Artificial sweeteners, also known as, non-nutritive sweeteners (NNS) or low-calorie sweeteners, are used as sugar substitutes for individuals with diabetes. A non-nutritive sweetener is a sweetener that does not provide calories or energy. Artificial sweeteners are used in more than 6000 food products and can be used as a substitute to decrease calories in the product (Shmerling, 2019). They are in products such as diet beverages, yogurts, desserts, and gum. The food industry has maximized marketing campaigns to advertise that sugar substitutes are a healthier alternative for diabetics. Artificial Sweeteners allow individuals with diabetes to consume sweet treats without elevating their blood glucose too much, too fast. Also, they are used to lower the calories in food products because only a small amount is needed. However, due to the small amount of NNS needed, it is mixed with bulking agents or sugar alcohols as fillers. Consumers do not realize than NNS is 10 times sweeter than sucrose. Depending on the type of sweeteners used, it can have an intense sweetness compared to sucrose.
Common types of artificial sweeteners
Some FDA approved sugar substitutes come in color-coded packaging:
Aspartame (blue) - Nutrasweet, Equal
Saccharin (pink) - Sweet’N’Low
Stevia-derived (green) - Truvia
Sucralose (yellow) - Splenda
Health effects of artificial sweeteners
Recent findings have disclosed that some NNS can affect good bacteria in the gut, increase risk for metabolic syndrome, and increase the risk for cancer (Purohit & Mishra, 2018***). One study reveals that there was an association with the risk of lymphoma and leukemia with aspartame consumption. However, the study did not quantify the exact amount of aspartame consumption to establish the levels in which it can be carcinogenic. Another study assessed that there is a positive relationship between the risk of developing urinary tract or bladder cancer with the consumption of NNS (Lohner et al., 2017). Aspartame and saccharin were the two NNS that may have a correlation with the risk of cancer but more research is needed.
Another concern is that the potency of the sweetness of NNS can affect taste receptors. Artificial sweeteners are more potent than table sugar and high-fructose corn syrup (Strawbridge, 2019). The more a person consumes NNS, the more they will find less intensely sweet foods like fruit to be sweet and palatable. Also, since NNS products does not taste as sweet, consumers might eat more of it. Although, NNS may reduce caloric intake, it has less nutritional value and may not have beneficial effects to help control diabetes because it still alters insulin sensitivity (Sylvetsky et al., 2016).
Natural is better!
Studies have shown that artificial sweeteners have health concerns, however, there is not enough evidence to prove these risks that will prevent individuals from consuming it. Most of the studies did not relate that the effects of consuming NNS in large quantities over a long period of time. Sweeteners like Sucralose and Stevia are noted to be safe or minimal since it does not get metabolized in the body. Perhaps, natural sugar-containing foods such as fruit, is a better option for diabetics. Fruits are high in fiber, are nutrient-dense, and are low in glycemic load; which will not affect their blood glucose to spike compared to consuming refined sugars (Sylvetsky et al.,2016).
Hahn, J. (2019, April 17). The Truth Behind Artificial Sweeteners. Retrieved November 7, 2019, from https://www.hahnholistichealth.com/2019/04/17/the_truth_behind_artificial_sweeteners/.
Lohner, S., Toews, I., & Meerpohl, J. J. (2017). Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutrition Journal, 16(1). doi: 10.1186/s12937-017-0278-x
Purohit, V., & Mishra, S. (2018). The truth about artificial sweeteners – Are they good for diabetics? Indian Heart Journal, 70(1), 197–199. doi: 10.1016/j.ihj.2018.01.020
Rabin, R. C. (2016, February 19). Artificial Sweeteners and Weight Gain. Retrieved November 7, 2019, from https://well.blogs.nytimes.com/2016/02/19/artificial-sweeteners-and-weight-gain/.
Shmerling, R. H. (2019, February 21). Sweeteners: Time to rethink your choices? Retrieved November 7, 2019, from https://www.health.harvard.edu/blog/sweeteners-time-to-rethink-your-choices-2019022215967.
Strawbridge, H. (2019, October 10). Artificial sweeteners: sugar-free, but at what cost? Retrieved November 7, 2019, from https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030.
Sylvetsky, A. C., Blau, J. E., & Rother, K. I. (2016). Understanding the metabolic and health effects of low-calorie sweeteners: methodological considerations and implications for future research. Reviews in Endocrine and Metabolic Disorders, 17(2), 187–194. doi: 10.1007/s11154-016-9344-5
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