Do you feel like you are surrounded by sweets? Cookies, ice-cream, candy, soda and other sugary treats are everywhere, along with the extra calories and simple carbohydrates they contain. For people with diabetes and those trying to cut calories and carbohydrates, sugar is a big no-no, so the words "sugar-free" can be music to their ears—or at least satisfaction for a sweet tooth.
"Sugar-free" food products are sweetened by sugar substitutes, which go by many names: non-nutritive sweeteners, low-calorie sweeteners, no-calorie sweeteners, artificial sweeteners and alternative sweeteners. No matter what you call them, they all taste similar to sugar, but contain little to no calories and have little glycemic response.
Despite FDA approval, artificial sweeteners have been accused of causing everything from mood and behavioral disorders to headaches, multiple sclerosis, obesity, heart disease and cancer. While some individuals may attribute these symptoms to artificial sweeteners, there are no published, peer-reviewed, controlled scientific studies to support these accusations. According to the National Cancer Institute, there is no scientific evidence that any artificial sweeteners approved for use in the United States cause cancer. The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) says adults can safely enjoy a range of non-nutritive sweeteners when consumed in a diet that is guided by federal nutrition recommendations such as the Dietary Guidelines for Americans.
Before any sugar substitute reaches the market, the U.S. Food and Drug Administration (FDA) reviews several studies (including short and long-term toxicity, carcinogenicity, neurotoxicity and reproductive toxicity studies) to assess its safety. Currently, the FDA has approved seven non-nutritive sweeteners for use in the United States: acesulfame-potassium, aspartame, luo han guo, neotame, saccharin, stevia (Rebaudioside A) and sucralose.
In addition, the FDA establishes Acceptable Daily Intakes (ADI) for each artificial sweetener. An ADI is the amount of artificial sweetener a person can safely consume (per kilogram of body weight) on average, every day, over a lifetime without incurring any health risks. This includes a 100-fold safety factor, meaning that the ADI is 1/100th of the actual amount that is considered safe for daily consumption.
So how much artificial sweetener can an adult safely consume each day, according to these ADIs established by the FDA? Here's an example: To reach the ADI for aspartame (which is 50 mg/kg body weight per day), a 150-pound adult would need to consume 20 (12-ounce) cans of diet soda OR 42 (4-ounce) servings of sugar-free, diet gelatin OR 97 packets of tabletop sweetener in a single day.
Artificial Sweeteners and Obesity
Obesity is a complex problem without a single cause. A single component of the food supply, such as sugar, can't be blamed for obesity or weight gain, but research does show that non-nutritive sweeteners may promote weight loss in overweight and obese individuals when they replace the intake of sugar calories (sugar has 16 calories per teaspoon) with sugar substitutes. However, others raise the question of whether a sweet food environment increases the risk of obesity through appetite, intake and food regulation mechanisms.
Preliminary studies on animals suggest that high intakes of artificial sweeteners may affect appetite control (i.e. by eating more sweet foods—artificially sweetened or not—you crave more of them). Therefore, the Beverage Guidance Panel recommends that adults consume no more than 32 ounces of artificially sweetened beverages daily. Individuals who want to use artificial sweeteners should do so within the context of a sensible weight-management program that includes a balanced diet and regular exercise.
Artificial Sweeteners and the Glycemic Response
Artificial sweeteners do not affect blood sugar levels or the glycemic response. Therefore, the American Diabetes Association states that non-nutritive sweeteners are appropriate for people with diabetes and may help control calorie intake. Individuals with diabetes should work with a registered dietitian and/or certified diabetes educator to develop a customized eating plan. If you have diabetes or other reasons to watch your sugar intake, check with your healthcare provider before trying sugar substitutes; sugar-free doesn't always mean safe for everyone.
Let's take a closer look at the seven FDA-approved non-nutritive sugar substitutes:
Acesulfame-Potassium (Acesulfame-K) goes by the brand names Ace-K, Sunett and Sweet One. It is a combination of organic acid and potassium that is often blended with other sugar substitutes.
Luo han guo (Luo hand kuo) extract also goes by names such as swingle fruit extract and monk fruit extract. The sweetness comes from a combination of several mogrosides, the sweetening constituents of the monk fruit. It is classified as General Recognized As Safe (GRAS) by the FDA and is intended for use as a tabletop sweetener, a food ingredient and a component of other sweetener blends. It is currently available as a blend by the name of Nectresse.
But remember, you need to control calories in your entire eating plan to lose weight. Removing the sugar from a soda, cookie or candy bar does not turn it into a health food. Without monitoring your portion size, you can still get too many calories and zero nutritional benefits from foods and drinks that contain artificial sweeteners.