Sweet Nothings - A Short Review of Sweeteners
Author: Winston Craig, MPH, PhD, RD.
We are naturally attracted to sweet things. They are often the center of birthdays, anniversaries, and special celebrations. At such times, the high sugar items such as cake, punch, pie and ice-cream are usually preferred over the natural sweetness of fruits. The quality of the diet does suffer when sugar intake is above 15-20% of the daily calories. Soft drinks account for about one-third of all the intake of added sugars.
Some have switched from sucrose (table sugar) to using honey, molasses, turbinado sugar and other less refined forms of sugar in the belief that these provide superior nutrition. Another sweetener, high fructose corn syrup (HFCS), is now ubiquitous in our foods and beverages. A heavy use of soft drinks, including those sweetened with HFCS, has been blamed for the present epidemic of obesity. High fructose intakes may cause elevated levels of blood triglycerides.
Foods and gums listed as sugarless usually contain sugar alcohols, such as sorbitol, isomalt, or xylitol, which are poorly absorbed and thus provide less calories and a lower blood glucose response. In addition, they do not promote dental caries as other sugars do, but may have a laxative effect when large amounts are consumed.
Recently, we have seen a number of new high intensity sweetening agents hit the market. These substances are 200 to 600 times as sweet as sugar. Because they provide no calories and have no effect on blood sugar these high intensity sweeteners are useful for those desiring a sweet flavor and who wish to better manage weight problems and their blood sugar levels, such as those persons with diabetes. In addition, these sweetening agents do not produce dental caries.
While saccharin (Sweet ‘N Low) has been around for a long time, newer high intensity sweeteners are now available including aspartame (Nutrasweet or Equal), sucralose (Splenda), and acesulfame-K (Sunett or Sweet One ). These are all approved as general-purpose sweeteners. Because they provide sweet taste with little volume, manufacturers combine the sweetener with a bulking agent (such as polydextrose or maltodextrin) to make it easier to use. Reliable data shows that normal humans can consume aspartame safely and it is not associated with serious adverse health effects, such as skin and respiratory problems, as reported in the media. Persons with phenylketonuria are warned to avoid aspartame since they have an inability to process the amino acid phenylalanine.
Stevia (Truvia and PureVia) is a natural (non-synthetic) sweetening agent. Originally from Paraguay and used extensively in various parts of the world, stevia was approved last year in the US for use in food, soft drinks, and as a tabletop sweetener. Water extracts of stevia leaves are 300 times sweeter than sucrose. Like other high intensity sweeteners stevia provides no calories and has no effect on blood glucose, so it is an attractive choice as a natural sweetener for the management of diabetes. Clearly, there are many sweetening agents from which to choose.
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A modest amount of sustained weight loss can substantially reduce the risk of diabetes in overweight individuals. Middle-aged individuals who lost 1 lb/year for 8 years, then kept the weight off for another 8 years, reduced their risk of diabetes between 37 and 62 percent. Those who lost 1 lb/year for 16 years lowered their risk of diabetes up to 82 percent.