Sweeteners and sugar replacements: side effects can be bitter

Until the seventeenth century, men used honey to sweeten foods or drinks; only later was introduced white refined sugar (sucrose), whose consumption is nowadays up to 20 pounds per capita a year. Research has shown a strong correlation between this figure and the increase of diseases such as obesity, tooth decay and arteriosclerosis. That's why our society is increasingly becoming "light". Beverages, chewing gum, yogurt and other low-calorie foods proliferate on the shelves of supermarkets. In most of these products sugar is replaced with low-calorie sweeteners about whom there is often a lot of confusion. Especially regarding the pros and cons. Do you know, for example, that there is an ADI (Acceptable Daily Intake) established from FDA? Let's start saying that there are basically two types of sweeteners: the NATURAL ones and the ARTIFICIAL or synthetics ones.

NATURAL SWEETENERS are polyols like sorbitol, xylitol and mannitol (present in fruits or other parts of plants): these are less caloric than normal cooking sugar (sucrose), providing 2.4 calories per gram versus 4 of sucrose but have a good sweetening power. For this reason, they are used in an increasing number of low-calories foods.

They also don't cause caries development; in particular xylitol, which is precisely why we often find it in products for the health of teeth and gum. Fructose is the best known and used natural sweetener. Two of the features that make it different from common sugar are its glycemic index (fructose is one of carbohydrates with lower glycemic index) and its sweetening power (about one third higher than that of sucrose). Contrary to what happens with glucose, fructose does not stimulate significant release of insulin. Recently fructose is decidedly chatted: a research found that ingestion of large amounts of fructose in laboratory animals for a sufficiently long time causes obesity, insulin resistance and increased risk of cardiovascular disease. But I'm persuaded we have to think with our mind and to be critical also of these results. In fact giving megadoses of a substance for a prolonged time is the best way to get negative effects. Even water can be deadly if taken in excessive doses (hyponatremia, excessive dilution that reduces the levels of sodium in the blood). The search is trivial because we already know that any excess nutrient (even beneficial) leads to metabolic dysfunction...
That said, it's good to remember that there could be some side effects abusing of these natural sweeteners. Polyols aren't absorbed and ferment in the gut, causing bloating, flatulence or diarrhea, when consumed in excessive amounts. It is not an unimportant issue because malabsorption of fructose, for instance, affects approximately 40% of North Americans and Europeans. One way to accelerate the absorption of fructose is to mix it with glucose; is the typical case of sports drinks that contain a mix of these two carbohydrates. So... always read labels in order to know how many grams of polyols are contained in the food you're going to eat! As a reference, know that the American Dietetic Association advises that greater than 50g/day of sorbitol or greater than 20g/day of mannitol “may cause diarrhea.” - Journal of the American Dietetic Association 2004; 104:256.
Another natural sweetener is stevia, a plant grown in Paraguay and Brazil. Although the use of stevia was accepted in the United States only in 2008, there has been plenty of controversy swirling around it for years. Here are some FACTS. Stevia is drastically sweeter than sugar (300 times). When we eat something so sweet, we actually induce our body to react as if we were giving a lot of calories to burn; however, all these calories don't come because stevia doesn't contain any calories.

We are taking in calories from the other components of the food eaten: only a part of what our body is expecting. As a result, we still feel hungry, we could overeat and, ultimately, gain weight. Being "all natural" doesn't automatically make stevia any safer than any of the other sugar substitutes out there. Always be careful, use your mind, keep up to date on the latest studies on the subject, don't be tempted to use extra doses.

- ARTIFICIAL/synthetic SWEETENERS under the lens. They were originally born to help diabetic patients, but their use has expanded to "light" foods and beverages though there are still lively discussions about their potential negative effects. They absolutely don't cause tooth decay and have a strong sweetening power; they became popular in the "diet" industry because the doses used are practically calories-free. Acesulfame, aspartame, saccharin, sucralose, neotame: just read the ingredient list of light products to realize the frequency with which these sugar replacements show up.
- Acesulfame K (examples of brand names: Sunette, Sweet One,...). Acesulfame Potassium (K) was approved by the FDA as a safe artificial sweetener in July, 1988; it is 200 times sweeter than refined sugar. Unfortunately, several potential problems associated with the use of acesulfame have been raised. The findings showed that it stimulates insulin secretion so it can worse the natural reaction of the body causing hypoglycemia ("low blood sugar attacks"). Acesulfame K apparently causes lung tumors, breast tumors, rare types of tumors of other organs (such as the thymus gland), several forms of leukemia and chronic respiratory disease (tests made on rats), even when less than maximum doses were given. According to the Center for Science in the Public Interest, it was petitioned on August 29, 1988 for a withdrawal of approval by the FDA because of "significant doubt" about its safety.

- Aspartame (example of brand name: Equal). Aspartame is found in many diet soft drinks since it is 60-200 times more sweet than sucrose. It breaks down when heated, so it's not recommended for use in cooking or baking.

It contains circa 10% methanol, a toxic poison which is released in the intestine when the methyl group of aspartame meets enzyme chymotrypsintoxic poison which is released in the intestine when the methyl group of aspartame meets enzyme chymotrypsin (sorry for these technical terms, but it's to show scientific evidence). In some people it may even be responsible for allergic reactions, headache, convulsions and lymphomas (!!!).

- Saccharine (example of brand name: SweetN'low,...): between 200 and 700 times sweeter than white sugar, it contains cyclamate, a substance suspected to be toxic and carcinogenic. In the 1970s, saccharin fell from favor when studies linked its use to the development of bladder tumors in male rats. However, later studies showed that the tumors' formation was dependent on the way rats metabolized saccharin, which differs from the way humans do. Warning labels on saccharin products were removed in 2000.
- Sucralose (example of brand name: Splenda - 600 times sweeter than table sugar). A surprising study found that this artificial sweetener is a contaminant detected in wastewater, surface water and groundwater. In the United States, water samples from 19 water treatment plants (more than 28 million people served) were tested to find sucralose. The sweetener is found to be present in: • drinking water: 15 out of 19 treatment plants • treated water: 13 out of 17 plants • 8 water distribution systems out of 12. According to the study sucralose "was found persistent regardless of the presence of residual chlorine or chloramine" (Environmental Science and Technology August 31, 2011). This is problematic because sucralose can be very harmful to human health and it seems to be a widespread contaminant in water supplies in the United States. The site www.truthaboutsplenda.com lists consumer complaints of Splenda. Some of the most common symptoms, which are usually noted within a period of 24 hours after consumption, include: gastrointestinal problems (gas, bloating, diarrhea, nausea, vomit,...), increased blood sugar, headaches, allergic reactions (swelling, scabs, rashes, hives, wheezing, coughing, ...), shortness of breath, sneezing, palpitations, joint pain, anxiety, depression,...
- Neotame (made by the NutraSweet Company from Monsanto). It is assigned the International Numbering System (INS) food additive code E 961. It’s based on the aspartame formula — despite the fact that 80% of all FDA complaints pertain to adverse reactions from aspartame. Since neotame is just modified aspartame, it could potentially lead to the same health problems associated with the latter, including: cancer, diabetes, emotional disorders, epilepsy/seizures, fatigue, headaches/migraines, insomnia, memory loss, premature birth. On the other hand, however, it's between 7,000 and 13,000 times sweeter than common sugar, so it's used at very low levels: that's why it's ranked as "safe" also by the consumer advocacy group "Center for Science in the Public Interest".

Here are the Acceptable Daily Intakes (ADI) established for the artificial sweeteners. The ADI is the estimated amount per kilogram of body weight (bw) that a person can safely consume - on average - every day over a lifetime without risk. The ADI usually indicates an amount 100 times less than the maximum level at which no side effect occurs in animals.

Acesulfame-K: 15mg/kg bw/day

Aspartame: 50mg/kg bw/day

Saccharin: 5mg/kg bw/day
Sucralose: 5mg/kg bw/day
Neotame: 18mg/day.

Everything in moderation
Foods with labels that read "low in sugar", "no added sugar", "low glycemic response", or "sugar free" most likely contain one or more sugar replacements (for example sugarfree gums often contain four or five different sugar replacements). If chosen as a part of a healthy diet, foods made with sugar repacements or packets of sugar replacements added to drinks (such as coffee and tea), can help a person suffering from diabetes manage his carbohydrate intake. However, sugar-free foods are not necessarily carbohydrate-free, and often their nutrients are not so valuable. As written above about stevia, sweeteners may cause inadequate food behaviors. If you eat low sugar content, you are likely to crave carbohydrates, because the body tries to get what the sweet taste made him hope. Another warning: words "sugar free" can be tricky! Foods containing polyols can be quite caloric; moreover, some foods sweetened with artificial sweeteners contain lot of fat. So read the nutritional values printed on the packaging!!

Best advice for everyone looking for a healthy style of life: rather than resorting to artificial sweeteners for weight loss, it is preferable learning little by little to eat less sweet and less sweets!

Brand names are mentioned for the sole purpose to make easy understanding where that kind of sweetener is present