The Skinny on Sugar Substitutes

 In Medical Weight Loss

Sugar substitutes can be an attractive alternative for those of us looking for the sweet taste of sugar without the associated calories. Artificial sweeteners are used widely for this purpose and are present in a variety of “sugar-free” and “diet” foods and beverages. But with so many forms on the market, and conflicting information about possible health concerns, people often ask what the best choice is. We will summarize the most common artificial sweeteners that have been deemed safe for human consumption by the U.S. Food and Drug Administration (FDA), and we’ll briefly mention some of the newer novel sweeteners.

Saccharin (most popularly known as “Sweet ‘N Low”) has been present for decades. It gained tremendous popularity among individuals including dieters and diabetics, as it contained no calories and did not raise blood sugar levels. In the 1970s, research linked saccharin to bladder tumors in male rats that were fed high doses of the substance. This prompted safety-warning labeling of saccharin-containing foods. Since that time, dozens of human studies have been done, and showed that the rat studies did not translate to humans. The National Institutes of Health, and other health agencies, concluded that saccharin did not cause cancer or other serious health problems in humans. The warning label was subsequently removed, and saccharin remains one of the most popular artificial sweeteners used worldwide.

Aspartame (brand names include “Equal” and “NutraSweet”) contains no calories and is also very commonly used. It has also been surrounded by controversy at times, and has been accused of causing numerous health issues including weight gain, depression, headaches, dementia, cancer, lupus and others.  However, since its approval by the FDA in 1981, there has been no conclusive scientific evidence proving aspartame causes any of these conditions. Aspartame is considered safe for the general population, with the exception of individuals having the rare genetic disorder Phenylketonuria, which is screened for at birth. But, if a person feels that s/he has sensitivity to aspartame (or any food additive) it is best to avoid using the product. It is noteworthy to mention that aspartame is not stable when heated, and therefore should not be used in cooking or baking.

Sucralose (brand name “Splenda”) does contain calories, but since it is 600 times sweeter than sugar, very small amounts are needed to achieve a significant level of sweetness. It was approved by the FDA in 1998 and is one of the few sugar substitutes that isn’t sensitive to heat, making it useful in baking. There is some data suggesting that sucralose can reduce the level of beneficial bacteria in the gut. Additionally, since Splenda is not carbohydrate-free, it can trigger some insulin release, which may make it difficult to lose weight when used in excess.

Acesulfame potassium (“Ace-K”; “Sunette”) is a lesser known, but widely used artificial sweetener approved in 1988. It can have a slightly bitter aftertaste, but is sometimes used in combination with other artificial sweeteners to as a flavor-enhancer or to preserve the sweetness of sweet foods. Like several other artificial sweeteners, there have been some concerns raised about possible detrimental health issues, but the FDA currently deems it to be generally safe.

Stevia  Also known as “Truvia” is a non-caloric natural sweetener, derived from the leaves of the Stevia rebaudiana shrub. Like some of the other sugar substitutes, it can have a slightly bitter aftertaste. The FDA recognized Truvia as GRAS – (Generally Regarded As Safe) in 2008. It has been widely available for use in Asia for many years.

Luo Han Guo (“Nectresse”), like Stevia, is another plant extract based natural sweetener. It is made primarily from monk fruit extract, along with small amounts of erythritol, sugar and molasses. It is heat stable and suitable for baking, and is generally recognized as safe.

So, that’s the “skinny” on the most common sugar substitutes. It is important to remember that “sugar-free” does not translate into “calorie-free”. Sugar-free items also do not necessarily lead to weight loss, especially if we consume sugar-free foods then overcompensate by eating or drinking additional calories elsewhere. As with anything we consume, it’s best to be mindful of the calories per serving, serving size, and overall nutritional quality to ensure we eat a well balanced diet overall.

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