The steady rise in diabetes patients globally has pointed to the restriction of table sugar by medical professionals, which shows a budding interest in sugar-free and low-carbohydrate diets. Furthermore, the rising prevalence of obesity in developed nations associated with sugar-sweetened beverages lead to the discovery of several artificial sweeteners(AS). Artificial sweeteners(AS) are amongst the most popular sugar substitutes as they are great sweetening agents and have none or close to nil calories. This is the reason why there is an increased demand for sugar substitutes across the world.
However, over time, some artificial sweeteners were claimed to be unsafe, which was why they were even withdrawn from the market. Some researchers have cautioned that excessive consumption of artificial sweeteners can lead to abnormal weight gain and further result in diabetes and other health-related problems. Hence, team diahome would like to bring some facts to your coffee table.
Artificial sweeteners, commonly known as sugar substitutes, are chemical compounds added to your food and diet drinks to make them sweet. These artificial sweeteners are frequently referred to as intense sweeteners as they present a flavour comparable to normal table sugar; however, they taste sweeter than that.
While some artificial sweeteners contain calories, the quantity required to sweeten food and drinks is very small, and you end up eating almost zero calories. Hence, these artificial sweeteners are further classified into nutritive and non-nutritive sweeteners and work in a similar way in which the normal sucrose or sugar work on your taste buds.
Just like sugar, these sweeteners also fit the taste buds of your tongue perfectly and send signals to the brain to identify the sweet taste. However, the only difference between sugar and artificial sweeteners is that while the body can break down sugar in the form of calories, these sweeteners are nearly calorie-free and present your taste buds with a sweet taste without any added calories.
Fitness and health-conscious individuals looking for healthier alternatives to sugar have driven the industry to make available a plethora of artificial sweeteners in the market today. However, the FDA (Food and Drug Administration) has only accepted and sanctioned one natural low-calorie sweetener and five artificial sweeteners. Some of the most commonly used and FDA-approved artificial sweeteners are mentioned below.
1. Saccharin (commonly sold under the brand name “sweet and low”)
Saccharin is one of the most commonly used artificial sweeteners amongst people with diabetes or those looking to cut back on table sugar. One packet of Saccharin contains only 4 calories, and it is one of the sweeteners generally regarded as safe. However, to ensure safety during pregnancy, pregnant women are advised not to consume this artificial sweetener. Although it was withdrawn from use in 1977, because it was shown to cause bladder cancer in rats, it is now approved for use by the USFDA as it was deemed that it would not affect humans. Most countries allow it, some have banned its use, while some advise caution.
2. Aspartame (commonly sold under the brand name Equal and Nutrasweet)
Aspartame is another artificial sweetener that is most commonly used by health or weight-conscious people and people who have diabetes. It is 200 times sweeter than sucrose and is primarily composed of amino acids (smallest units of protein). These health-conscious people or people with diabetes can easily use Aspartame in their hot or cold drinks or diet desserts to satisfy their sugar cravings. While this is an approved artificial sweetener by the FDA, it is not safe for consumption for people suffering from the genetic disorder phenylketonuria without the consultation of a medical practitioner. There have been studies that indicate allergic responses to specific ingredients of aspartame. Toxicity in very high doses has also been studied. Evidence suggests that aspartame is safe “at current levels of consumption” – in small amounts. It might however be contraindicated in people who have a condition called phenylketonuria – and such people are advised to avoid aspartame.
3. Sucralose (commonly sold under the brand name Splenda)
Unlike the other sweeteners, Sucralose consists of zero calories, making it most ideal for diabetes patients to satisfy their need for sweets.
However, some studies have shown that excessive consumption of sucralose daily can result in bloating and diarrhoea if the person consuming it holds a sensitive digestive system. While Sucralose is approved by the FDA for consumption, its long term effects, interaction with other compounds is not clear.
4. Neotame is a relatively recent addition to the safe list of artificial sweeteners.
It is chemically related to aspartame, rarely used. Since it is more stable than aspartame, it is used in baked goods. You might find this rarely in some imported baked goods/chocolates.
5. Acesulfame -K
It is another sweetener that is approved by the US FDA and hence generally regarded as safe. Although it is not very popular in India, some imported “sugar free” drinks and other products might contain acesulfame – K.
6. Stevia (commonly sold under the brand name “truvia”)
Stevia sweetener is extracted from the stevia plant. That is the reason why this Stevia is considered a natural sweetener. However, it should be remembered that the term”natural” does not mean”absolutely safe”. There can be interactions with foods and drugs which we might not be aware of. Since in moderate amounts, stevia does not seem to have any adverse effects, it is also considered safe to be used.
While the AS approved for use by the US FDA are now being widely used, they have also published an acceptable daily intake (ADI) for each sweetener. Table shows the ADI for the five sweeteners
Although the ADI is much higher than what we currently consume, our sensitivity to large amounts of AS is still under study. There are studies that conflict each other in the use of these sweeteners, that associate AS with development of type 2 diabetes, cancer,weight gain, gastro-intestinal diseases etc.(https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4899993/) . Since these studies have several limiting factors, their findings have not been considered as conclusive,although they warrant further research. Hence considering the long term safety of the use of the AS, and the fact that international agencies such as the FDA, have done extensive studies on their safety, we recommend that individuals may use AS, in small amounts – as sweeteners in coffee/tea amounting to 3-4 cups a day. When used in sweets, desserts and drinks as a sugar substitute, it should be remembered that the safe upper limit can be crossed if there is an excess intake.
After all that is said and done, consuming artificial sweeteners in moderation, for, e.g. in your coffee/tea 3-4 times a day, is generally regarded as safe and will be well within acceptable limits of consumption. They can be part of your weight loss or diabetes management regime, provided you follow the other healthy lifestyle principles, including healthy eating and adequate physical activity. Since long-term studies on excess consumption of such sweeteners are still not available, the best way to go would be moderation. For further information or clarity regarding the daily management of diabetes, you can contact the experts in the field through the Diahome app.
Author: Sripriya Ravi, MSc,M.Phil,MS, Dietitian/Diabetes Educator, Diahome
Diahome is the one you can rely on for all your diabetes-related needs, whether you wish to opt for home consultations, home blood collection, online reporting as well as receiving medications at a discount.