Sweet Fix: Natural & Artificial Sweeteners

Sweet Fix: Natural & Artificial Sweeteners
Melissa Claire K. Uy, MD

High Intensity Artificial Sweetener Picture Common Brand Name Sweetness compared to table sugar Acceptable daily intake  (mg/kg/d)
Aspartame Equal 200x 50
Sucralose Splenda 600x 5
Acesulfame K Sweet One 200x 15
Neotame Newtame 700013,000x 0.3
Saccharin Sweet and Low 200-700x 15
Stevia Sweet Leaf 200-400x 4
Luo Han Guo Monk Fruit 100-250x Not Specified

Sugar comes in many different forms. The one that is most commonly used is table sugar, which is made by processing sugarcane. Another form of sugar is the high-fructose corn syrup, which is cheaper than table sugar and is commonly used in processed foods. Unfortunately, since added sugar means extra calories and weight gain, it can lead to diabetes and increased levels of triglycerides in the blood.

One of the means by which diabetes can be prevented or delayed is by decreasing the intake of added sugars. The World Health Organization (WHO) recommends that people have to keep their sugar intake below 10% of their total energy needs per day and reduce it to 5% for even greater benefits. This amount is equivalent to less than a serving (250 mL) of commonly consumed sugary drinks like iced tea or sodas.

Natural Sweeteners are those that are produced by nature from fruits, vegetables, nuts, seeds and roots without added chemicals. Examples are raw honey, maple syrup and molasses. Raw honey is made by bees from the nectar of a flower and it contains antioxidants, one of which is Vitamin C. On the other hand, maple syrup comes from the sap of maple trees and contains fewer calories and a higher concentration of minerals than honey. Blackstrap molasses contain substantial amounts of calcium, magnesium, potassium and iron. Foods containing natural sugar, such as fruits, tend to be more nutritious compared to just plain table sugar – they may contain vitamins and fiber that helps in digestion and they may have a lower glycemic load. These are healthier alternatives and have less calories than table sugar, but be cautious! They can still lead to increases in blood sugar and promote weight gain if taken in large amounts.

Non-caloric or low-calorie sweeteners are those that can be used instead of table sugar to help prevent or control weight gain. They do this by decreasing the total amount of calories that are being taken in.

Non-caloric high intensity sweeteners are regulated as food additives and are approved for use by the Food and Drug Administration (FDA). These include aspartame, sucralose, acesulfame-k, neotame, saccharin and advantame. Other non-caloric sweeteners are Stevia and Luo Han Guo or monk fruit, which are designated as “Generally Recognized As Safe” (GRAS) by the FDA. These sweeteners are sweeter than table sugar but have zero calories. They are used to make diet drinks, baked goods, frozen desserts, candy and chewing gum. They can also be added to coffee or tea, or sprinkled on top of food.

Sugar alcohols such as sorbitol, xylitol, maltitol, lactitol, erythritol and glycerol, have lower calories than table sugar and are used primarily to sweeten “sugar free” candies, cookies, and chewing gums. They do not promote tooth decay since they are not fermentable by oral bacteria.

All of these artificial sweeteners may seem to provide a quick solution for people who crave sweets to help them lose weight and prevent diabetes, but caution should be exercised because sweetness that is not accompanied by other caloric content may only offer partial, but incomplete activation of the body’s food reward pathways. This leaves them still feeling hungry and looking for other food to eat. This may then lead to a heightened motivation to eat.

A miniscule amount of artificial sweetener produces a sweet taste comparable to table sugar, and people who routinely use artificial sweeteners may start to find less intensely sweet foods, such as fruits and vegetables, less appealing and unpalatable. Also, frequent intake of sweet food, even those that use artificial sweeteners, may actually encourage sweet cravings by activating pleasure centers in the brain and this may ultimately lead to addiction to sweets and sugar dependence from other foods.

Finally, we should always keep in mind that processed foods, which may contain sugar substitutes, generally don’t offer the same health benefits as fruits and vegetables. Also, taken in large quantities, sugar alcohol can actually increase blood sugar levels and cause abdominal discomfort, like flatulence, bloating and even diarrhea. In the end, limiting the consumption of any sweetener is still the best healthful move we can all make.

Sweetener Sweetness compared to table sugar Kcal/g
Sorbitol 60% 2.5
Xylitol 100% 2.5
Maltitol 75% 2.7
Lactitol 35% 2
Erythritol 70% 0.2
Glycerol 40% 4

References Standards of Medical Care in Diabetes (2019, Jan). Diabetes Care. Volume 42, Supplement 1. Harshey, K (2019, Feb 1). Diabetic Retinopathy: Myths and Facts. Retrieved from https://www.practo.com Eye Complications (2018, Nov 19). Retrieved from http://www.diabetes.org. Lee, et al (2015). Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye and Vision. 2:17 Community Eye Health Online Course. Retrieved from http://www.uniteforsight.org


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