Tribune Print Share Text

Sugar substitutes—friend or foe?

Created date

July 26th, 2011

Artificial sweeteners. Sugar substitutes. Non-nutritive sweeteners. What exactly are they, and which is which? The preferred term is no-calorie or low-calorie sweeteners and that s exactly what they do, says Robyn Flipse, M.S., R.D., a registered dietitian and nutrition consultant in Bradley Beach, N.J. They add a sweet taste to food and beverages without adding the number of calories typically found in sugar and sugar-sweetened products.

Using them for better health

These products can be one tool in your efforts to put together a healthy and sensible diet for your needs, Flipse says. For instance, the American Diabetes Association approves the use of low- or no-calorie sweeteners as part of a healthy diet for people with diabetes. If you want to make a small change to keep your weight under control, use them in place of sugar, Flipse says. You could lose up to a pound each week if you use no-calorie or low-calorie sweeteners in place of sugar a few times a day provided you stick to a sensible diet. Have some in your coffee or iced tea, or have a sugar-free dessert or diet soda instead of a regular one. These sweeteners, however, are not a magic bullet for losing weight, Flipse cautions. They don t cancel out calories you get from other foods, nor do they help you lose weight by simply adding them to your diet. Be cognizant of your total daily calories, follow a healthy meal plan, and get some exercise every day. Along with these benefits, sugar substitutes are unlikely to cause cavities.

No-calorie versus low-calorie

There are six no-calorie sweeteners approved by the Food and Drug Administration (FDA). Although some may contain a few calories, not enough are absorbed by your body to make a difference. Most low-calorie sweeteners used today are naturally occurring compounds called sugar alcohols, which lend a sweet taste but contain fewer calories than sugar. Examples are sorbitol, mannitol, and xylitol. Your body absorbs some of the calories in these products. Sugar alcohols do not contain alcohol but are in fact carbohydrates. Unlike no-calorie sweeteners, sugar alcohols can raise blood sugar levels in some people if eaten in large amounts. If you have diabetes, you can consume sugar alcohols but still must pay attention to the total amount of carbohydrates in your diet. Some sugar alcohols, especially sorbitol, may have a laxative effect if you eat a large amount, says Eugenio Machado, M.D., senior medical director for Riderwood, an Erickson Living community in Silver Spring, Md.

Safety concerns

Sugar substitutes are generally safe when used in small or even moderate amounts, Machado says. Concerns that have come up in the past about some of them causing cancer or other medical conditions have not been borne out by research. According to the National Cancer Institute, studies during the early 1970s linked saccharin with the development of bladder cancer in laboratory rats. For this reason, Congress mandated that further studies be performed and required that all products containing saccharin carry a warning label. Subsequent studies of patterns, causes, and control of diseases in humans found no association between saccharin use and cancer in humans. Thus the warning label was removed in 2000. Cyclamate, which was previously used in combination with saccharin, was also associated with bladder cancer in animals. These compounds were therefore banned in the U.S. in 1969. Research since then, however, has shown no association between cyclamate and cancer in humans. A petition was filed with the FDA to approve cyclamate, but it is not being considered at this time until more studies are done to prove its overall safety. There is a tremendous amount of misinformation out there about low- and no-calorie sweeteners, Flipse says. Anyone can go online and find a website or blog that tells terrifying stories about their use. Some people have reported headaches or other side effects when using aspartame. So many groups have been interested in aspartame s safety that it has been studied more than any other sweetener on the market, Flipse says. Over 200 studies have been done that support aspartame s safety in humans. There is, however, a select group of people that must avoid aspartame. Aspartame is not recommended for people with a genetic disease called phenylketonuria (PKU) because their bodies are unable to process it, Machado says. If you have a health condition, are taking medications, or have dietary restrictions, it s always best to talk to your doctor or a registered dietitian to make sure sugar substitutes are suitable for you to use, Flipse says.

Slipping in unnoticed

Sugar substitutes are easy to identify in foods with labels that read sugar-free or no added sugar. Labels claiming low-sugar, reduced sugar, without added sugar, or even reduced fat may also be on products containing low-or no-calorie sweeteners. Foods that are making a calorie claim meaning a label that reads low-calorie, calorie-free, reduced calories, or light may also have these sweeteners as ingredients, Flipse adds. Some manufacturers may not want to make a calorie claim but are using these products in foods for other reasons to impart a different texture, for instance, Flipse says. So if for whatever reason you want to avoid sugar substitutes, read your labels carefully. Common brand names of FDA-approved no-calorie sweeteners Acesulfame K: Sunett, Sweet One Aspartame: Equal, NutraSweet Neotame: Neotame (related to aspartame, not yet widely used) Rebiana: Truvia, SweetLeaf, PurVia Saccharin: Sweet N Low, Sweet Twin Sucralose: Splenda