The latest Dietary Guidelines for Americans send an unmistakable message: Added sugar has no place in a healthy diet. For policymakers and health professionals, that guidance is long overdue. For everyday people, however, the real question is not whether sugar should be reduced — but how.
Public health efforts often fail when they demand perfection. Americans are repeatedly told to eliminate entire categories of food, only to abandon those plans weeks later. A more effective approach focuses on substitution rather than sacrifice, meeting people where they are and giving them tools that make healthier choices realistic over the long term.
Sugar alternatives, including Splenda, fit squarely into that model. Sucralose is roughly 600 times sweeter than sugar, meaning far less is needed to achieve the same taste. When used in place of sugar, it allows consumers to significantly cut added sugar without changing what they eat or drink. That kind of practical adjustment makes sustained behavior change far easier.
New clinical evidence reinforces this common-sense approach. A large, long-term randomized trial published in Nature Metabolism, known as the SWEET study, compared diets that included sugar with diets that replaced sugar using non-sugar sweeteners such as sucralose. Over more than a year, participants who substituted sugar experienced better weight outcomes and improvements in gut health — an increasingly important marker of overall metabolic health.
As a physician with a family history of diabetes, these findings align with what I see in real-world patient care. People succeed when dietary guidance respects human behavior. Completely abstaining from sweets is challenging and is seldom effective. Smart and moderate substitution is far likelier to succeed.
The peer-reviewed SWEET study also helps correct lingering misconceptions. For years, consumers were warned that sucralose might disrupt gut bacteria — a claim rooted largely in an outdated animal study that has since been questioned by the journal that published it. Human clinical data now tell a different story: Replacing sugar with non-sugar sweeteners can support both weight management and gut health.
This matters at a national level. Obesity affects nearly 90 million Americans, and diabetes continues to drive healthcare costs, disability, and lost productivity. Reducing sugar intake is one of the most effective levers we have to reverse those trends, but only if people can realistically follow the guidance.
That’s where sugar alternatives offer value. Much like nicotine replacement helped millions move away from smoking, sugar substitutes can help people transition away from excessive sugar consumption without an all-or-nothing mandate. It’s a harm-reduction strategy rooted in choice, not coercion.
The growing MAHA movement is right to focus on diet as a cornerstone of national strength. Leaders across government, including Health and Human Services Secretary Robert F. Kennedy Jr. and Agriculture Secretary Brooke Rollins, have emphasized the need to rein in sugar consumption. Non-sugar sweeteners give people a way to act on that advice without turning healthy eating into an exercise in deprivation.
Kennedy has advocated that if you are going to eat French fries — not the healthiest snack — they should at least be fried in fat that is less processed than certain seed oils. If people embrace sugar alternatives such as stevia and sucralose to reduce refined sugar intake, then they will lower their blood sugar, decrease their chances of diabetes, and go a long way toward better health.
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For patients managing diabetes, families watching their weight, and anyone trying to align daily habits with the new dietary guidelines, sugar-free sweeteners like sucralose are a practical tool. The science is increasingly clear, and the logic is straightforward: Making healthier choices easier is how we achieve lasting results.
Reducing sugar doesn’t require taking sweetness out of life. It requires smarter options — and the freedom to use them.
Dr. Nan Hayworth is a board-certified ophthalmologist and former member of Congress from New York.