Sizing Up Sugar Substitutes

As rates of obesity, type 2 diabetes, and heart disease continue to expand, so does the sugar substitute industry. That many of us are continually looking to the next, best sugar substitute may be an indication of how uneasy we are about their safety and effectiveness.

Many avoid aspartame by reaching for sucralose. Others avoid sucralose by seeking out the latest in sugar alcohols. The discussions and controversy are ongoing. Which sugar substitute is safe?

Supposedly Safe Sweeteners

For those who wish to believe sugar substitutes are safe and effective, it’s easy to understand why. After all, our government says they only approve those that pass rigorous testing under the Food and Drugs Act. This is the same government and set of regulations, however, that allowed controversial trans fats, genetically modified foods, and some questionable food additives to make their way into our diets.

Aspartame, also known as Equal™ and NutraSweet™, shows up on many food labels and is sold as a tabletop sweetener. Health Canada says that methanol, which is a byproduct of digesting aspartame, is not foreign to the human diet. While this is true, studies show that an average person’s daily intake of methanol from natural sources is less than 10 mg. Aspartame beverages contain 55 mg/L and long-term studies have suggested that methanol may cause cancer.

The effects of aspartame are documented by the FDA’s own data presented in 1995. They no longer take adverse reaction reports, but at that time, aspartame accounted for more than 75 percent of all adverse reactions reported to the FDA’s Adverse Reaction Monitoring System, which collected and evaluated potential adverse effects to food and colour additives.

H.J. Roberts, author of the book Aspartame Disease: An Ignored Epidemic (Sunshine Sentinel Press, 2001), suggests that the effects of aspartame are often misdiagnosed as arthritis, lupus, multiple sclerosis, and Alzheimer’s disease, along with many other conditions.

Sucralose, also known as Splenda®, is a popular artificial sweetener used in food manufacturing and sold for use as a tabletop sweetener and baking ingredient. A US Internet survey by the Center for Science in the Public Interest (CSPI) in April 2004 showed that nearly half of users (47 percent) incorrectly believed Splenda® was a natural product. This is probably due in large part to the effective marketing slogan: “Made from sugar, so it tastes like sugar.” While Splenda® is made with sugar, the end product is artificial and contains no sugar, which is why it has no calories.

McNeil (makers of Splenda®) tells consumers that the body does not absorb sucralose; however, the FDA’s “Final Rule” report on sucralose showed that 11 to 27 percent of the compound is absorbed into humans. Dr. Janet Starr Hull (janethull.com), author of the book Sweet Poison: How the World’s Most Popular Artificial Sweetener is Killing Us: My Story (New Horizon Press, 2001), says that shrinkage of the thymus gland in animal studies using sucralose is a great cause for concern since the thymus gland is a foundation of immunity.

Acesulfame potassium, also known as acesulfame K, potassium acesulfame, ace K, and ACK and marketed as Sunett®, is the latest artificial sweetener to be approved by Health Canada. While it has been deemed safe by the European Union’s Scientific Committee for Food, many individuals and organizations disagree.

According to CSPI, who spoke out against the inadequate and poor-quality testing of this sweetener, a byproduct of acesulfame potassium has been shown to negatively affect the thyroid in animals when taken in large doses. Despite peer-reviewed studies and wide consensus among the scientific community, CSPI is also concerned that the cancer-causing potential of this sweetener may not be fully understood due to the lack of long-term, up-to-date, adequate testing.

At the very least, this sweetener should be avoided by people who are on a potassium-restricted diet or who have sulfa-antibiotic-based allergies.

Sugar alcohols (or polyols), such as lactitol, maltitol, mannitol, sorbitol, xylitol, erythritol, isomalt, and hydrogenated starch hydrolysates are technically not artificial sweeteners because they are nutritive (contain energy/calories), unlike non-nutritive sweeteners such as aspartame, sucralose, and acesulfame potassium.

Sugar alcohols are neither sugars nor alcohols but have a chemical structure that partially resembles sugar and alcohol. They occur naturally in a wide variety of fruits and vegetables; however, when produced commercially, they are made from other carbohydrates such as sucrose, glucose, and starch. These sugar substitutes are about half as sweet as sucrose (table sugar) and are not completely metabolized by the body, which means they are low in calories.

The sugar alcohol sweetener known as xylitol is considered safe and healthy by many and is marketed as a natural, healthy alternative to table sugar.

Since sugar alcohols aren’t technically a form of sugar, products sweetened with them are often labeled “sugar-free.” While research shows that sugar alcohol has a smaller blood sugar and insulin response when compared to eating glucose, it does influence the body. As with any processed product, quality is a key factor in determining whether it should be included in a healthy diet.

The flipside to sugar alcohol’s low-calorie contribution to the body is that because they are not well absorbed or metabolized, they remain in the gastrointestinal tract where they may cause problems. The biggest known danger of eating too much of these sugar substitutes is the potential for abdominal discomfort and laxative effects such as diarrhea.

Saccharin and cyclamates are not permitted by Health Canada to be used as food additives due to health-related concerns, but these artificial sweeteners are sold as tabletop sweeteners. Saccharin is marketed as Hermesetas®, while cyclamates, marketed as SucarylTM, are used in Sugar TwinTM and Weight WatchersTM. In Canada, saccharin can only be bought at pharmacies. Animal studies in the late 1960s and early 1970s linked saccharin and cyclamates with the development of bladder cancer.

The Root of a Sweet Tooth

While there is much discussion about which sugar substitutes are safe and which aren’t, I often wonder why there isn’t more discussion about what is at the root of our need for sweets. If the threats of obesity, diabetes, heart disease, and cancer aren’t enough to make us change our habits, there must be something pretty strong behind our desire for the taste of sugar.

The emotional root of our need for sweets may stem from a lack of nourishment. I often ask my nutrition clients to keep a diet diary. Once they become aware of how they use sugar as a substitute for love, companionship, acceptance, or to counter undesirable feelings, they can take steps to making better choices for themselves. Substituting artificial sweetness for sugar won’t fulfill emotional needs any better than sugar will.

The physiological root of our sugar cravings also stems from a lack of nourishment. When we eat processed foods, we fill the body with empty calories and create imbalance in our blood sugar and hormone levels, which causes cravings for sugar–that’s how even sugar-free or low-calorie food can contribute to obesity and disease. In the big picture we need to understand that all of the processed foods we eat, sweet or not, act like sugar in the body and are converted to and stored as fat.

With this in mind, substituting sugar is not the answer to our health problems. If it were, our health would improve along with the sales of sugar substitutes. It makes much more sense to enjoy natural sweeteners and whole foods, while cutting down on processed foods–some of the biggest culprits in obesity and disease.

Health Canada and the Canadian Diabetes Association maintain that “normal use” of artificial sweeteners do not pose a health risk; however, the term “normal” is both subjective and vague–leaving the decision up to the user. In any case, artificial sweeteners do nothing to benefit the body or help with the root of the problem.

So, which sugar substitute is safe? Good question, but a better question is: Why are we obsessed with sweets and what can we do about it? Finding health naturally, not artificially, is the key to enjoying the sweetness in life.

In Canada the Following Sweeteners Have Been Approved as Food Additives:

• aspartame
• sucralose
• acesulfame potassium
• isomalt
• lactitol
• maltitol
• mannitol
• sorbitol
• xylitol
• erythritol
• hydrogenated starch hydrolysates