Holidays, Sugar, and the Not-So-Sweet Truth About Non-Sugar Sweeteners

Practical Takeaways for Parents

1. Focus on the big picture—overall dietary pattern matters most

2. Sugar – moderation and mindful use

3. Check labels—be aware of hidden sweeteners

4. Avoid giving young children (especially under 2 years) foods and beverages high in sugar or non-sugar sweeteners

5. More research is needed to understand the impact of non-sugar sweeteners on our health

Halloween has come and gone, but for many families, the aftermath is still very real. Candy wrappers linger, leftover sweets tempt little hands (and grown-ups too!), and routines around meals and snacks may feel off track. And with the upcoming holiday season, it can feel like an endless parade of candy, desserts, and indulgent meals. From Halloween leftovers to Thanksgiving pies and holiday cookies, families are constantly navigating sweets and sugary treats — often while trying to maintain balanced meals and healthy routines.

It’s normal for kids — and adults — to overindulge a bit during the holiday. The good news is that with simple strategies, you can help your family return to balanced eating habits without guilt or stress.

It’s tempting to look for ways to keep sugar under control. That’s when many families start noticing foods and drinks labeled “sugar-free” or “no added sugar.” These options sound healthier, but they often contain non-sugar sweeteners — ingredients that replace sugar’s calories while keeping the sweet taste.

Before we dive into non-sugar sweeteners, it’s important to first consider the messages we’re sending kids about sugar. How we talk about sugar — and the way we frame it — can shape children’s relationship with food for years to come.

Building a Healthy Relationship with Sweets

Holidays like Halloween are valuable teaching moments. Completely restricting candy or labeling sweets as “bad” can sometimes backfire, leading children to crave them more or feel guilty when they eat them. Instead, parents can model balance and trust by allowing candy in moderation — without fear or shame.

Here are a few dietitian-approved strategies that promote positive eating habits during candy season:

• Avoid using candy as a reward or punishment. This can attach emotional meaning to sweets.

• Serve candy alongside balanced meals or snacks. Pairing chocolate or treats with protein or fiber (like fruit, yogurt, or nuts) helps moderate blood sugar spikes.

• Teach mindful enjoyment. Encourage kids to slow down and notice taste, texture, and satisfaction.

• Keep perspective. A few days of extra candy around Halloween won’t undo a balanced diet. What matters most is the overall pattern of eating across weeks and months.

  
  

When parents set this tone, children learn that sweets are simply one small part of a healthy diet — not something to fear or overindulge in secretly.

It’s no surprise that many parents start wondering about sugar substitutes and “sugar-free” treats as a way to cut back. But are these non-sugar sweeteners really a healthier option for kids, or do they come with their own set of concerns?

As a registered dietitian, I often hear parents ask whether non-sugar sweeteners are a safe way to reduce sugar in their children’s diets. The short answer: they can play a role in managing sugar intake, but they’re not a magic solution — and for kids, the science suggests caution.

What Are Non-Sugar Sweeteners?

Non-sugar sweeteners (sometimes called non-nutritive sweeteners or NNS) are substances added to foods or beverages to provide sweetness without the calories (or with far fewer calories) than regular sugar (sucrose, high-fructose corn syrup, etc.). They allow products to taste sweet while reducing—or eliminating—added sugar content.

Types of non-sugar sweeteners to know:

• Artificial sweeteners: These include aspartame, saccharin, and sucralose.

• “Natural” non-nutritive sweeteners: For example, stevia and monk fruit extract.

• Sugar alcohols (polyols): These include xylitol, erythritol, sorbitol. They have some calories but much less than sugar and are considered nutritive sweeteners though they are sometimes lumped with non-sugar sweeteners.

  
  

These substances are widely used in “diet,” “light,” “zero sugar,” or “reduced sugar” products, including beverages, yogurts, snack bars, and even items marketed to children, often without obvious front-of-package labels.

Current Recommendations – General Population & Children

For the General Population

Many health authorities recognize that replacing sugar-sweetened beverages with non-sugar sweetened ones may reduce calorie intake and help moderate sugar consumption (though the effect is modest). However, they emphasize that NSSs are not a “magic bullet” and should not replace the overall goal of a healthy, balanced diet. The World Health Organization (WHO) published a guideline in 2023, recommending against the use of NSSs for weight management in people without diabetes, as we do not have strong evidence suggesting any benefits of weight control when people use NSSs. In addition, the science behind NSSs is nuanced due to the variations in the sources, metabolism, and side effects of these NSSs.

For Children

When children are involved, the guidance is more cautious. Although all NSSs that are currently used in the U.S. at the amounts that are allowed are considered safe by the Food and Drug Administration (FDA), the health risks of NSSs among children are not well understood. There is minimal data on children younger than two.

While there are no official guidelines in the U.S. for the use of NSSs in children, researchers from Milken Institute School of Public Health at George Washington University recommend a cautious approach to the use of NSSs in children, and suggest limiting their use in foods/beverages marketed to children until more definitive evidence is available. 

In simpler terms: for most healthy children, NSSs are NOT necessary, and the focus remains on limiting added sugar, encouraging water, milk, whole foods, and preventing early formation of high sweetness-preference habits.

What Does the Evidence Say?

Weight, BMI & body composition

A recent systematic review and meta-analysis in children, adolescents and young adults (ages 2-24) found that among randomized controlled trials (RCTs), adolescents and people with obesity gained less weight when they had non-nutritive sweetener- (NNS) beverages compared to sugar-sweetened beverages (SSBs). But prospective cohort studies (observational studies that follow people up for a period of time) found no significant association between NNS beverage intake and BMI change.

Another review study found that lower intake of NSSs in adults was associated with lower BMI gain compared to higher intake of NSSs. In children, intake of NSSs led to a smaller increase in BMI z-score than sugar intake. However, the evidence ranged from very low to moderate certainty, meaning that there were only a limited number of small studies, inconsistent results were found, or generalizability might be compromised due to certain biases.

Thus, replacing sugary drinks with NSSs may help limit some weight gain in the short term, especially in children with overweight/obesity. But NSSs alone are not a guarantee of weight loss or better health, especially if the overall diet and activity remain unchanged.

Blood glucose, metabolic health, and gut

In adults, some trials suggest modest improvements in fasting glucose when sugar is replaced with NSSs, but the conclusion is not strong as there are so many different types of NSSs, leading to mixed results. 

For children, the data are very limited. One study conducted in 1994 showed a significantly higher increase in blood glucose levels among children who were given NSSs compared to sugar. The policy statement published by the American Academy of Pediatrics in 2019 and reaffirmed in 2025 indicated that clinical trials looking at lipid profiles, cardiovascular disease outcomes, or long-term metabolic outcomes in kids are lacking.

Animal studies have suggested alterations in the gut bacteria, which could lead to increased risk of diabetes, and increased weight, although human studies are needed to confirm the findings. 

Safety concerns & long-term effects

While common sweeteners are approved and have acceptable daily intake (ADI) levels, some research underlines that we cannot exclude potential harms. 

1. Taste-preference and sweet-seeking behaviour

   One concern is that early exposure to high sweetness (whether from sugar or non-sugar sweeteners) may reinforce a preference for very sweet foods, which could displace less-sweet, more nutrient-dense foods (vegetables, plain yogurt, etc.). However, there’s limited research to confirm the connection here.

   
   

   Emerging research also raises questions—e.g., studies exploring gut microbiota changes, endothelial/vascular effects, cognitive outcomes—but these are early and often observational or mechanistic, so not yet definitive for children.

2. False sense of “healthy” 

   A more practical concern: parents may see “zero sugar” or “no sugar added” and assume the product is a healthy food, when in fact it may still be low in nutrients and have the same ultra-sweet taste burden. Some NSSs may be hidden in kids’ products and label language may not clearly signal their presence.

   
   

3. Displacement of nutrient-rich foods

   If NSS sweetened foods and beverages replace opportunities for whole foods (fruit, plain yogurt, water), the overall diet quality may suffer. It is possible that some children will replace milk with NSS sweetened beverages.

   
   

4. Gut microbiota, metabolic regulation

   Some mechanistic and animal studies show that certain sweeteners may alter gut microbiota or influence metabolic signalling—but human data, especially in children, are very limited. Because children are still developing physiologically, the long-term implications are unclear.

   
   

Safe Levels & What That Means

Regulatory agencies (e.g., the Food and Drug Administration (FDA) in the U.S., the European Food Safety Authority (EFSA) in Europe) establish Acceptable Daily Intakes (ADIs) for non-sugar sweeteners. An ADI is the amount (milligram per kilogram body weight) that can be safely consumed every day over a lifetime, based on rigorous toxicological and safety testing.

For example:

• Aspartame: 50 mg/kg body weight set by the FDA

• Sucralose: 5 mg/kg body weight

• Saccharin: 15 mg/kg body weight

  
  

It’s important to note: usual consumption by children and adults is typically well below ADIs. For many families, occasional use of a product with a non-sugar sweetener is unlikely to approach the ADI threshold.

However, special considerations for children:

• Children have lower body weight, so the mg/kg dose matters.

• Multiple sources (drinks, yogurts, snack foods) may cumulatively increase intake. This indicates that we need to continuously review the ADIs and what amount should be allowed in individual products.

• Given the ubiquity of sweeteners in processed foods, keeping track of how much a child is consuming can be challenging. The AAP policy statement highlights a challenge in collecting reliable exposure data from consumers over time.

• Long-term exposure starting early in life is less studied, so the margin of unknowns is larger.

  
  

In practice: while safe use within limits is accepted, prudent use (limiting frequency/quantity) is wise—especially for children.