Sweet or Sour? The Scoop on Sugar Substitutes

I often say that sugar substitutes, aka artificial sweeteners, can evoke a similar emotion among us as politics often does. Many of us embrace a candidate wholeheartedly, others cautiously dip in a toe or two, while there’s another group of us who are ardently against them. That’s okay. We have the right to our own opinions and choices. Given that, many of us consume sugar substitutes in beverages and in thousands of other products. Some of you may be surprised to know that sugar substitutes also can be found in some toothpastes, mouthwashes, cough drops and even some medicines.

Sugar substitutes, like Equal, Sweet’N Low, Splenda and Truvia are very concentrated and therefore sweeter versions of the real thing. The theory is that we therefore use less of them. Most of us likely do just that. And that’s a good thing. Because I recommend that we look at these artificial sweeteners as we should most things. Moderation is key.

There are some benefits that can be realized from these little colored packets. They basically have no calories, so they can be an aid in weight loss/weight management. I hear some of you in the anti-sugar substitute camp already sighing. But consuming more calories than we burn can cause us to gain weight. Sugar substitutes can help us cut calories.

There have been several studies, including a small one from Denmark recently reported inDiabetic Living magazine. Using healthy subjects, it was found that drinking 4 cups of regular sugar-sweetened soda over a 6 month period resulted in a much greater increase in total cholesterol, triglycerides and abdominal fat than those who drank diet soda. I know, many of you are saying that you have read studies that say diet soda consumption can actually lead to obesity. I’m in the camp that if someone wants to drink a soda, the diet one is the better choice. Regular sodas are just bags of sugar, with all the associated calories, masquerading as a beverage. I’ve counseled many obese patients who have counted regular soda consumption as part of their daily diets. Other foods that contain artificial sweeteners are not necessarily low in fat and/or calorie, so it’s always advised to read the nutrition facts labels.

Another interesting thing about sugar substitutes is that they don’t affect blood sugar. This is particularly important for people with diabetes who need to monitor carbohydrate intake and keep their blood sugars under control as best they can. But again, not all products that contain artificial sweeteners are carbohydrate free, so it’s important to read those very informative nutrition facts labels.

A frequent question that patients ask me is in regard to the safety of sugar substitutes. In the United States, the FDA has determined that they are safe for us to use. Many studies have led them to this conclusion, even for those who are heavy users. I still say moderation makes sense. For example, there are some people who have phenylketonuria, a condition that in which aspartame (Equal, NutraSweet) should be avoided. Pregnant women should avoid saccharine and limit/avoid other artificial sweeteners. I recommend that pregnant women speak with their healthcare providers for their recommendations.

Artificial sweeteners have been around for a long, long time. And I expect they’ll continue to be with us for generations to come. It’s up to you what you want to consume. Choose them, or not. Just make the healthiest choices most of the time and you’re on a good path.


Visit Lisa Tillinger Johansen at www.fastfoodvindication.com, on Facebook at Lisa Tillinger Johansen and on Twitter @LisaTJohansen


Source: Shafer, J., McCulloch, M & Burnett, J., The ultimate guide to sugar substitutes, Diabetic Living, Spring 2012

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