Trends of consumption show 90% of U S adults consume low-calorie, sugar-free and/or reduced fat foods and beverages at least once every two weeks. (O'Brien-Nabors, 1998 Calorie Control Council)

WHY USE SUGAR SUBSTITUTES?

The 2000 Dietary guidelines advise "Choose beverages and foods that limit your intake of Sugars", because added sugars can displace other foods that provide nutrients and can promote tooth decay. Although, today for people with diabetes, scientists have discovered that sugar is no worse for blood glucose levels than other carbohydrates, sugar substitutes are desirable for other reasons.

The four sugar substitutes on the market are:

However, in theory low-calorie sweeteners can save calories using average sugars intake of 95 grams/day (24 tsp); 380 kcal/day deficit=1 pound weight loss every 9-10 days. But both use of sweeteners and overweight and obesity in America are increasing.

All low-calorie sweeteners contribute no or very few calories to foods and beverages. All are so intensely sweet that a smidgen goes a long way and has almost no calories. All but aspartame are useful in cooking but may change the texture in baked goods. All but saccharin are popular as a table top additive, great tasting without a bitter aftertaste. The safety of any substitute is well accepted if used in moderation. Individually each one has a long history of chemical stability.

Cyclamate, banned in 1970 because of a possible link to bladder cancer, has since been shown to be safe. The FDA is considering two others; Neotame, 8,000 times sweeter than sugar, has potential to replace high-fructose corn syrup and Alitame, a peptide consisting of an amine (compound derived from amino acids) and the two amino acids aspartic and alanine.

An herb called stevia has a sweet taste but is not approved as a food additive, because FDA is not convinced it is safe, but like other herbs whose safety has not been proven, it can be sold as a dietary supplement.

Blends of some low-calorie sweeteners in foods and beverages act synergistically to produce the desired level of sweetness with smaller amounts of each sweetener. Two examples are Carnation Instant Breakfast sugar free nutrition drinks and Diabetisweet, a table top and baking sweetener. Health authorities around the world have reasonably concluded that there is no scientific basis to expect any physiologic effects to emerge from blended sweetener systems and even further reduces the already safe levels of use and dietary intake.

I learned from this session the use of low-calorie sweeteners results in a wide range of food choices that can aid individuals in managing their caloric andcarbohydrate intakes. By providing good tasting alternatives low-calorie sweeteners offer the best method to date of reducing calories while maintaining the palatibility of the diet. Many companies are developing new foods every day.

Isomalt is a good tasting, sugar-free sugar replacer ingredient in candies, cookies, breathments , cough drops, and other products. It is non-cariogenic and low glycemic. Its calorie value is half that of sugar. This booth provided professional education materials which explained how and why Isomalt is very different than sugar-free intense sweeteners. Kriten McNutt answers questions in the August issue of Diabetes Interview. Sugar replacers replace sugar, cup-for-cup. They provide sweetness but also fill the space or volume as a purpose for sugar in products such as cookies, hard candies, chocolates, fudge, breath mints and cough drops. The replacers are not calorie-free but provide fewer calories than sugar because they are not completely digested and/or absorbed. Products with sugar replacers are marketed as between meal snacks because they do not promote dental caries and have little or no effect on blood glucose or insulin levels since absorption is slower. Other sugar replacers names end in 'ol' and called sugar alcohols to describe their chemical structure (xylitol, sorbitol, maltitol all naturally found in fruit) synthesized by hydrogenating certain sugars. These low-digestible carbohydrates can cause gas or softer, watery stools than usual.

Acesulfame Potassium was discovered by accident in 1967. The FDA approved its use as a table top sweetener and in dry beverage mixes and chewing gum in 1988. Safety up to 15 milligrams is equal to 20 diet sodas a day.

Many products were displayed at this booth. Kris Schroeder, R.D., C.D. at Swedish Medical Center, Seattle, WA (kris.schroeder@mail.swedish.org) provided literature about this calorie free sweetener that is 200 times sweeter than sugar.

The advertising boasts 'great taste-not aftertaste'. Acesulfame Potassium is not metabolized and passes through the body unchanged. The dietitian said there are 4000 favorite foods and beverages people can still enjoy without the high level of sugar and calories. This ingredient provides a fast burst of sweetness that immediately engages the taste buds giving a clean taste sensation that doesn't linger unpleasantly. The trident that I sampled is not cavity forming and is good.

The table top sweetener is called Sweetone and is marketed as a non-aspartame sweetener. The many products meet the needs of the growing number of diet consumers. Sales have increased from 42 million in 1978 to 144 million in 1998.

Examples of familiar foods that contain Sunett Acesulfame potassium:

picture Chocolate Manufacturers Association spoke to Colleen Lowther, MA, RD (colleenrd@yahoo.com)

In itâs Chocolate and Health scientific overview for the heath professional, with technical assistance from ADA, I found data from the U.S.D.A and the Journal of the American Chemical Society has a ranking of the Oxygen Radical Absorbance Capacity (ORAC) a measure of the ability of foods to subdue harmful free radicals that can damage our bodies. In ORAC units per 100 grams Dark Chocolate tops the list with 13,120 compared to blueberries, 2400 and grapes, 739. Now cocoa powder and chocolate is advertised as a high quality polyphenol antioxidant, with the potential like fruits and vegetables to reduce the risk of developing heart disease and certain cancers. A good excuse to add chocolate to the diabetes meal plan too? Miss Lowther predicts sales to sky rocket.

Sugars in chocolate products have individual characteristics and functions. Sweeteners differ according to their chemical structure. There are 4 major groups: Sugars (sucrose, glucose, fructose, lactose, maltose), syrups, sugar alcohols, and alternative sweeteners. White sugar results from refining of raw sugar that is 99.9% pure. Crystals are separated by size and standard granulated sugar used at the table is called fine, while the baking industry uses superfine or Îultrafineâ sugar for chocolate candy.

SPLENDA

The new kid on the block provides a wide range of products. The only no calorie sweetener made from sugar. Tastes like sugar and pours like sugar so our diabetic customers are questioning itâs use. It is available in bulk for use in baking and cooking. It has 1 gram carbohydrate (maltodextrin) and the label states it is suitable for people with diabetes, no warning label. Sucrolose, the sweetening ingredient in splenda is not a carbohydrate and has been shown, in clinical trials, to have no effect on blood glucose or insulin levels.

EQUAL

The highlight of this exhibit was the All Things Equal newsletter. Like saccharin, Aspartame was discovered by accident. In 1965, James Schlatter was doing research on ulcer drugs when he licked his finger to pick up a piece of paper and noticed it tasted sweet. From a spill in the lab, he found this substance was 180 times sweeter than sucrose. It is a synthetic combination of 2 amino acids found naturally in foods (aspartic acid and phenylalanine ). Itâs only drawback is a loss of sweetness if exposed to heat. In addition, I think the public does not realize the differences in use of Equal for recipes, compared to products of Equal sweetener of Spoonful when they try to substitute on their own. For example, a Fruit Smoothie recipe of 1 cup each orange juice, fat-free plain yogurt, strawberries and a frozen banana calls for 1 3/4 teaspoon Equal for Recipes or 6 packets Equal sweetener or 1/4 cup Equal Spoonful.

Aspartame can be added at the end of the cooking cycle. After ingestion it is used by the body in the same way as when derived from foods such as meats, dairy products, fruits and vegetables. Only people with the hereditory disease Phenylketonuria (PKU) must avoid Aspartame.

SWEET'N LOW

Saccharin is 500 times sweeter than sugar. It is stable when heated and is not broken down by the body so it is eliminated without providing calories. It was discovered in 1878 by accident. It is available as acid saccharin, sodium saccharin, and calcium saccharin. The question of safety in the past would require an intake of at least 800 diet sodas a day. The FDA established an acceptable daily intake (ADI) of 2.5 mg/kg body weight, or 147 mg for a 130# adult. A packet of sweetân low contains 30 mg and a diet soda is 125 mg.

The only drawback is, for some people, a bitter after taste. However, this can be masked by blending it with other sweeteners. The sweetân low confectionary product line leads in sales with 34% of the market. New products showcased at ADA were numerous, tasty, Wafer Bars, Mints, Bits and Hard candies, all 30-40% less calories and 40-50% less fat than the reference items.

The Sugar Association, Inc, Rachel McConnell, Communications Coordinator, rachel@sugar.org

SUGAR AS A SWEETENER FOR PEOPLE WITH DIABETES

Carbohydrates are simply chains of single sugars hooked together. Sucrose (white table sugar) is a chain of glucose and fructose molecules. Several studies have shown that sucrose when fed as part of a meal does not cause increases in blood glucose levels any more than do most starches (complex carbohydrate). However, studies have linked sugar (concentrated sweets) consumption by diabetics with an increase in blood triglycerides, a type of fat in the blood that increases risk for heart disease. The OTHER CARBOHYDRATE list in the ADA Exchange Lists for Meal Planning states these foods can be substituted in the meal plan even though they do contain sugar. However, they do not contain many important vitamins and minerals like the starch, fruit and milk foods they may replace. Because of the concentrated source of carbohydrates and/or fat the portion sizes are very small.

REFERENCES

to Top

Calorie Control Council http://www.caloriecontrol.org
American Academy of Family Physicians http://www.aafp.org
Stewart's Beverages www.Sdiets.com
www.isomaltusa.com
www.splenda.com
www.DiabeticCooking.com
www.diabeticproducts.com
www.equal.com
www.sugar.org
www.diabetes.org
www.kraftfoods.com
www.healthfree.com/herbgarden/stevia.htm
Vegetarian Resource Group www.vrg.org/journal/diab
www.diabeteslife.net
www.diabetes.org
www.diabeteswell.com

Blumental M. Legal and Regulatory. AHPA Petitions FDA for Approval of Stevia Leaf Sweetener. Herbal Gram. 1992;26:22,55-57

Brown A. Understanding Food Principles and Preparation. Belmont, CA: Wadsworth;2000

Low-calorie Sweeteners and Health. John P. Foreyt, PhD. Departments of Medicine and Psychiatry, Baylor College of Medicine, Houston, Texas. Speaker ADA Food and Nutrition Convention and Exibition, Denver, Co. October, 20000

Position of the American Dietetic Association: Use of nutritive and nonnutritive sweeteners J Am Diet Assoc. 1998;98:580

This site was developed by Connie McLellan, RD. LD. Oregon State University, Graduate Student Dietetic Management Distance Program

to Top

Updated: Sunday, March 30, 2008.