Are sugar substitutes unhealthy?

I was having breakfast with a friend last week. I noticed him avoiding sugar substitutes and asked why. He didn't know of any scientific studies but said he preferred food that doesn't pretend. His reasoning went like this: Sweeteners mimic natural taste. This is dishonest and not the way we should treat our biology.

That was a more nuanced reasoning that isn't the same as "natural is good, artificial is bad" (the natural-artificial reasoning is, IMO, luddite - a sorry excuse for being lazy). It is still not the same as conclusions drawn from scientific studies. Nevertheless, it strikes me as a good thumbrule; useful to navigate the world of food where giant corporations are squarely focussed on your tongue and your wallet.

Sweeteners have a history. It is well worth your time and health to know more about the stuff you consume.

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Most of our family avoids it for various reasons. Some folks get headaches, my dad and I get upset stomachs, and we have at least one cousin with phenylketonuria. Mom prefers the taste of diet sodas to the real stuff though.

Here in Canada, we have access to Stevia extracts through health-food stores, which I recently got to try out. I find that the "taste profile" of it on the tounge is different than sugar, so I don't use it much myself.