A Spoonful Of Sugar Substitutes

If you are trying to decrease the amount of added sugar and calories you consume, you may be tempted to use artificial sweeteners or other sugar substitutes. Sugar substitutes are substances used to sweeten food products instead of regular table sugar (sucrose). There are a number of different types of sugar substitutes: artificial sweeteners, sugar alcohols and natural sweeteners. A variety of foods and beverages such as soft drinks and baked goods contain sugar substitutes and are marketed as “sugar-free” or “diet” products. 

Artificial sweeteners are regulated by the Food and Drug Administration (FDA) as food additives. They must be reviewed and approved by the FDA before they can be sold. Based on the available scientific evidence, the FDA determines whether the artificial sweetener is safe to consume in the amounts that people normally consume. Sometimes the FDA will designate a substance “generally recognized as safe” (GRAS) meaning that the substance is safe for its intended use based on scientific data and/or the substance has such a long history of use in foods that it is generally considered safe.

Potential Benefits of Artificial Sweeteners

Artificial sweeteners (also known as high-intensity sweeteners) add the taste of sweetness while adding few or no calories  and no nutrients. These sweeteners are derived from plants, herbs, or from regular sugar, and some are chemically manufactured. They are much sweeter than sugar. Therefore, very small quantities of the artificial sweeteners are needed for sweetening foods and beverages. Some artificial sugars are not absorbed by the body which means that they pass through the digestive tract unchanged and don’t contribute any calories.  The use of artificial sweeteners could help you reduce the amount of added sugars you consume which could lead to eating less calories overall. Reducing calories could help you reach and maintain a healthy body weight which would help lower your risk of developing heart disease and diabetes. In addition, artificial sweeteners are not carbohydrates and therefore generally do not raise blood sugar levels which is a good benefit for people with diabetes. Artificial sugars also do not contribute to tooth decay.

Artificial Sweeteners Available

The FDA has approved six artificial sweeteners: aspartame, saccharin, acesulfame potassium (Ace-K), neotame, sucralose and advantame and recognizes two artificial sweeteners as GRAS: stevia and monk fruit extract. 

Name of Artificial Sweetener	Brand Names	Sweetness Intensity Compared to Table Sugar (Sucrose)	Types of Foods Found In	FDA Approved or GRAS
Aspartame	Nutrasweet® Equal® Sugar Twin®	200x	Used as a tabletop sweetener and found in a wide variety of foods and beverages, including cereals, yogurt, frozen and gelatin desserts, candy, sugar-free gum, juices, diet sodas.	Approved
Saccharin	Sweet Twin® Sweet’N Low® Necta Sweet®	200-700x	Oldest artificial sweetener on the market. It was discovered in the late 1800s. Used as a table top sweetener, in beverages such as soft drinks and in processed foods such as canned fruit, baked goods and candy.	Approved
Acesulfame Potassium (Ace-K)	Sweet One® Sunett®	200x	Generally used in combination with other artificial sweeteners and is frequently found in sugar-free sodas frozen desserts, candies, and baked goods.	Approved
Neotame	Newtame®	7000-13,000x	Used in low-calorie foods and beverages, but to a lesser extent than other sweeteners. Can be used for cooking and baking.	Approved
Sucralose	Splenda®	600x	Used as a tabletop sweetener and as a  replacement for sugar in cooking and baking in recipes. It is found in many low-calorie foods and beverages, such as baked goods and other desserts, canned fruits, dairy products and syrups.	Approved
Advantame		20,000x	Not commonly used at this time. Can be used for cooking and baking.	Approved
Stevia	Truvia® PureVia® Enliten®	200-400x	Used in a wide range of foods and beverages, including teas and juices, and as a tabletop sweetener. It is often blended with another artificial sweetener to reduce bitterness.	GRAS
Monk Fruit Extract	Nectresse® Monk Fruit in the Raw® PureLo®	100-250x	Often blended with other artificial sweeteners. Can be used for cooking and baking.	GRAS

Two of the artificial sweeteners are considered “natural” due to what they are derived from. Stevia is extracted from the leaves of the Stevia rebaudiana plant, an herbal shrub native to South America. The FDA has approved refined stevia as an artificial sweetener, but it hasn’t approved whole leaf stevia or crude stevia extracts. Monk fruit extract is made from crushed monk fruit. It is the newest artificial sweetener on the market, but it has been used as a sweetener in China for almost 1,000 years. 

Possible Issues with Artificial Sweeteners

The way in which the body and brain respond to artificial sweeteners is vey complex. It is possible that people who use artificial sweeteners may consume extra calories from other food sources due to giving themselves permission to eat other high calorie foods because they are eating a lower calorie food. For example, a person is consuming a nonfat yogurt that contain aspartame instead of sugar for breakfast so they decide to also eat 2 slices of bacon. This way of thinking could offset weight loss or other health benefits of consuming artificial sugar.

It is possible that the use of artificial sweeteners could change the way people taste food. Very small amounts of high-intensity sweeteners produce a sweet taste similar to larger amounts of sugar without the same number of calories. When people frequently consume high-intensity sweeteners there could be overstimulation of sugar receptors leading to a limited tolerance for more complex tastes such as less intensely sweet foods (e.g. fruits) and non-sweets foods (e.g. vegetables). Thus, using artificial sweeteners could cause a person to avoid highly nutritious foods in favor of extremely sweet artificially flavored foods with less nutritional value.

Artificial sweeteners may also prevent people from associating sweetness with caloric intake. People may end up craving more sweets, choose sweet foods instead of nutritious foods and end up gaining weight. The San Antonio Heart Study showed that participants who drank more than 21 diet sodas each week were twice as likely to become overweight or obese compared to people who did not drink diet soda. It also appears that artificial sweeteners may be addictive. Research in rats showed that rats were more likely to choose oral saccharin instead of intravenous cocaine. 

Are Artificial Sweeteners Safe?

Based on the best science and research available, the FDA has determined that the artificial sweeteners listed in the table above pose a reasonable certainty of no harm to consumers when used in amounts people normally eat/drink. There is no strong scientific evidence that any of these artificial sweeteners cause cancer or other serious health problems. However, there is a lack of research on the effects of consuming large amounts of these artificial sweeteners over many years. In general, artificial sweeteners do not offer nutritional benefits since they do not contain any nutrients.

Even though the artificial sweeteners are considered safe by the FDA and may offer some health benefits such as weight management and lower blood sugar levels, it may be prudent to focus on consuming them in moderation. The limited use of the more “natural” artificial sweeteners such as stevia and monk fruit extract may make more sense; however, these are both still highly processed products.

Sugar Alcohols

A second category of sugar substitutes is sugar alcohols such as sorbitol, xylitol, lactitol, mannitol, erythritol, and maltitol. They are carbohydrates that occur naturally in some fruits and vegetables; however, most are manufactured. Sugar alcohols do not contain ethanol which is found in alcoholic beverages and therefore do not affect the body like alcohol does. The FDA also regulates the use of sugar alcohols. Sugar alcohols contain about half as many calories as sugar per gram, and they tend to be between 25% and 100% as sweet as sugar. As a result, they are not categorized as high-intensity sweeteners. They are lower in calories than sugar and do not promote tooth decay or cause a large increase in blood sugar levels. Since the body does not completely absorb sugar alcohols, the effect on blood sugar levels is less than other sugars. They are usually used in products that are labeled “sugar-free” or “reduced sugar” such as  candies, cookies and chewing gums and are often combined with artificial sweeteners to make the products taste sweeter. Sugar alcohols can have a major drawback. When eaten in large amounts they may cause bloating, gas and diarrhea. 

Natural Sweeteners

Finally, natural sweeteners are sometimes used as sugar substitutes and are promoted as a healthier option compared to sugar or other sugar substitutes (artificial sweeteners and sugar alcohols). However, these “natural sweeteners” often undergo processing and refining. The natural sweeteners that the FDA generally recognizes as safe (GRAS) include: fruit juices and nectars, honey, molasses, and maple syrup. Natural sweeteners can be used to sweeten foods at home and are also found in processed foods. They are considered “added sugars” because they are added to foods during processing or cooking/baking. Natural sweeteners may appear to be healthier than sugar, but the bottom line is that their vitamin and mineral content is not significantly different than sugar and the body processes the foods similarly. If you prefer the taste of one of these natural sweeteners, it is fine to use it, but keep in mind that there is no advantage to consuming any particular type of added sugar. 

The Bottom Line

Rather than consuming high amounts of sugar substitutes (artificial sweeteners, sugar alcohols, and natural sweeteners), it would be better to consume moderate amounts of any of these products. Keep in mind that “sugar-free” foods are not “calorie-free” foods and eating more calories than you need can cause weight gain. Foods that naturally contain sugar, such as whole fruit, tend to be nutrient-rich, high in fiber and offer health benefits that processed foods don’t offer. Whole fruits are a good option for satisfying a craving for something sweet. On the other hand, high amounts of refined sugar or even high amounts of natural sweeteners found in many processed foods and baked goods will lead to rapid increases in blood sugar and insulin levels, increases in triglycerides, and increases in inflammatory mediators and oxygen radicals thereby increasing the risk for diabetes, cardiovascular disease and other chronic diseases. A good plan would be to eat less real sugar by focusing on ways to lower added sugars in your diet.

Tips for Decreasing Added Sugars 

Some ideas for decreasing added sugars:

• Slowly cut back on how much sugar (or sugar substitutes) you add to the foods you eat and drink. Try cutting back to half the amount and then continue to decrease the amount.
• Only drink water rather than regular or diet soda, energy drinks, coffee drinks, juice beverages, etc.
• Compare food labels when shopping and choose products with smaller amounts of added sugars.
• Add fruit to foods you may normally add sugar to such as cereal, oatmeal or plain yogurt. Use fresh, frozen, dried or canned (in water or juice) fruit.
• Enjoy fruit for dessert instead of cookies, pastries or candy.
• Decrease the amount of sugar you use in cookies, brownies or cakes by one-third to one-half. You will likely not notice the difference.
• Swap out some of the sugar in a recipe with unsweetened applesauce (use equal amounts).
• Try using extracts like almond, vanilla, orange or lemon in recipes instead of adding sugar.
• Enhance the flavor of foods with spices (ginger, allspice, cinnamon or nutmeg) instead of sugar. 
• Look for lower sugar options for ketchup, BBQ sauce and other condiments or use lower sugar items such as salsa, mustard or hot sauce.
• Look at restaurant menus online so you can avoid both the high-fat and high added sugar options.

Information Compiled From:

https://my.clevelandclinic.org/health/articles/15166-sugar-substitutes–non-nutritive-sweeteners
https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states
https://foodinsight.org/everything-you-need-to-know-about-stevia-sweeteners/
https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030
https://www.healthline.com/nutrition/monk-fruit-sweetener#benefits
https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/tips-for-cutting-down-on-sugar
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/6-ways-to-reduce-your-sugar-intake/art-20267400