A sugar substitute is a food additive that provides a sweet taste like that of sugar while containing significantly less food energy.
Some sugar are produced by nature, and others produced synthetically.
Sugar substitutes is known as high-intensity sweeteners are compounds with many times the sweetness of sucrose, common table sugar.
High-intensity sugar substitutes require so little sweetener
that their energy contribution is often negligible.
The sensation of sweetness caused by these compounds is sometimes different from sucrose, so they are often used in complex mixtures that achieve the most natural sweet sensation.
Six high-intensity sugar substitutes have been approved for use: aspartame, sucralose, neotame, acesulfame potassium (Ace-K), saccharin, and advantame.
Food additives must be approved by the FDA, as safe.
Cyclamates are prohibited from manufacturing as a sweetener within the United States.
The majority of sugar substitutes approved for food use are artificially synthesized compounds.
Sorbitol, xylitol and lactitol are examples of sugar alcohols, known as polyols.
These are, in general, less sweet than sucrose but have similar bulk properties and can be used in a wide range of food products.
In the United States, the FDA provides guidance for the daily limits for consuming high-intensity sweeteners, a measure called Acceptable Daily Intake (ADI).
Acceptable Daily Intake (ADI) is defined as an amount in milligrams per kilogram of body weight per day (mg/kg bw/d), indicating that a high-intensity sweetener does not cause safety concerns if estimated daily intakes are lower than the ADI.
The ADI is the amount of a substance that is considered safe to consume each day over the course of a person’s lifetime.
FDA also published estimates of sweetness intensity, called a multiplier of sweetness intensity (MSI) as compared to table sugar.
The ADIs in milligrams per kilogram of body weight per day are:
Acesulfame potassium, ADI 15, MSI 200
Advantame, ADI 32.8, MSI 20,000
Aspartame, ADI 50, MSI 200
Neotame, ADI 0.3, MSI 7,000 to 13,000
Saccharin, ADI 15, MSI 200 to 700
Sucralose, ADI 5, MSI 600
Stevia (pure extracted steviol glycosides) has an ADI of 4 and a MSI of 200 to 400
Sugar substitutes are used instead of sugar for a number of reasons, including:
Dental care- Carbohydrates and sugars usually adhere to the tooth enamel, where bacteria feed upon them and quickly multiply, and convert the sugar to acids that decay the teeth.
Sugar substitutes do not erode teeth as they are not fermented by the microflora of the dental plaque.
Xylitol, which tends to prevent bacteria from adhering to the tooth surface, thus preventing plaque formation and eventually decay.
A Cochrane review, however, found only low-quality evidence that xylitol in a variety of dental products actually has any benefit in preventing tooth decays in adults and children.
Diabetes mellitus – Many artificial sweeteners allow sweet tasting food without increasing blood glucose.
Others artificial sweeteners release energy but are metabolized more slowly, preventing spikes in blood glucose.
A 2015 meta-analysis of numerous clinical studies showed that habitual consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice increased the risk of developing diabetes, although with inconsistent results and generally low quality of evidence.
Many sugar substitutes are cheaper than sugar in food formulation.
Sugar substitutes are often lower in total cost because of their long shelf-life and high sweetening intensity.
The three sugar substitutes commonly used in the United States are saccharin (e.g., Sweet’N Low), aspartame (e.g., Equal, NutraSweet) and sucralose (e.g., Splenda, Altern).
Other agents include xylitol, cyclamate, ace-K, Neotame, and stevia are used.
When sweeteners are provided for restaurant customers they are often available in paper packets: the colors are typically white for sucrose, blue for aspartame, pink for saccharin, yellow for sucralose or cyclamate, tan for turbinado, orange for monk fruit extract, and green for stevia.
Sucralose is the world’s most commonly used artificial sweetener.
Sucralose is a chlorinated sugar that is about 600 times as sweet as sugar.
Sucralose is used in beverages, frozen desserts, chewing gum, baked goods, and other foods.
It is stable when heated and can therefore be used in baked and fried goods.
Sucralose is extremely insoluble in fat and, thus, does not accumulate in fatty tissues.
Sucralose also does not break down.
Only about 15% of sucralose is absorbed by the body and most of it passes out of the body unchanged.
Aspartame is derived from the two amino acids aspartic acid and phenylalanine, and is about 200 times as sweet as sugar.
Can be used as a tabletop sweetener or in frozen desserts, gelatins, beverages, and chewing gum.
When cooked or stored at high temperatures, aspartame breaks down into its constituent amino acids, making it undesirable as a baking sweetener.
It is more stable in somewhat acidic conditions, such as in soft drinks.
When eaten, aspartame is metabolized into its original amino acids.
Aspartame is intensely sweet, so relatively little of it is needed to sweeten a food product, and is thus useful for reducing the number of calories in a product.
Multiple reviews have found aspartame is safe for consumption at current levels.
Cyclamate is banned in the US on weak evidence of carcinogenic activity, and remains in common use in many parts of the world.
Saccharin is 300 to 500 times as sweet as sugar and is often used to improve the taste of toothpastes, dietary foods, and dietary beverages.
Its bitter aftertaste of saccharin is often minimized by blending it with other sweeteners.
Saccharin is no longer considered a potential hazard to human health.
Stevia has characteristics of zero glycemic index and zero calories,.
Acesulfame potassium (Ace-K) is 200 times sweeter than sucrose, as sweet as aspartame, about two thirds as sweet as saccharin, and one third as sweet as sucralose.
It has a slightly bitter aftertaste, especially at high concentrations.
Often blended with other sweeteners to give a more sucrose-like taste, whereby each sweetener masks the other’s aftertaste and also exhibits a synergistic effect in which the blend is sweeter than its components.
Acesulfame potassium is stable under heat, even under moderately acidic or basic conditions, allowing it to be used as a food additive in baking or in products that require a long shelf life.
Acesulfame potassium in carbonated drinks, it is almost always used in conjunction with another sweetener, such as aspartame or sucralose.
It is also used as a sweetener in protein shakes and pharmaceutical products, especially chewable and liquid medications, where it can make the active ingredients more palatable.
A 2017 review did not find evidence supporting the use of non-nutritive sweeteners for weight loss, with a possible association of routine consumption with weight gain and risk of heart disease.
A 2010 review concluded there is a correlation between consumption of artificially sweetened beverages and weight gain in children.
Artificial sweeteners may weaken the association of sweet taste of food cue with post-ingestive caloric satisfaction, not fully activating the brain, leading to the over-consumption of high-calorie sweet tasting foods alongside artificial sweeteners, which may cause weight gain.
A 2015 review found that there is no evidence that non-caloric sweeteners cause metabolic disorders in humans, or an an increased risk of cancer.
Sugar alcohols are sweetening and bulking ingredients used in manufacturing of foods and beverages.
Sugar alcohol substitutes, supply about a half to one-third less calories than sugar, are converted to glucose slowly, and do not spike increases in blood glucose.
Insufficient evidence exist to suggest that replacing dietary sugar with non-caloric sweeteners alone is beneficial for energy balance, weight loss, or diabetes risk factors.
Restriction in calories is more important than avoidance of sugar for weight management, and non-caloric sweeteners may be useful for managing blood sugar in people with diabetes.
Studies show non-sugar sweeteners reduce the risk of type two diabetes and overweight and obesity, however of the research suggests that they may increase the risk of overweight, diabetes, and cancer.
Studies suggest that artificial sweeteners affect the oral and fecal microbiome as well as the plasma and metabolome and they may impair glycemic responses at doses lower than those typically consumed each day.
In a review of 27 observational studies and 29 randomized and none randomized clinical trials investigating whether non-sugar sweeteners influence health outcomes including body weight, BMI, glycemic control, oral health, eating behavior, preference with sweet taste , Cancer, blood pressure, cardiovascular disease, kidney disease, mood, behavior, neurocognition, and adverse effects (Meerpohl JJ).
Conclusions of the above trials showed a minor benefit from non-sugary sweetners on BMI and fasting blood could close in adults, but the certainty of evidence was low or very low.
In children to randomized clinical trials showed no significant differences in weight.
There was no evidence supporting the use of non-sugar sweeteners to help overweight or obese adults or children lose weight.
There was no evidence of substantial harms of using non-sugary sweeteners.
High consumption of artificially and sweetened types of beverages associated with higher risk of heart disease
Sugary drinks and artificially sweetened beverages are associated with a higher risk of cardiovascular disease, which suggests artificially sweetened beverages may not be the healthy alternative they are often claimed to be.
Researchers looked at data from the French NutriNet-Santé cohort to investigate the relationship between the risk of cardiovascular disease and consuming sugary drinks and artificially sweetened drinks.
Records for 104,760 participants were included.
Artificially sweetened beverages were defined as those containing non-nutritive sweeteners.
Sugary drinks consisted of all beverages containing 5% or more sugar.
First incident cases of cardiovascular disease during follow-up from 2009-2019, which were defined as stroke, transient ischemic attack, myocardial infarction, acute coronary syndrome and angioplasty.
Compared to non-consumers, both higher consumers of sugary drinks and of artificially sweetened beverages had higher risks of first incident cardiovascular disease.
Studies suggests artificially sweetened beverages may not be a healthy substitute for sugar drinks.