Artificial sweeteners — to use or not to use them?
This is a question I have been asked by more people than I can count throughout my career as a dietitian.
Whether teaching diabetes classes, doing individual counseling sessions or just pushing my cart through the grocery stores, people want to know if sugar substitutes are safe to use.
Even when your body mass index (BMI) is in the normal range and you do not have diabetes, many people still want to lose weight or simply maintain their current weight – by eating fewer calories. Most of us also want to cut out the simple sugar and added sugars in our daily meals. The Dietary Guidelines for Americans recommends that we all reduce our intake of added sugars in the foods and beverages we choose.
The fact is that using sugar and foods with added sugars is more harmful to your health than the amount of sugar substitute you would use according to research. The health consequences of sugar intake can be dangerous and include diabetes, obesity, and cardiovascular disease.
While that means we will need to get our “sweet tooth” fulfilled using some other means than spoonfuls of sugar, the less artificial sweetener you use in general, the better. All of the products we will discuss have been approved by the Food and Drug Administration (FDA) and are considered safe under their guidelines. Scientific research had to be provided to prove their safety and reviewed through scientific means.
Sugar substitutes are also call high-intensity sweeteners because they are sweeter than regular sugar, do not add calories and do not raise blood sugar levels.
Sugars are simple carbohydrates (compared to complex carbohydrates such as starches like bread, cereals, pasta). Sugars include sucrose, glucose, and fructose. Sugar alcohols (mannitol, sorbitol, xylitol, isomalt, etc.) are made from sugars and are usually 60-70% sweeter than sugar therefore you use less. They still contribute calories similar to sugar but provide fewer calories since you are using less. They also do not raise blood sugar in the same way that sugar does and are often used in diabetic foods. They are considered natural.
Sugar is found naturally in some foods such as fruits and added to other foods during processing to add sweetness. The simple sugars provide the same amount of calories per serving. Glucose and fructose are one unit, or monosaccharide, while sucrose is two units, or disaccharide. All sugars are changed into glucose in the body and used for energy.
Fructose is broken down differently, in the liver, and can be lipogenic, or fat producing. What we know as table sugar, sucrose, is found in sugar cane or sugar beets. Sucrose contains glucose and fructose. The glucose is used for energy and the fructose is stored as fat.
Let’s look at each of the different sugar substitutes and sweeteners available.
Saccharin/Sweet and Low
The original sugar substitute was discovered in 1878 and was first used in 1879. It is over 300 times sweeter than sugar.
There is controversy about this sweetener and it held a warning on the label until 2000. It has a bitter aftertaste and is therefore not a desired alternate for many uses. It is unstable when heated but is able to be stored. Saccharin is used in drinks, candies, cookies, medicines and toothpaste. It is often mixed with aspartame for diet drinks.
Saccharin is currently not considered a potential threat to human health, according to the FDA and EPA. The acceptable daily limit for saccharin is 5 mg/kg of body weight. People who are allergic to sulfa drugs may be allergic to saccharin including headache, breathing trouble and diarrhea.
Aspartame was first approved to be used in 1981. This sugar substitute is 200 times sweeter than sugar.
It is not heat stable and is usually not used in cooking, however its sweet taste lasts longer than sucrose and is therefore often mixed with other sugar substitutes.
Some people experience headaches when using this sweetener.
Although it has been the subject of many controversial studies, Aspartame is considered safe by the FDA at its current level of exposure, except for those who should avoid it due to phenylketonuria (PKU).
The FDA reports the acceptable daily intake of Aspartame to be 50 mg/kg body weight per day.
Stevia is extracted from the stevia plant, it is 300 times sweeter than sugar.
Due to its origin, it can have a licorice like aftertaste at higher concentrations.
In the US Stevia was recognized as safe in 2008, though some may feel symptoms of fullness or nausea after using.
Sucralose was first approved for use in 1998.
Sucralose is made in a process of chlorinating sugar. It is estimated to be 320-1,000 times sweeter than sugar.
It is stable in heat and can be used for cooking.
There is controversy with research studies that were, in many opinions, poorly designed studies. It is generally recognized as safe by the FDA and many other organizations. CSPI has added it to their avoid list due to recent studies suggesting a link to leukemia in mice.
Sucralose can be found in more than 4500 products today. The acceptable daily limit set by the FDA for sucralose is 5 mg/kg of body weight. It can cause side effects in some people, such as gas, bloating, nausea, rash, mood changes and respiratory symtpoms.
Ace-K was first approved for use in 1988.
This product is 200 times sweeter than sugar and is often used in diet soda.
It also has been reported to have a bitter aftertaste and is blended with other artificial sweeteners.
It is stable under heat and has a long shelf life.
The FDA has approved it for general use as a food additive. The acceptable daily limit set by the FDA for Ace-K is 15 mg/kg of body weight per day. It lacks long term studies but was still approved for use.
Appearing soon — Advantme
This sugar substitute was recently approved by the FDA and was recognized as safe for food and beverages; it is the sixth one approved.
Advantme was developed in Japan and is said to be 20,000 times sweeter than sucrose. It is derived from aspartame and vanillin and is stable in high temperatures.
Advantame received consent to be used as a tabletop sweetener or as an ingredient for cooking purposes. Within the next few years Advantame is expected to hit the US market.
Proper Use of Sugar Substitutes
It is important to remember, no matter which sugar substitute you choose to use or which your taste buds prefer, that it is best to use them in moderation. Decreasing calories should be the goal in order to lose weight. Therefore, changing eating habits to reduce foods with added sugars, as well as sweets in general, is a good way to go.
Weight loss and healthy eating takes a commitment to better eating habits. It isn’t always as simple as just having a diet soda and eating whatever else interests you in order to be successful. Some studies show that using diet soda with sugar substitutes can cause a craving for sweets which could result in a higher caloric intake.
When we look toward improving our diets, remember that what we drink contributes greatly to the sugar and calories we eat each day. Read the labels to learn where the sugar is hiding and avoid those foods with added sugar. When reading labels remember that added sugars appear on the label in a variety of ways including brown sugar, corn syrup, honey, molasses, raw sugar, syrup, fructose, corn sweetener and sucrose.
There are still few studies that show whether the use of artificial sweeteners are safe for pregnant or lactating women or children. As a result, most experts recommend against the products for these people.
It doesn’t appear that for most people that an occasional diet soda or sugar free candy will be harmful but it may not help you achieve your health goals without other interventions.