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The Skinny on Sugar Substitutes

While you may be choosing a low-calorie option, it's still high in health risks. 

I remember my first conscious exposure to artificial sweeteners. A friend in college baked an entire batch of cookies with a calorie-free sugar substitute and offered me one. My reaction: I can eat ten cookies and not consume any sugar? Bring ’em on!

A few years later, I shifted to the other extreme—avoiding artificial sweeteners at all costs—after a nutritionist told me that drinking a diet coke was akin to sewing the seeds of cancer in my body.

But the recent hype around Splenda prompted me to question my all-or-nothing outlook.

The average American consumes 15 to 20 percent of their daily calories from refined sugar, twice the recommended amount, according to a nutrition study at Tufts University. Can substituting some of that refined sugar for some blood-sugar-spike-free sweeteners be that bad in the bigger picture?

I decided to do some investigating to find out the differences among artificial sweeteners. Is there any real proof that they’re harmful? Perhaps modern advances actually have resulted in a sweetener that will let me have my cake and skinny jeans, too.

What exactly is an artificial sweetener?
“[Sweeteners] are made in a laboratory based off chemicals. Nothing actually comes from nature,” says Lindsay Segal, a graduate student in the physician assistant program at Samuel Merritt College in Oakland. “The body hasn’t seen many of these chemicals before—because it shouldn’t—so you’re introducing things into your body that pretty much are not meant to be there.”

Though different sweeteners have different make-ups, all are meant to be a substitute for sugar and sweeten food and drinks without the calories.

They can’t be sold without an approval from the Food and Drug Administration, which regulates and studies food additives for extended periods of time, and has approved five such sweeteners: saccharin, aspartame, sucralose, acesulfame k, and neotame. The last two are rarely used in the U.S. Image source: Joe Pitz

Saccharin
Brand names: Sweet’N Low, Sugar Twin, Necta Sweet
Maximum daily intake considered safe: About nine to twelve packets of sweetener, according to the Mayo Clinic
Where you find it: Hot chocolate mixes, candies, sugar-free syrups
Numbers: 4 calories, 1 carb per pack

This is the one that caused all the hoopla about cancer a decade ago—you know, the pink packets sporting the warning label we were all afraid of: “This product contains saccharin, which has been determined to cause cancer in laboratory animals.” The additive was originally used in diet sodas, though it’s mostly been replaced by aspartame and sucralose (a.k.a Splenda) nowadays. I’ve found it on the label of some prepared foods, medicines, sugar-free gum, and, of course, on the table at my local breakfast spot—in the little pink packs next to the sugar. And whatever happened to the cancer scare? “The bladder tumors seen in rats are due to a mechanism not relevant to humans,” says the FDA. Somehow that doesn’t eliminate the spooky factor for me.

Aspartame
Brand names: NutraSweet and Equal
Maximum daily intake considered safe: Around eighteen to nineteen cans of diet soda
Where you find it: Diet soda, cereals, sugar-free ice cream, yogurt
Numbers: 3.65 calories, one carb per pack

Most foods you see in the supermarket with bright letters reading “sugar-free!” or “low-calorie!” use this in place of sugar. Sounds great, but there’s a little more to it.

“Aspartame is partially broken down into methanol in the small intestine,” says Segal.

Methanol is fine in small doses, she says, since most of it is absorbed and broken down into formaldehyde and then formic acid—“two things that are okay in our bodies,” according to Segal. However, in higher doses, they’re not. “If there’s too much formaldehyde, the body can’t process it, and some turns toxic,” she says. “This stops a key process in how cells get their nutrients. They stop getting an adequate oxygen supply which, in turn, can end up killing the cell.”

The FDA admits that this is true, but maintains that recommended amounts don’t pose any risk of reaching these harmful levels. In fact, the recommended amounts are one hundred times less than anything that could cause damage. But I’m still not sold on the whole formaldehyde-in-my-brain thing.


Sucralose
Brand names: Splenda
Maximum daily intake considered safe: About six cans of diet soda, according to the Mayo Clinic
Where you find it: Jellies, milk products, baking mixes, salad dressings, beverages
Numbers: zero calories, zero carbs

Everything about Splenda touts how it’s just as sweet as sugar, sans the calories, insulin surge, and side effects of other artificial sweeteners. Call me a cynic, but nothing can be that good.

The reasoning behind all this praise is that the product claims to be more “natural” than other chemical sweeteners—the brand’s slogan actually reads, “Made from sugar.”

Here’s how Segal puts it: The molecule is, in fact, made from sucrose (sugar), but it’s chemically altered into something different. It has three chlorine molecules where sugar has three pairs of oxygen-hydrogen bonds. The significance?

“This altered molecule actually just slips through our bodies undigested because the body doesn’t know what it is,” she says. That’s why it has zero calories.

“They claim it’s safe because of that, but, at the same time, it’s kind of unsettling to know that a chemical compound is running through your system that your body can’t recognize.”

The manufacturer’s studies also show that the chemical causes shrunken thymus glands and enlarged livers and kidneys in lab animals. Again, the FDA maintains that these results don’t translate to humans.

Truly natural alternatives
Since the FDA doesn’t have an official definition of natural, let’s go with mine: not coming from a scientific laboratory; something that can actually be found in—call me crazy—nature.

Diabetics have been using these products—polyalcohol sugars like sorbitol, xylitol, maltitol, and mannitol—for years, and they come from places like forests and gardens. Xylitol, for example, can be found in birch tree pulp. Like artificial sweeteners, they don’t cause the insulin spike that sugar does. While they don’t have the magical zero calories, they do have half the amount that sugar does.

Stevia, known in South America as “the sweet herb,” has been used for over 400 years, and is extremely popular in Japan. It’s two to three times sweeter than sugar, so to sweeten, say, your iced tea, you need just a small amount, which further decreases the calorie count. I’ve used this in baking muffins, which I gave to my boyfriend without telling him they were healthy. (He loved them.) It’s sweet in a way that reminds me of honey.

I’m not claiming that I’ll never pick up a diet soda again, but at least I’ll know what’s really going on when I do. Segal maintains that a slip-up every once in a while is no big deal:

“All of these effects will only happen in extremely high doses,” she says. “The FDA has researched the heck out of these things and continues to say they are safe, so there has to be truth to that.”

As for the cancer factor, it’s a gamble I’m just not sure I’m willing to take. As Segal puts it: “It’s kind of like the chicken or the egg thing.”

Updated July 29, 2009

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