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Sugar substitutes

See Artificial sweeteners

A sugar substitute is a food additive that provides a sweet taste like that of sugar while containing significantly less food energy.

Some sugar substitutes are natural and some are synthetic.

Those that are not natural are called artificial sweeteners.

An important class of sugar substitutes is known as

High-intensity sweeteners are compounds with many times the sweetness of sucrose, common table sugar.

With high-intensity sweeteners, much less sweetener is required and energy contribution is often negligible.

The sensation of sweetness caused by these compounds is sometimes notably different from sucrose.

Seven intensely sweet sugar substitutes have been approved for use:stevia, aspartame, sucralose, neotame, acesulfame potassium (Ace-K), saccharin, and advantame.

Cyclamates have been prohibited in the U.S. since 1969.

The U.S. Food and Drug Administration regulates artificial sweeteners as food additives.

Food additives must be approved by the FDA, which publishes a Generally Recognized as Safe (GRAS) list of additives.

Stevia is exempt under FDA’s GRAS policy.

The majority of sugar substitutes are artificially synthesized compounds.

Some bulk natural sugar substitutes are known, including sorbitol and xylitol, which are found in berries, fruit, vegetables, and mushrooms.

Sugar substitutes products are produced by catalytic hydrogenation of the appropriate reducing sugar.

For example, xylose is converted to xylitol, lactose to lactitol, and glucose to sorbitol.

Some non-sugar sweeteners are polyols, known as sugar alcohols.

Sugar substitutes commonly used in food:

Aspartame

Cyclamate

Saccharin

Stevia

Sucralose

Sugar substitutes are used for:

To assist in weight loss by replacing high-energy sugar or corn syrup with other sweeteners having little or no food energy.

Dental care – sugar substitutes are not fermented by the microflora of the dental plaque.

Xylitol prevents bacteria from adhering to the tooth surface, thus preventing plaque formation and eventually decay.

Xylitol cannot be fermented by bacteria, so the bacteria have difficulty thriving, thus helping to prevent plaque formation.

Patients with diabetes can limit their sugar intake with artificial sweeteners, and can enjoy a varied diet while closely controlling their sugar intake.

Some sugar substitutes release energy and are metabolized more slowly, potentially allowing blood sugar levels to remain more stable over time.

Reactive hypoglycemia results in an excess of insulin after quickly absorbing glucose into the bloodstream.

Like diabetics, patients with reactive hypoglycemia must avoid intake of high-glycemic foods, and often choose artificial sweeteners as an alternative.

Alternative sweeteners are low in cost because of their long shelf-life and high sweetening intensity.

In the case of a response to artificial sweeteners, even if blood sugar does not increase, there can be increased hypoglycemia or hyperinsulinemia and increased food intake the next time there is a meal.

Experimental evidence that artificial sweeteners may exacerbate, rather than prevent, metabolic disorders such as Type 2 diabetes.

Artificial sweeteners increase the blood sugar levels in humans by altering the composition and function of the gut flora.

Mice given drinking water supplemented with artificial sweeteners developed greater glucose intolerance than mice drinking pure water, or water with only sugar added.

There are differences in the gut bacteria between subjects who habitually consume artificial sweeteners and those who did not, as well as markers for diabetes, such as raised blood sugar levels and glucose intolerance.

The increase in human consumption of artificial sweeteners coincides with the modern epidemic incidence of obesity and diabetes.

Data indicates that artificial sweeteners may contribute to, rather than alleviate, obesity-related metabolic conditions, by altering the composition and function of bacterial populations in the gut.

Eating natural sugars like glucose instead of a sugar substitute can also have negative health effects, as calories contained in sugar-sweetened beverages contributes to increases in body weight and body fat, and that replacement of sugar by artificial sweeteners reduces weight.

Sucrose has a high glycemic index, glucose medium, and fructose low.

The consumption of added sugars has been positively associated with multiple measures known to increase cardiovascular disease risk amongst adolescents as well as adults.

The food and beverage industry is increasingly replacing sugar or corn syrup with artificial sweeteners in a range of products traditionally containing sugar.

Some commonly consumed foods with alternative sweeteners are diet sodas, cereals, and sugar-free desserts such as ice cream.

Patients with diabetes can greatly benefit from alternative sweeteners that do not affect their blood sugar levels drastically.

Aspartame is about 200 times as sweet as sugar and 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.

Aspartame is more stable in somewhat acidic conditions, such as in soft drinks.

Deemed safe for human consumption by over 100 regulatory agencies in their respective countries.

Cyclamate-based sugar substitute sold in Canada.

The Food and Drug Administration banned the sale of cyclamate in 1969 after lab tests in rats involving a 10:1 mixture of cyclamate and saccharin indicated that large amounts of cyclamates causes bladder cancer, a disease to which rats are particularly susceptible.

Saccharin is300 to 500 times as sweet as sugar and is often used to improve the taste of toothpastes, dietary foods, and dietary beverages.

The bitter aftertaste of saccharin is often minimized by blending it with other sweeteners.

Saccharin causes cancer in male rats by a mechanism not found in humans.

The EPA has officially removed saccharin and its salts from their list of hazardous constituents and commercial chemical products, and is no longer considered a potential hazard to human health.

Stevia has been widely used as a natural sweetener with unique characteristics of zero glycemic index and zero calories,

Sucralose is a chlorinated sugar that is about 600 times as sweet as sugar.

It is used in beverages, frozen desserts, chewing gum, baked goods, and other foods.

It I is stable when heated and can therefore be used in baked and fried goods.

About 15% of sucralose is absorbed by the body and most of it passes out of the body unchanged.

It is is extremely insoluble in fat and, thus, does not accumulate in fatty tissues.

Does not break down and will dechlorinate only under conditions that are not found during regular digestion.

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.

Like saccharin, it has a slightly bitter aftertaste, especially at high concentrations.

Often blended with other sweeteners which 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.

Unlike aspartame, acesulfame potassium is stable under heat, allowing it to be used as a food additive in baking or in products that require a long shelf life.

In carbonated drinks, acesulfame potassium is almost always used in conjunction with another sweetener.

Acesulfame potassium is is also used as a sweetener in protein shakes and pharmaceutical products, where it can make the active ingredients more palatable.

The three compounds used most as sugar substitutes in the United States are saccharin (e.g., Sweet’N Low), aspartame (e.g., Equal, NutraSweet) and sucralose (e.g., Splenda, Altern).

Maltitol and sorbitol are often used, frequently in toothpaste, mouth wash, and in foods no sugar added foods.

Erythritol is increasingly used as a replacement for these other sugar alcohols in foods.

Erythritol is less likely to produce gastrointestinal distress when consumed in large amounts.

Paper packet colors are typically white for natural sugar, blue for aspartame, pink for saccharin, yellow for sucralose, tan for turbinado, orange for monk fruit extract, and green for stevia.

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.

In a review of 27 observational studies and 29 randomized and nonrandomized 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.

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.

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.

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