The Skinny on Sweeteners

Are you confused by the vast array of sweeteners that are used in foods? I find that our society has demonized the word “sugar,” perhaps because we think of blood glucose as blood “sugar” and for decades we associated sugar with being bad for diabetics.

Many people that I encounter, including patients, tell me that when they read a nutrition facts panel, they look to see how much sugar is in the product. I always follow up by asking them, “Do you know how many grams of sugar you need each day and do you understand the difference between naturally occurring sugars and added sugars?” The answer is always a resounding “no.”

Some studies have linked long-term consumption of sugar to dental problems, diabetes, obesity and heart disease, so moderation is key. But sugar isn't the only option. Many natural and artificial sweeteners exist out there, but it's hard to keep track. And new research suggests that no-calorie sweetners may not be the best alternative...

Emerging Alternatives to Sugar

Saccharin was first “discovered” by accident in the lab by Constantin Fahlberg in 1878 and became used commercially shortly thereafter. Its use became widespread during sugar shortages during World War I. Its popularity increased in the 1960s and 1970s – as pink packets of Sweet’n Low were seen everywhere and many diabetics, and consumers, were happy with the calorie-free sweetener that did not impact blood glucose. It is considered to be 200 to 700 times sweeter than sugar, and some find the taste unappealing.

Aspartame was approved for use in 1981 and for use in foods in 1983. It is 180 to 200 times sweeter than sugar and brand names include Equal and NutraSweet. But there has been some controversy over the safety of aspartame. When the FDA approves ingredients, companies must prove there is no harm from consumption – the term often used is carcinogenic (or cancer-causing). However, advances in research and testing methods have researchers questioning safety from a different perspective – neurotoxicity and other illnesses.

Aspartame is among the most controversial of the sweeteners, perhaps because of its possible link to increased rates in multiple sclerosis, autism, irritable bowel, celiac disease or even food allergies. But more research needs to be done before we will have the answers.

Acesulfame-K (potassium) is another non-caloric sweetener that is 180-200 times sweeter than sugar. It was first approved in 1988. Like other sweeteners, it has its fair share of controversy as well.

Sucralose is 600 times sweeter than sugar. It was approved for use in the U.S. in 1998, and is sold under the brand name, Splenda. Once again, a very stable artificial sweetener – it can be found in a wide array of packaged foods.

Sugar Alcohols may be found on labels as sorbitol, mannitol, xylitol, ethryritol, maltitol, glycerol, and are actually part of a fatty acid molecules. Often they are found in gums and hard candies, but can be found in foods and beverages as well.

Stevia or rebiana is 250-300 times sweeter than sugar. Brand names include Truvia, PurVia and Stevia in the Raw. Stevia had been used as a liquid sweetener, found in health food stores and new plants, and processes have yielded a granule sweetener that is also highly stable in many food and beverages.

Agave is NOT a calorie-free sweetener, but one that you may have heard about. It has a lower glycemic index than granulated sugar, but is quite similar to high fructose corn syrup. Agave is also predominantly grown in Mexico, so the cost of foods and beverages containing it is higher because it is imported. The exotic nature of this sweetener does not mean it is any better than the others.

Honey is also considered “natural” and has a distinct flavor, which doesn’t always make it a taste-neutral substitute.

High Fructose Corn Syrup, introduced in the mid 1970s, is a natural sweetener made from corn that was developed to have a sweetness equivalent to that of sugar. It is the most commonly added sweetener in processed foods and beverages, but is predominantly found in soft drinks.

Sweeteners are not just used to sweeten foods and beverages alone. In some cases, they are used as a flavor “enhancer” – frequently seen in products labeled “low sugar” or “low calorie.”

Worth Your Weight in Sugar

For decades, non-caloric sweeteners have been marketed as being “healthier for you” because they have less calories. But the numbers are showing a relationship (though few dare say causation) between the percent of people using artificial sweeteners, the amount of products containing artificial sweeteners and the percent of the population that are obese.

Non-caloric sweeteners (“natural or artificial”) are not neutral – they work on the taste receptors throughout the body – not just on the tongue, but in the small intestine and pancreas. The metabolic cascade ensues with insulin and glucagon being released.

Sugar is a fuller, more satisfying taste whereas artificial sweeteners are one dimensional. Few people who use non-caloric sweeteners are satisfied with just one packet – in fact, they keep increasing their false sense of “sweet” as their taste preference and drive are not completely satisfied. When the brain is fooled, caloric needs are not met and this leads to overconsumption of calories.

The example I use is that when your gas tank is empty, you can fill it up with water, the gauge will read full, but the car won’t operate. It’s the same thing with our bodies – we can only store up to six hours of carbohydrates, which is our body’s preferred fuel – especially our brains, which is why we need to consume carbohydrates throughout the day.

There is no doubt that the manufacturers of each sweetener attempt to make their case and place doubt on any findings contrary to their product. We do not have evidence that supports long term safety – looking beyond cancer. It really comes down to calories and energy balance.

As a parent, I’m not willing to have my children be the Petri dish for experimentation for industry. I do advocate eating foods closer to the way they are found in nature. In our household, we say “no” to non-caloric sweeteners in foods and beverages.

Felicia D. Stoler, DCN, MS, RD, FACSM is a doctorally trained registered dietitian, exercise physiologist, TV personality and expert consultant in disease prevention, wellness and healthy living. She is the author of "Living Skinny in Fat Genes: The Healthy Way to Lose Weight and Feel Great." She hosted TLC's groundbreaking series "Honey We're Killing the Kids!" Become a fan of Felicia on Facebook, follow her on Twitter or visit her website FeliciaStoler.com