- April. 12 2021
As featured on Figure Athlete.
If you’re reading this article, you’re probably familiar with the term sugar substitute. Whether it’s because you’re looking for low-cal options to liven up your oatmeal, or want to stay away from sugar because you dislike what it does to your body, you know you have options.
Yet beyond that, you may be confused as hell as to what’s good, bad, indifferent, low-calorie, no calorie, FDA approved, not approved, natural…and so forth. The issue of sugar substitutes is almost as touchy as the upcoming Presidential election!
Opinions and studies abound, so let’s take a close look at the facts.
A sugar substitute is defined as a food additive that duplicates the effect of sugar or corn syrup in taste, yet typically contains fewer calories per serving.
There are two types — natural and synthetic (a.k.a. artificial sweeteners).
The most popular class of sugar substitutes is known as “high-intensity sweeteners.” These compounds create sweetness multiple times stronger than table sugar. Aspartame, saccharin, acesulfame potassium, sucralose, and neotame all fall under this category.
Aspartame is a widely known sweetener, being present in diet soft drinks, gum, and as a tabletop sweetener under trade names NutraSweet and Equal. Aspartame is 180 times sweeter than sugar by weight, has no bitter aftertaste, and contains 4 calories per gram.
One fact you may not know, is that aspartame was originally an attempt at an anti-ulcer drug. The experimenter got some on his finger and when he licked it off (not sure why anyone would do that), he noticed its sweetness.
Aspartame was FDA approved in 1981, after many years of testing and inconclusive results.
There’s been a conspiracy theory surrounding FDA Commissioner Hayes, who approved aspartame when he was appointed by President Reagan. By doing so, he overrode the decision of the Public Board of Inquiry (PBOI), an independent board of advisors put in place by the FDA to review the relationship between aspartame and brain cancer.
Hayes, who had close friends tied to the artificial sweetener industry, backed up his decision by citing data from a single Japanese study that hadn’t been available to members of the PBOI during their review (1).
You’ve surely seen the controversial claims linking aspartame to brain tumors, systemic lupus, multiple sclerosis, blurred vision, headache, fatigue, and Alzheimer’s disease; yet to date, the FDA stands behind its original approval of the sweetener, claiming aspartame to be one of the most thoroughly tested food additives ever approved.
What Are the Facts?
There’s been a vast amount of research conducted on aspartame, some of it suggesting a correlation in the rise of brain tumors related to the higher consumption of aspartame, concluding that it could be partially to blame (2). Other research, often supported by artificial sweetener companies, has found no link between aspartame and health-related issues (3).
Who Else Is Weighing In?
The American Heart Association and the American Diabetes Association approve the sweetener, however, the Center for Science in the Public Interest advises against the consumption as it “probably increases the risk of cancer” (4).
Aspartame has also been investigated and approved by the Joint Expert Committee on Food Additives of the United Nations Food and Agricultural Organization and the World Health Organization.
The European Commission Scientific Committee on Food has declared aspartame as safe to use, and in 2006, the European Food Safety Authority reaffirmed the previously established adequate daily intake to be appropriate.
Myth or Fact: Does aspartame turn to formaldehyde in the body?
Fact. It’s true, states David Hattan, Ph.D., director of FDA’s division of health effects evaluation.
Consumption of aspartame results in the production of methanol, formaldehyde, and formate, all substances considered toxic at high levels. However, the levels consumed by humans are modest, and substances such as methanol are found in similar high amounts in food products such as citrus juice and tomatoes (5).
Myth or Fact: Can the two amino acids in aspartame, phenylalanine and aspartic acid, cause neurotoxic effects, such as brain damage?
Fact, in certain individuals and in high doses.
A group of individuals with a rare hereditary disease called phenylketonuria aren’t able to metabolize the amino acid phenylalanine properly, causing a build up in their system far higher than normal. During pregnancy, high levels of phenylalanine can be transferred from mother to baby, causing severe issues relating to brain development.
While protein sources are the main factor for these women to watch, they should be aware of the presence of phenylalanine in foods and beverages that contain aspartame as well, so they can avoid their ingestions of it (5).
Aspartic acid may cause brain damage in high amounts; however the FDA figures that the average aspartame user consumes roughly 4 to 7 % of the acceptable daily intake the agency has set for the sweetener (5).
Saccharin was discovered in 1879 (making it the first artificial sweetener) and was used to sweeten food in both world wars. It’s 300 to 500 times sweeter by weight than sugar.
In 1972 and 1973, the FDA reviewed saccharin through studies done on rats. It was found that ingestion of the sweetener may cause bladder cancer in the animal, but further analysis concluded that impurities — not the sweetener — may’ve been to blame.
Then in 1977, the FDA proposed a ban on saccharin in the form of a tabletop sweetener due to a speculation by a Canadian study, which declared the sweetener to be responsible for those tumors found in the lab rats, after all.
Public upheaval ensued as media stories broke that the test rats were fed the equivalent of 800 diet sodas per day, and Congress responded by passing an act which placed a two year moratorium on any ban on saccharin while further research was done.
This act also required foods containing the sweetener to be labeled with the warning, “Use of this product may be hazardous to your health. This product contains saccharin which has been determined to cause cancer in laboratory animals.”
A population-based study conducted the same year by the FDA and NCI concluded that “in general,” people who use the sweetener have no greater risk of bladder cancer than the population at large. The study did find “suggestive evidence” that individuals consuming more than six serving per day may be at greater risk (5).
Saccharin was later determined, by the International Agency for Research on Cancer, to not be carcinogenic to humans on the basis of evidence that it’s carcinogenic to rats by a non-DNA reactive factor not relevant to humans due to critical differences in urine composition. In 2001, the US repealed the warning label requirement.
Today you may recognize saccharin in the form of Sweet ‘N Low. It has zero calories per gram and is often used in baking goods because, unlike aspartame, it doesn’t degrade at high temperatures. It’s also used to sweeten toothpaste, beverages, and many diet foods, often blended with other sweeteners to lessen the bitter aftertaste.
Who Else Is Weighing In?
On its “Cancer Facts” sheet, the National Cancer Institute states that epidemiological studies do not provide clear evidence of a correlation to human cancer. The National Toxicology Program, run by the US government, includes saccharin on its list of “anticipated carcinogens,” but considered removing it based on available safety evidence. “We know for certain that it causes cancer in animals,” states Andrew Laumbach, Ph.D., consumer safety officer in FDA’s Office of Pre-market Approval.
However, he also says that animal studies don’t always predict how the substance will behave in the human body. The American Dietetic Association, the American Medical Association, and the American Cancer Society all consider saccharin acceptable and safe.
Sucralose, known by its trade name Splenda, is a chlorinated sugar that’s 600 times sweeter by weight than table sugar. It was approved by the FDA in 1998 after a review of more than 110 animal and human safety studies over twenty years (5). It’s currently the leader in table top usage.
Splenda has 4 calories per gram, retains a shelf life far greater than sugar, and does not degrade when exposed to heat, so it can be used in cooking. New methods of production for sucralose are emerging, allowing the circumvention of Tate & Lyle’s patent, so it may soon replace aspartame as the leading artificial sweetener.
The health related concerns tied to sucralose pertain to the fact that it belongs to a group of chemicals called organochlorides, some types of which are toxic or carcinogenic. However, sucralose is metabolized in a way that reduces toxicity since it doesn’t accumulate in fat cells or break down inside the body (6).
Acesulfame potassium, a.k.a. Acesulfame K or by the trade name Sunett, is 200 times sweeter by weight than sugar. It was first approved in 1988 as a tabletop sweetener, and is now approved for use in food products and beverages. It has zero calories per gram, a shelf life far better than table sugar, and doesn’t break down with exposure to high heat.
Acesulfame K has been reviewed by the Joint FAO/WHO Expert Committee on Food Additives (JECFA), which concluded that it’s safe for use, at least at levels less than the acceptable daily intake of 15 mg/kg of body weight. The European Union’s Scientific Committee for Food has also approved acesulfame potassium for use in foods and beverages.
However, the Center for Science in the Public Interest in the USA disputes these safety claims, stating that carcinogenicity may not be completely understood due to flaws in the research protocols and studies.
Polyols, a.k.a. sugar alcohols, aren’t technically considered artificial sweeteners, but contain fewer calories than table sugar by weight, do not cause tooth decay, and don’t have negative effects on blood sugar levels.
Xylitol, sorbitol, lactitol, mannitol, and maltitol all fall into this group, and are mainly used in desserts and gum. It should be noted that some people have problems digesting sorbitol and mannitol, leading to upset stomach, gas, and diarrhea.
Artificial sweeteners cost far less to manufacture than natural ones, resulting in higher profit margins. Then there’s the fact that the World Health Organization (WHO) estimates over 1.6 billion adults to be overweight (in addition to the 400 million being obese), with the total cost associated with being overweight/obese in the US alone reaching approximately $117 billion (7).
We have a recipe for huge dollars across the board in the artificial sweetener manufacturing industry.
A report published by Global Industry Analysts, titled Artificial Sweeteners: A Global Strategic Business Report, explains that the current focus on weight loss has stimulated a $3.5 billion-dollar global artificial sweeteners market, of which the US and Europe make up 65 %. The global sweetener market grows at a compound annual rate of 3.7 % each year (8).
Is all this making your head spin? Just want to stick to the sweet stuff that hasn’t been modified in seven different ways? Don’t freak, you still have options.
There’s honey, molasses, evaporated cane juice, rice syrup, barley malt, fructose; however, for the sake of writing an article and not a novel, I’ll talk about two others in particular — stevia and agave nectar.
Stevia is an herbal supplement derived from a South American shrub. It’s 250 to 300 times sweeter by weight than sugar.
Stevia has been used as a sweetener by the Guarani Indians of Paraguay for hundreds of years and is still a main staple sweetener in Japan and China. It’s now available in the US, Canada, Australia, and New Zealand, primarily as a “dietary supplement”. It has zero calories per gram and does not affect blood sugar levels.
Depending on where you look for information, you’ll get a different answer, citing studies to back up whatever claim you read. Some studies show mutagenic properties, while others prove this inconclusive. Some show that stevia helps improve insulin sensitivity in rats and reduce hypertension in humans, while others say that it has no effect on hypertension but is still safe for long term use (9).
Despite more recent research showing no harmful effects from stevia use, government agencies are still concerned with toxicity, stating that there’s not enough conclusive evidence to approve it as a sweetener.
In 1991, the FDA labeled stevia an “unsafe food additive” and restricted its import, stating that “toxicological information on stevia is inadequate to demonstrate its safety” (10). Since Stevia occurs naturally, it doesn’t require a patent to produce.
More conspiracy theories arise with this point, as some stevia advocates claim that the FDA’s actions were in response to industry pressure, acting against their own guidelines, which state that any natural substance used prior to 1958 with no reported adverse effects should be GRAS. Further, a GRAS petition was submitted in 1995 citing over 900 studies, none of which indicated any safety concerns related to human health.
One Thailand study in particular, done in 1991, concluded that even at doses 1000 times normal human dosage, hamsters demonstrated no difference in growth rate or sexual performance, over a three generation span (11). Additionally, throughout Japan, cancer is very rare, although stevia has been used abundantly for over 30 years.
Who Else Is Weighing In?
According to the American Herbal Products Association, “Stevia leaf is a natural product that has been used for at least 400 years as a food product, principally as a sweetener or other flavoring agent.
None of this common usage in foods has indicated any evidence of a safety problem. There are no reports of any government agency in any of the above countries indicating any public health concern whatsoever in connection with the use of stevia in foods.”
The World Health Organization (WHO) conducted a thorough investigation of recent studies in 2006 and concluded that “stevioside and rebaudioside A (stevia components) are not genotoxic in vitro or in vivo and that the genotoxicity of steviol and some of its oxidative derivatives in vitro is not expressed in vivo” (9). In other words, it’s safe for consumption as a food additive.
Many homeopathic and alternative doctors support the use of stevia as a dietary supplement and sweetener as well.
With the consumer demand for natural products ever-growing, the big dogs want to get into the play. On May 13th, Whole Earth Sweetener Company filed papers through the FDA on behalf of itself and Pepsi for approval to use a stevia based sweetener called PureVia. Then on May 20th, The Coca-Cola Company and Cargill announced plans to gain approval for the use of a stevia based sweetener, called Truvia, as a food additive and to market the sweetener in the US by 2009.
Both sets of partners are pushing for GRAS classification, planning to use rebaudioside A (just one of the components) to provide the desired sweetness without a bitter aftertaste (12).
The production of stevia is still not standardized, so taste and strength do vary depending on brand. One manufacturer, SweetLeaf, claims to currently stand alone as the only stevia based sweetener that uses pure water alone in its proprietary extraction process (13).
Further, this is the only stevia extract to have received GRAS status, allowing it to be sold as a sweetener rather than dietary supplement. The manufacturer also notes that their product is free of chemicals, formaldehyde, acetic acids, and chlorine, of which many artificial sweeteners may contain (13).
Agave nectar (or agave syrup) is a sweetener produced in Mexico from agave plants. It’s sweeter than honey, although not as thick or as flowery in taste. Agave nectar is quickly becoming a preferred sweetener among many health aficionados as it doesn’t contain any chemicals.
It’s made up of primarily fructose and glucose, and is known for its low glycemic index. One tablespoon contains 60 calories, 0 grams of fat, 16 grams of carbohydrates (15 of them sugars), 1 gram of fiber, and no protein. Since agave nectar is sweeter than sugar, you can substitute 1/3 cup for every cup of sugar needed in a recipe.
Some raw food proponents argue that since agave nectar is heated to roughly 140 to 160 degrees Fahrenheit, it’s not a “natural” food and shouldn’t be touted as a “raw” food, as it’s lost much of its health benefits during the manufacturing process.
Further, with the ratio of fructose to glucose being so high (typically a 90/10 split), it may not be healthy to consume agave nectar in large quantities (14).
So who’s right? Who do we believe? Can we trust the FDA, or do the people in charge have personal agendas?
What about the research itself? One argument made time and time again is the issue of rats’ versus human DNA. Can we be sure that cancer found in rats would parallel that of humans? And how objective is research done by a product’s manufacturer?
Is the large quantity of sugar substitutes given during the rat experiments comparable to true life consumption? After all, even water can kill you in overly excessive quantities!
And another thing, what does the term “moderation” mean, anyway? How do we know if we’re consuming moderate amounts?
I don’t have answers to these questions. Research is an ever ongoing process, and new information is constantly coming to light. You now have pros and cons of each option, providing you with tools and knowledge necessary to make a decision based on study findings to date.
Ultimately, there’s no one right or wrong answer across the board.
I know you’re probably thinking, “Ok, what does she use?”
My personal stance is this: I tend to use stevia mostly in my diet; however, I use Splenda and agave nectar from time to time in my baking, and do enjoy a Diet Coke, Orbit gum, or sugar-free pudding once in a while. Based on the information to date, I feel comfortable having both natural and artificial sweeteners in small amounts — not as an integral part of my meals, beverages, and snacks.
The volume of high-intensity sweeteners usage will likely continue to increase as patent protections expires and new competitors enter the market. It’s up to us as consumers to continue educating ourselves rather than believing everything the media puts forth.