohols, according to the Calorie Control Council, because it is absorbed and eliminated quickly from the body. It found that many stevia glycoside derivatives were toxic to specific leukemia, lung, stomach, and breast cancer cell lines. Uncontrolled Blood Sugar: How Dangerous Is It. Melis MS. Reb-A is about 200 times sweeter than table sugar. 2005 - 2023 WebMD LLC. View abstract. Some people with diabetes claim it's fine, while others . The study found stevia lowered total cholesterol, LDL (bad) cholesterol, and triglycerides with no negative side effects. But if you often have foods and drinks with lots of added sugar, the empty calories can add up. Mayo Clinic does not endorse companies or products. It's possible this is because people who consume a lot of sweet food or drinks in general even those with NSSs experience a greater craving for sweeter and unhealthy foods. View abstract. Ac., CYT, 12 Benefits of Ginkgo Biloba (Plus Side Effects & Dosage). The side effects of stevia include gastrointestinal issues, extremely low blood sugar levels, endocrine disruption, sore muscles, and numbness. Which is a leading reason it's studied for use in diabetic patients. Some sugar substitutes also are sold on their own in packets or other containers. View abstract. 10. View abstract. CFSAN/Office of Food Additive Safety. Chan P, Tomlinson B, Chen YJ, et al. Its unclear if occasional stevia use in lower amounts would have the same impact. (2010). 2003;41(3):359-374. For example, Truvia is a blend of Reb-A and erythritol, and Stevia in The Raw is a blend of Reb-A and dextrose (packets) or maltodextrin (Bakers Bag). Evaluation of the genotoxicity of stevioside and steviol using six in vitro and one in vivo mutagenicity assays. Metabolism 2004;53:101-7. And there are other possible problems. However, subsequent research led the FDA to reverse the ban as hundreds of studies' reviews showed no increased risk of cancer linked to stevia consumption. Progesterone is a hormone released into the ovary that plays a role in menstruation and the early stages of pregnancy. other information we have about you. Metabolism 2000;49:208-14. Monitor your blood pressure closely. Can Fam Physician. Phytomedicine 2002;9(1):9-14. This content does not have an English version. Because the FDA have not approved crude stevia extracts and stevia leaves as a food additive, companies are not allowed to market them as sweetening products. Br J Clin Pharmacol 2000;50:215-20. It is safe to consume stevia every day. information highlighted below and resubmit the form. Sugar substitutes are in many kinds of foods and drinks labeled sugar-free or diet. Metabolism 2003;52(3):372-378. What is stevia? Learn about the pros and cons of sugar substitutes, also called artificial sweeteners. While several studies have identified potential side effects of stevia over the last few decades, most were done using laboratory animals, and many have since been disproved. That means a can of sweetened cola with 10 teaspoons of added sugar has about 160 calories. View abstract. Hives. (2017). Consumption of stevia may be linked to cancer. 2018;122:132-142. The plant contains steviol glycosides, such as stevioside and rebaudioside, which are actually a lot sweeter than regular sugar. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states. 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Melis MS. https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet.
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