Is sweet and low bad for you?

The way artificial sweeteners were discovered could have been a scene out of the classic comedy The Nutty Professor.

In 1879, Ira Remsen, a researcher from Johns Hopkins University in Baltimore, Md., noticed that a derivative of coal tar he accidentally spilled on his hand tasted sweet. While he did not morph into the slim but obnoxious Buddy Love (as did the characters played by Jerry Lewis and later Eddie Murphy in their film versions of the comedy), his spill set the stage for the development of saccharin — an artificial sweetener known today to many seasoned dieters as Sweet-n-Low.

Now more than 125 years later, saccharin is joined by a growing list of artificial sweeteners with varying chemical structures and uses, including acesulfame potassium (Sunett, Sweet One); aspartame (NutraSweet, Equal, Advantame); neotame (Newtame), and sucralose (Splenda).

Stevia, another sugar substitute, is an extract from a South American plant, and while it is billed as “natural,” the sugar alcohol ethanol is used as a solvent in the extraction process. SweetLeaf,Truvia, and Pure Via are other artificial sweeteners that contain stevia extract but use different manufacturing processes. (It is worth noting that “natural” isn’t a defined or regulated term in the food industry. The FDA says that for a food to be called natural, it can’t contain artificial or synthetic ingredients, including color additives.)

These products substitute for sugar. For example, they can replace corn syrup, used in many sodas and sweetened drinks, and table sugars. But are artificial sweeteners safe? Can they help people shed extra weight, or do they lead to weight gain? What role should they play in person’s diet — if any?

One thing is certain: American consumers embrace these sweeteners: A 2017 report in the Journal of Academy of Nutrition and Dietetics found that 25% of American children and over 41% of American adults use low-calorie sweeteners.

Here’s what else WebMD found out:

Artificial sweeteners are compounds that offer the sweetness of sugar without the same calories. They are anywhere from 30 to 8,000 times sweeter than sugar and as a result, they have much fewer calories than foods made with table sugar (sucrose). Each gram of table sugar contains 4 calories. Many sugar substitutes have zero calories per gram.

Saccharin is an artificial, or nonnutritive, sweetener that is used in the production of various foods and pharmaceutical products including:

  • Baked goods
  • Jams
  • Chewing gum
  • Drinks
  • Tinned fruit
  • Medicines and
  • Toothpaste

It is 200 to 700 times sweeter than sucrose (table sugar), does not raise blood sugar levels and like all nonnutritive sweeteners has no calories.

However, it does have a bitter or metallic aftertaste, especially at high concentrations.

Saccharin is unstable when heated but does not react chemically with other food ingredients, which makes it good for storage.

The substance was first discovered in 1878 by researcher Constantin Fahlberg, who was working on coal tar derivatives in a laboratory at the John Hopkins University in Baltimore.

Use of the substance became widespread during the sugar shortages of World War I.

Its popularity further increased during the 1960s and 1970s among dieters as a result of its ‘calorie-free’ status.

Benefits of saccharin

Saccharin has numerous advantages, including:

Can be blended with other sweeteners

Saccharin is often blended with other artificial sweeteners to compensate for each sweetener’s weaknesses.

For example, it is commonly mixed with cyclamate in countries where both these sweeteners are legal, with each sweetener used to mask the other’s off-taste.

Blends of saccharin and aspartame are also often used in diet carbonated soft drinks to ensure that some sweetness remains in the event that syrup is stored beyond aspartame’s relatively short shelf-life.

Helpful to people with diabetes

Consumption of saccharin-sweetened products can benefit diabetics as the substance goes directly through the human digestive system without being digested. While saccharin has no food energy, it can trigger the release of insulin in humans due to its sweet taste.

Does saccharin raise blood sugar levels?

Although marketed as a ‘calorie-free’ sweetener, several recent studies have found that saccharin actually raises blood glucose levels. It is thought that these effects are due to changes in gut bacteria triggered by the sweeteners.

However, most of these studies have been conducted on mice, and those that have been conducted on humans have involved very small sample sizes.

Because of this, it’s difficult to draw solid conclusions from the research. However, most studies indicate that the sweetener stevia does not influence blood glucose levels , which makes it a viable option if you are concerned about the possible effects of saccharin.

Safety

Use of saccharin in human food has been plagued by safety concerns. During the early 1970s, studies on laboratory rats linked saccharin with the development of bladder cancer in rodents.

As a result, the U.S. Food and Drug Administration (FDA) pushed for a ban on saccharin use in the United States based on the Delaney Clause of the Federal Food, Drug, and Cosmetic Act enacted in 1958, which prohibits the addition to human food of any substances that induce cancer in humans or animals.

But following strong opposition to the ban from the general public (saccharin was the only artificial sweetener available at that time), the United States Congress intervened and allowed saccharin to remain in the food supply as long as all food containing the artificial sweetener was labelled with a health warning.

Since then, numerous human-based studies have concluded that the elevated bladder cancer risk found in rats does not translate to humans.

In 2000, the warning labels on saccharin-sweetened products were removed and in the following year, the FDA reversed its position on sacchari, declaring it safe for consumption.

Saccharin is now one of five FDA-approved artificial sweeteners, and is also an approved food additive in Europe and most countries around the world.

Possible side effects

While the association between saccharin consumption and bladder cancer risk has been disproved, many health groups still believe that its use should be limited in:

  • Infants
  • Children
  • Pregnant women

This is due to the possibility of allergic reactions.

Saccharin belongs to a class of compounds known as sulfonamides, which can cause allergic reactions in some individuals.

Reactions can include:

  • Headaches
  • Breathing difficulties
  • Diarrhoea and
  • Skin problems

Artificial Sweeteners and Cancer

What have studies shown about a possible association between specific artificial sweeteners and cancer?

Saccharin

Studies in laboratory rats during the early 1970s linked saccharin with the development of bladder cancer, especially in male rats. However, mechanistic studies (studies that examine how a substance works in the body) have shown that these results apply only to rats. Human epidemiology studies (studies of patterns, causes, and control of diseases in groups of people) have shown no consistent evidence that saccharin is associated with bladder cancer incidence.

Because the bladder tumors seen in rats are due to a mechanism not relevant to humans and because there is no clear evidence that saccharin causes cancer in humans, saccharin was delisted in 2000 from the U.S. National Toxicology Program’s Report on Carcinogens, where it had been listed since 1981 as a substance reasonably anticipated to be a human carcinogen (a substance known to cause cancer). More information about the delisting of saccharin is available in the Report on Carcinogens, Fourteenth Edition.

Aspartame

Aspartame, distributed under several trade names (e.g., NutraSweet® and Equal®), was approved in 1981 by the FDA after numerous tests showed that it did not cause cancer or other adverse effects in laboratory animals.

A 2005 study raised the possibility that very high doses of aspartame might cause lymphoma and leukemia in rats (1). But after reviewing the study, FDA identified many shortcomings in it and did not alter its previous conclusion that aspartame is safe. In 2005, the National Toxicology Program reported that aspartame exposure did not cause tumors in or affect the survival of two types of genetically modified mice (2).

In 2006, NCI examined human data from the NIH-AARP Diet and Health Study of over half a million retirees. Increasing consumption of aspartame-containing beverages was not associated with the development of lymphoma, leukemia, or brain cancer (3).

A 2013 review of epidemiologic evidence also found no consistent association between the use of aspartame and cancer risk (4).

Sucralose

Sucralose, marketed under the trade name Splenda®, was approved by the FDA as a sweetening agent for specific food types in 1998, followed by approval as a general-purpose sweetener in 1999. Sucralose has been studied extensively, and the FDA reviewed more than 110 safety studies in support of its approval of the use of sucralose as a general-purpose sweetener for food.

In 2016, the same laboratory that conducted the aspartame studies discussed above reported an increased incidence of blood cell tumors in male mice fed high doses of sucralose (5). However, as with the aspartame studies, FDA has identified significant scientific shortcomings concerning the reported study results.

Acesulfame potassium, Neotame, and Advantame

Three other artificial sweeteners are currently permitted for use in food in the United States:

  • Acesulfame potassium (also known as ACK, Sweet One®, and Sunett®) was approved by the FDA in 1988 for use in specific food and beverage categories, and was later approved as a general-purpose sweetener (except in meat and poultry) in 2002.
  • Neotame, which is similar to aspartame, was approved by the FDA as a general-purpose sweetener (except in meat and poultry) in 2002.
  • Advantame, which is also similar to aspartame, was approved by the FDA as a general-purpose sweetener (except in meat and poultry) in 2014.

Before approving these sweeteners, the FDA reviewed numerous safety studies that were conducted on each sweetener, including studies to assess cancer risk. The results of these studies showed no evidence that these sweeteners cause cancer or pose any other threat to human health.

Cyclamate

Because the findings in rats suggested that cyclamate might increase the risk of bladder cancer in humans, the FDA banned the use of cyclamate in 1969. After reexamination of cyclamate’s carcinogenicity and the evaluation of additional data, scientists concluded that cyclamate was not a carcinogen or a co-carcinogen (a substance that enhances the effect of a cancer-causing substance). A food additive petition was filed with the FDA for the reapproval of cyclamate, but this petition is currently being held in abeyance (not actively being considered). The FDA’s concerns about cyclamate are not cancer related.

Biologist William K. Purves of Harvey Mudd College offers this explanation:

To understand how something can taste sweet and yet add no calories to the diet, we should address two questions. First, what are calories, nutritionally speaking? Second, what constitutes a sweet taste?

Calories are a measure of the energy made available when we digest and metabolize food. The energy drives the replacement of molecules we have lost, enables us to move, and so forth; we store excess energy as fat. A substance that we do not metabolize releases no energy it “has no calories” and is not a food.

A sweet taste results from the binding of molecules to specific receptor proteins in our taste buds. Sweet-taste-sensory cells in the taste buds have these receptor protein molecules embedded in their plasma membranes. Binding of a molecule to a receptor protein initiates a cascade of events within the taste-sensory cell that eventually releases a signaling molecule to an adjoining sensory neuron, causing the neuron to send impulses to the brain. Within the brain, these signals derived from the taste bud cause the actual sensation of sweetness. Other sensory cells, with different receptor proteins, report on other taste modalities: salty, sour, bitter, and “umami” (also referred to as glutamate, or “meat”).

The events that occur between binding by the “sweet receptor” and the sensation in the brain have nothing to do with whether a molecule can be metabolized to yield energy and thus “has calories.” The only factor in taste is whether the molecule can bind to the receptor.

So, what determines this binding ability? In April 2001, two research teams published independent contributions to answering this question. Both papers announced and described a protein, dubbed T1r3, which appears to be the primary receptor for sweet substances. The molecular structure of T1r3 can be seen here. Like all receptor proteins, T1r3 has a well-defined “pocket” where smaller molecules may enter and perhaps bind. Binding depends on a good fit of molecular shape and the presence of groups that interact chemically to stabilize binding.

Sucrose, the sugar in the sugar bowl, binds fairly well to T1r3 and hence leads to a sweet sensation in the brain. Enzymes readily metabolize sucrose, releasing energy and, if our diet contains excess calories, causing fat deposition.

Saccharin, once the most popular artificial sweetener, binds to T1r3 much more strongly than does sucrose, owing to the differing structures of the two molecules. Therefore, we sense saccharin as being approximately 300 times as sweet as the same amount of sucrose. Moreover, saccharin passes through the body without being metabolized and thus has no caloric content.

Aspartame (NutraSweetTM), currently the most-used artificial sweetener, also binds to T1r3 more strongly than sucrose does and tastes nearly 200 times as sweet. Unlike saccharin, however, aspartame is metabolized, yielding methanol and the amino acids phenylalanine and aspartic acid. Further metabolism of these products does yield calories, but far fewer than those obtained from the amount of sucrose required to produce the same sweetening effect.

Arno F. Spatola is a professor of chemistry and the director of the Institute for Molecular Diversity and Drug Design at the University of Louisville, where his current research focuses on peptides, including artificial sweeteners. He provides the following answer:

Is there any caloric value to artificial sweeteners? How am I able to have my cake (the sweetness of my food) and eat it too (avoid gaining weight from excess calories)? The answer to these questions, as in most areas of science, is that it depends.

Sweetness is a taste sensation that only requires interaction with receptors on our tongues. Many sugar substitutes, such as saccharin and acesulfame K (also known as SunetteTM), do not provide any calories. This means that they are not metabolized as part of the normal biochemical pathways that yield energy in the form of adenosine triphosphate, or ATP. In some cases, small quantities of additives such as lactose are added in order to improve the flow characteristics or to add bulk to the products. But the quantities of these added ingredients are so small that they do not represent a significant amount of energy-producing foodstuffs.

Sugar Substitutes

Sugar substitutes are chemical or plant-based substances used to sweeten or enhance the flavor of foods and drinks. You may have heard them called “artificial sweeteners” or “non-caloric sweeteners.” They can be used as a tabletop sweetener (for example, to sweeten a glass of iced tea) and/or as an ingredient in processed foods and drinks.

Most sugar substitutes are many times sweeter than sugar. It takes a smaller amount of these sugar substitutes to provide the same level of sweetness. Some sugar substitutes are low in calories. Others have no calories.

Sugar substitutes are regulated as food additives by the U.S. Food and Drug Administration (FDA). This means that the FDA reviews scientific evidence to be sure that a sugar substitute is safe before it can be used in foods and drinks.

Path to improved health

Sugar substitutes provide sweetness and enhance the flavor of food without adding the calories of sugar. Unlike sugar, they do not contribute to tooth decay. Most of them do not raise blood sugar levels. This may be helpful if you have diabetes and have to be careful about how much sugar you consume.

Sugar substitutes may also be helpful if you are trying to control the amount of calories you consume. They are found in most of the “light,” “reduced calorie,” and “sugar-free” foods and drinks available today. Although sugar substitutes have fewer calories than sugar, it’s best to limit them and focus on healthy food choices. Fruits, vegetables, lean meats, and whole grains are the best sources of nutrition for your body.

How can I tell if a food or drink contains a sugar substitute?

Sugar substitutes are used in many processed foods and drinks, including baked goods, soft drinks, powdered drink mixes, candy, puddings, canned foods, jellies, and dairy products. Check the ingredient list on the nutrition facts label for the names of the sugar substitutes listed above. This list gives ingredients in descending order by weight. Unless you add a sugar substitute yourself, it is often hard to know exactly how much a food or drink contains.

What sugar substitutes/artificial sweeteners are approved by the FDA?

The following sugar substitutes are FDA approved as food additives in the United States:

  • Acesulfame K (brand names: Sunett and Sweet One)
  • Advantame
  • Aspartame (two brand names: Equal and Nutrasweet)
  • Neotame (brand name: Newtame)
  • Saccharin (two brand names: Sweet ‘N Low and Sweet Twin)
  • Sucralose (brand name: Splenda)

According to the FDA, some sugar substitutes are “generally recognized as safe” (GRAS). This means they do not require FDA approval because qualified experts agree the scientific evidence shows these products are safe for use in foods and drinks. Sugar substitutes in this category include highly purified stevia extracts called “steviol glycosides” (two brand names: Pure Via and Truvia) and monk fruit extracts (two brand names: Monk Fruit in the Raw and PureLo).

Sugar alcohols are another class of sweeteners that can be used as sugar substitutes. Examples include mannitol, sorbitol, and xylitol. The FDA has determined that sugar alcohols are generally recognized as safe for use in foods and drinks.

Aspartame

Aspartame is a common low-calorie sugar substitute. It is a combination of 2 amino acids: aspartic acid and phenylalanine. It is about 200 times sweeter than sugar. It can be found in thousands of processed foods and drinks. Products that contain aspartame include yogurt, frozen desserts, pudding, dry dessert mixes, chewing gum, and soft drinks.

It is used as a tabletop sweetener. It can also be found in some medicines (for example, cough drops) and vitamins. Aspartame should not be used as a substitute for sugar when you are baking. It loses its sweet taste when it is heated.

Is aspartame safe?

Aspartame is one of the most researched sugar substitutes available in the United States. More than 100 studies have examined its safety. It has been approved by the FDA as a food additive since 1981.

People who have a rare condition called phenylketonuria (PKU) should not consume aspartame. This is because their bodies are unable to metabolize (process) phenylalanine, which is one of the amino acids in aspartame.

According to the National Cancer Institute, there is no evidence that aspartame and other sugar substitutes approved for use in the United States cause cancer or other serious health problems. Medical research studies have shown that these sweeteners are safe for most people when used in moderation.

Acesulfame K

Acesulfame K is a no-calorie sugar substitute that is 200 times sweeter than sugar. It is also known as acesulfame potassium or Ace-K. It is often used in combination with other sweeteners.

Acesulfame K can be found in a variety of processed foods and drinks, including baked goods, candy, frozen desserts, and soft drinks. It can also be used as a tabletop sweetener. It is used in some medicines and in oral hygiene products (for example, toothpaste and mouthwash).

It can be used in cooking and baking because it does not lose its sweet taste at high temperatures. For best results, follow the package instructions for using it in your recipes.

Is acesulfame K safe?

More than 90 studies have examined the safety of acesulfame K. It has been approved by the FDA as a food additive since 1988. According to the National Cancer Institute, there is no evidence that acesulfame K and other sugar substitutes approved for use in the United States cause cancer or other serious health problems.

Saccharin

Saccharin is a low-calorie sugar substitute that was first discovered in 1879. It is 200 to 700 times sweeter than sugar, depending on how it is used. Some people may notice an aftertaste when they consume saccharin. This is often eliminated in processed foods by combining saccharin with another sugar substitute.

Saccharin is found in many processed foods and drinks, including chewing gum, canned fruit, baked goods, and soft drinks. It is also used as a tabletop sweetener. It is used in some medicines and vitamins.

Saccharin can be used as a substitute for sugar when you are baking. For best results, follow the package instructions for using it in your recipes.

Is saccharin safe?

Saccharin is approved by the FDA as a food additive. You might remember that saccharin used to carry a warning label that said it was known to cause cancer in laboratory animals. However, there has been extensive research on the safety of this sugar substitute. In 2000, the U.S. government removed the requirement for a warning label on foods and drinks made with saccharin.

Stevia sweeteners

Stevia is a plant-based sugar substitute that has no calories. The term “stevia” refers to Stevia rebaudiana, which is a South American plant. Only certain parts of the plant are sweet. Highly purified extracts from the leaves of the plant are called “steviol glycosides.” They are 200 to 400 times sweeter than sugar.

The term “stevia” can refer to the whole Stevia rebaudiana plant. However, in this article, “stevia” refers to the sugar substitute made from steviol glycosides. That is how the term is commonly used.

Stevia is found in many processed foods and drinks, such as desserts, chewing gum, baked goods, candy, and yogurt. It is also used as a tabletop sweetener. Stevia can be used as a substitute for sugar when you are baking. For best results, follow the package instructions for using it in your recipes.

Is stevia safe?

According to the FDA, steviol glycosides are “generally recognized as safe” (GRAS). This means that qualified experts agree the available scientific evidence about this sugar substitute shows it is safe for use in foods and drinks.

Sucralose

Sucralose is a no-calorie sugar substitute. It is about 600 times sweeter than sugar.

It is used in thousands of processed foods and drinks. Some examples include soft drinks, juices, sauces, syrups, candy, desserts, baked goods, and canned fruits. It is used in medicines, nutritional supplements, and vitamins. It is also used as a tabletop sweetener.

Sucralose can be used in baking because it does not lose its sweet taste at high temperatures. For best results, follow the package instructions for using it in your recipes.

Is sucralose safe?

More than 110 studies have examined the safety of sucralose. It has been approved by the FDA as a food additive since 1998.

According to the National Cancer Institute, there is no evidence that sucralose and other sugar substitutes approved for use in the United States cause cancer or other serious health problems.

Sugar alcohols

Despite their name, sugar alcohols aren’t sugar, and they aren’t alcohol. They are carbohydrates that occur naturally in certain fruits and can also be manufactured. They get their name because they have a chemical structure similar to sugar and to alcohol. Sugar alcohols are also called “polyols.”

What products contain sugar alcohols?

Sugar alcohols are found in many processed foods, including hard candies, ice cream, puddings, baked goods, and chocolate. They can also be found in chewing gum, toothpaste, and mouthwash. They may be used in combination with another sugar substitute.

The most common sugar alcohols found in foods include:

  • Erythritol – 0.2 calories per gram and 60% to 80% as sweet as sugar
  • Isomalt– 2 calories per gram and 45% to 65% as sweet as sugar
  • Lactitol – 2 calories per gram and 30% to 40% as sweet at sugar
  • Maltitol – 2.1 calories per gram and 90% as sweet as sugar
  • Mannitol – 1.6 calories per gram and 50% to 70% as sweet as sugar
  • Sorbitol – 2.6 calories per gram and 50% to 70% as sweet as sugar
  • Xylitol – 2.4 calories per gram and the same sweetness as sugar

By comparison, there are 4 calories per gram of sugar.

How do I find sugar alcohols on a nutrition facts label?

If a food is labeled as “sugar free,” the amount of sugar alcohol (in grams) must be listed. If the food contains only 1 sugar alcohol, the name of that specific sugar alcohol is listed. Sugar alcohols are easy to spot on the label because most of them end in “tol.” If the food contains more than 1 sugar alcohol, the term “sugar alcohols” is listed.

How do sugar alcohols affect blood sugar levels?

Your body doesn’t completely absorb sugar alcohols, so they don’t affect your blood sugar levels as much as sugar and other carbohydrates do.

If you have diabetes, it is important to consider sugar alcohols when you are managing your blood sugar level. Check the nutrition facts label on a processed food to find the amount of sugar alcohol per serving (listed in grams). If a food has fewer than 5 grams of sugar alcohol per serving, it will likely have a very small effect on your blood sugar level.

Are sugar alcohols safe?

According to the FDA, sugar alcohols are “generally recognized as safe” (GRAS). This means that qualified experts agree the available scientific evidence shows they are safe for use in foods and drinks. However, you should consume them in moderation. Because sugar alcohols aren’t completely absorbed by your body, eating large amounts can lead to bloating and diarrhea.

Things to consider

Over the years, there has been much research done concerning the safety of sugar substitutes. The findings of this research support the conclusion that FDA-approved sugar substitutes are safe to use in moderation. Also, GRAS sugar substitutes (stevia extracts, monk fruit extracts, and sugar alcohols) are considered safe.

While they are considered safe, sugar substitutes can cause diarrhea. This can happen when you consume large amounts of a product such as sugar-free candy.

When to see a doctor

Health experts have debated for years the use of sugar substitutes. Some would say that sugar substitutes are still controversial. However, the scientific community and FDA agree that they are safe to use, especially in moderation. If you have concerns, you should talk to your doctor about how or when to include sugar substitutes as part of a healthy diet.

Questions for your doctor

  • Is one sugar substitute better for my health than another?
  • Is it better to use real sugar in moderation than to use a sugar substitute?
  • Is sugar-free eating better for my overall health?
  • Can sugar substitutes make me fat?
  • I’m pregnant. Are sugar substitutes safe for me?

Resources

U.S. Food & Drug Administration, High-Intensity Sweeteners

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