Satisfying Your Sweet Tooth With Low-Calorie Sweeteners: Part 1

Not too long ago, people with diabetes were told to avoid sugar. Sugar was pretty much seen as the downfall of diabetes; in fact, many people thought that eating sugar actually caused diabetes. We know now that isn’t true. Eating sugar doesn’t cause diabetes, nor does eating sugar (or something sweet) necessarily cause your blood glucose to rise any further or faster than eating another carbohydrate food, such as a piece of bread or an apple. (Remember, it’s the total amount of carb you eat that impacts your blood glucose, rather than the type of carb you eat.)

However, before you reach for the sugar bowl, it’s important to keep in mind that sugar and foods that contain sugar are not the most nutritious foods. Cakes, candy, cookies, and sodas are considered to be “empty calorie” foods. That is, they contain a lot of calories but have little, if any, vitamins, minerals, phytonutrients, or fiber. And because it’s often hard to limit portions of sweets, most people tend to eat more than a serving—for example, who eats just half a cup of ice cream?—thereby consuming too many calories and carbs. Is there a way to savor that sweet flavor without sacrificing good blood glucose control and without loosening up your belt? Maybe.

Low-calorie, or artificial, sweeteners are substances that provide a sweet taste without the calories and carbs of sugar. There are currently five low-calorie sweeteners approved by the U.S. Food and Drug Administration (FDA): saccharin, aspartame, acesulfame potassium, sucralose, and neotame. These sweeteners have little or no calories, and are used alone as sweeteners and also in many food products, such as candy, gum, ice cream, yogurt, and soft drinks. Let’s take a closer look.

Saccharin. Commonly known as “Sweet’N Low” or “SugarTwin,” saccharin has been around for a long time. Saccharin is 300 times sweeter than sugar. It doesn’t break down at high temperatures, making it suitable for cooking and baking. For a long time, a debate raged on about saccharin causing cancer. More than 30 studies with humans have shown that saccharin is safe to use, and in the year 2000, the warning label found on saccharin-sweetened foods and beverages was removed.

Aspartame. Known as “NutraSweet” and “Equal” in the United States, aspartame has been the reigning sweetener for many years. Aspartame was discovered in 1965 and is about 200 times sweeter than sugar. This sweetener has become quite popular because it tastes very much like sugar without leaving an aftertaste. Like saccharin, aspartame has been steeped in controversy, and there have been claims that this sweetener can cause all kinds of health problems. However, more than 200 scientific studies have confirmed that this sweetener is safe to use. (However, people with a rare genetic disorder called phenylketonuria should not use aspartame.) This sweetener is used by more than 200 million people around the world, and is used as a tabletop sweetener and found in beverages, candy, yogurt, ice cream, pudding, and even some vitamins and medicines. Aspartame can break down at high temperatures, however, so it isn’t always suitable for baking or cooking.

Acesulfame potassium. Sometimes called “ace-K,” acesulfame potassium is the sweetening ingredient in “Swiss Sweet,” “Sweet One,” and “Sunett.” It’s about 200 times sweeter than sugar. Discovered in 1967, this sweetener is heat stable and is found in tabletop sweeteners, desserts, candies, beverages, and cough drops. Ace-K can be used in cooking and baking. While not as popular as aspartame or sucralose, ace-K is combined with these two sweeteners in some foods.

Sucralose. Known as “Splenda” in the United States, sucralose is fairly new to the market and is 600 times sweeter than sugar. This is the only sweetener made from sugar and probably tastes more like sugar than any of the other sweeteners. Sucralose is considered safe for anyone, including pregnant women and children. It’s stable at high temperatures and can be easily substituted for sugar in recipes. It’s also found in a number of foods and beverages.

Neotame. Approved in 2002, neotame is the latest sweetener to hit the market. This sweetener is between 7,000 and 13,000 times sweeter than sugar. Although not yet widely used in the United States, neotame can be used in a variety of foods and beverages and is suitable for cooking and baking.

Two other sweeteners, alitame and cyclamate, are being considered for approval by the FDA. Alitame is a new product, while cyclamate was previously on the market in the United States. Cyclamate was banned in the 1970’s because of fears that it caused cancer. Since then, research has shown no link to cancer, and the sweetener’s maker has petitioned the FDA to re-approve cyclamate. Cyclamate is currently used in products sold in Canada and other countries.

Can using foods containing low-calorie sweeteners really help with diabetes and weight control? Maybe. Let’s compare two different sodas. Twelve ounces of regular Coke contain 140 calories and 39 grams of carbohydrate. The same amount of Diet Coke contains 0 calories and 0 grams of carbohydrate. If you’re a big Coke drinker, you could certainly save a lot of calories and carbs by switching to the diet version.

However, while foods sweetened with low-calorie sweeteners generally have fewer calories and carbohydrate than foods sweetened with sugar, often they still have some calories and carbohydrate. In other words, sugar-free doesn’t mean calorie- or carb-free. It’s still important to watch portion sizes and fit those carbs into your meal plan. As always, be sure to read the Nutrition Facts label for any food that you plan to eat. Don’t be fooled by the packaging.

Next week, we’ll take a look at sugar alcohols.

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Amy Campbell: Amy Campbell is the author of Staying Healthy with Diabetes: Nutrition and Meal Planning and a frequent contributor to Diabetes Self-Management and Diabetes & You. She has co-authored several books, including the The Joslin Guide to Diabetes and the American Diabetes Association’s 16 Myths of a “Diabetic Diet,” for which she received a Will Solimene Award of Excellence in Medical Communication and a National Health Information Award in 2000. Amy also developed menus for Fit Not Fat at Forty Plus and co-authored Eat Carbs, Lose Weight with fitness expert Denise Austin. Amy earned a bachelor’s degree in nutrition from Simmons College and a master’s degree in nutrition education from Boston University. In addition to being a Registered Dietitian, she is a Certified Diabetes Educator and a member of the American Dietetic Association, the American Diabetes Association, and the American Association of Diabetes Educators. Amy was formerly a Diabetes and Nutrition Educator at Joslin Diabetes Center, where she was responsible for the development, implementation, and evaluation of disease management programs, including clinical guideline and educational material development, and the development, testing, and implementation of disease management applications. She is currently the Director of Clinical Education Content Development and Training at Good Measures. Amy has developed and conducted training sessions for various disease and case management programs and is a frequent presenter at disease management events.

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