Are there any health concerns with using sucralose (Splenda)?
—John S. Hyland, MD, Conyers, Ga.

Sucralose, the most commonly used artificial sweetener in the United States, is a modified sucrose molecule that is 600 times sweeter than sugar. The majority of sucralose (85%) is unabsorbed and excreted in the feces unchanged.

Interestingly, since sucralose is not metabolized by gut flora, it does not cause the gas or osmotic diarrhea that can be associated with sugar alcohols, such as sorbitol. Sucralose is not transported in breast milk and does not cross the placenta or the blood-brain barrier. When studied in rats and mice, no acute toxicity was seen with high doses of 10-16 g/kg (1.75 lb of Splenda for a 175-lb person, which is equivalent to 1,000 lb of sweetness for a 175-lb adult) (Food Chem Toxicol. 2000;38 Suppl 2:S53-S69). The United States has set the Acceptable Daily Intake (ADI) for sucralose at 5 mg/kg/day, which would work out to be 0.5 lb a day of Splenda for a 100-lb individual (equivalent sweetness to 300 lb of sugar!).

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Although only long-term epidemiologic studies can fully confirm any product’s safety, the current literature does not show any health concerns with sucralose. The only report of adverse effects I could find in the literature involves one case report of sucralose-induced migraines (Headache. 2006;46:515 527).
—Susan Kashaf, MD, MPH (106-11)