Weekly Column_120 / August 16, 2012

Sugarless

By Charles Platkin, PhD

ASSORTED SWEETS

ASPARTAME (Marketed as NutraSweet, Equal, Canderel, or Spoonful)
Aspartame is one of the most popular sweeteners on the market and is used in more than 6,000 products around the world. It’s been around since 1965 (discovered while testing drugs for ulcers), was approved by the FDA in 1981, and is 200 times sweeter than table sugar. Aspartame is made up of two amino acids that are naturally found in meats, grains, and dairy products. It can lose its sweetness if it reaches excessive heat; therefore, it’s not ideal for baking. To come close to the FDA’s Acceptable Daily Intake (ADI), a 150-pound adult would have to consume 20 12-ounce diet sodas per day or 97 packets of NutraSweet.

The Rumors: Aspartame is dangerous; causes cancer, brain tumors, hypoglycemia, multiple sclerosis, lupus, and Alzheimer’s; and is unsuitable for diabetics. Some people have reported dizziness, hallucinations, or headaches after drinking diet soda.

The Research: In hundreds of clinical studies from scientists around the world, as well as investigations by the Centers for Disease Control (CDC), there has been no evidence of health risk from aspartame consumption. “After listening to and investigating many of the rumors related to aspartame over the years, I’m most certainly convinced that they have absolutely no merit. In fact, many can be attributed to other unrelated events — such as eating very little and drinking lots of diet soda — then claiming aspartame created a headache,” says Susan Schiffman, Ph.D., professor of medical psychology at Duke University Medical Center. Still other experts remain cautiously optimistic. Michael F. Jacobson, Ph.D., executive director of the Center for Science in the Public Interest explains, “Aspartame appears to be safe, but should be retested since it is so widely consumed — just to be assured that it’s safe in terms of cancer. As for the neurobehavioral problems, there doesn’t seem to be any evidence. If you are sensitive — don’t use it.”

One side note: there is a rare genetic condition called phenylketonuria (PKU). These individuals cannot metabolize phenylalanine (one of the amino acids in aspartame) and need to avoid products with aspartame. All products containing aspartame have a mandatory warning label specific to this condition.

Bottom Line: Aspartame seems okay, but I’m going to limit myself to a couple diet sodas and a few blue packets a day.

SACCHARIN (Marketed as Sweet’N Low and Sugar Twin)
This is the granddaddy of artificial sweeteners and has been around since 1879. It is 300 times sweeter than sugar and has no calories. One of its main problems, aside from rumors of it being carcinogenic, is its distinctive and strong bitter aftertaste.

The Rumors: It causes cancer.

The Research: According to many experts, you’d have to drink 750 cans of diet soda or have 10,000 tablets of saccharin a day, every day for your entire life to cause a problem. Despite this, several scientists still don’t feel comfortable with the decision to remove the cancer warning label. They claim that many studies on animals have shown that saccharin can cause cancer of the urinary bladder. “It’s just not completely safe. They did testing on rats, and who knows if as humans we are more or less sensitive? At the very least, I would caution against giving saccharin to children,” says Emmanuel Farber, M.D., Ph.D., adjunct professor of pathology, University of South Carolina School of Medicine.

Bottom Line: I’m probably going to avoid using saccharin.

ACESULFAME-POTASSIUM (Acesulfame-K or Ace-K, marketed as Sunette or Sweet-One)
Though a newcomer to the marketplace, acesulfame-K is gaining popularity and is now used in thousands of foods, beverages (e.g., Diet Sunkist and Pepsi One), and pharmaceutical products. It contains four calories per gram, but it’s 200 times sweeter than sugar (so you need a lot less). Although it’s been around since 1967, the FDA approved its use in 1998. Acesulfame-K is often used as a blend with other sweeteners, usually for the purpose of improving taste and stability in foods.

The Rumors: There have been claims that acesulfame-K causes cancer in animals and that the FDA approval of this product was based on flawed studies.

The Research: The British Medical Journal in 1996 validates the rumors. Many scientists voice their concerns in this paper about the need for more studies to determine whether or not acesulfame-K is carcinogenic. “The studies on acesulfame-K used very poor quality testing, and there are suggestions that it can cause cancer. The product needs to be retested by an independent third party. Until then I suggest to try and avoid it,” warns Dr. Jacobson.

Bottom Line: This one makes me nervous.

SUCRALOSE (Marketed as Splenda)
Also a relative newcomer, Splenda has been around since 1976, but only received FDA approval in 1998. It has no calories and is 600 times sweeter than table sugar. It’s starting to pop up in beverages, baked goods, desserts, dairy products, canned fruits, syrups, and condiments.

The Rumors: Cancer, genetic changes, birth defects, and immune system complications are among the claims associated with Splenda. Some believe that there has not been adequate research to be certain of its safety.

The Research: More than 100 animal and human studies were evaluated over a period of two decades. The results indicate that sucralose is completely safe. And according to Jacobson, “Sucralose is safer than saccharin, acesulfame-K, and cyclamate.” It is also more heat stable and doesn’t have the unpleasant aftertaste some people attribute to saccharin.

Bottom Line: Looks like this is the one to use, at least for the time being.

STEVIA (Marketed as a dietary supplement)
Stevia is not FDA approved, which is why it must be sold as a dietary supplement. Stevia, which has been around since the 16th century, has no calories, and is about 100 times sweeter than sugar.

The Rumors: Stevia is safe, healthy and natural. Allegedly, stevia can benefit people with diabetes, while others claim it can lead to cancer.

The Research: Just because stevia is natural does NOT mean it is safe. “Any chemical added to our food supply needs to be tested — so should stevia. It’s immaterial that it’s naturally occurring,” says Dr. Jacobson. In fact, the FDA has rejected stevia for use as a food additive. Similarly, Canada has not approved stevia, and across the ocean, the European Community stated that stevia is unacceptable for use in food. Studies have shown that stevia may promote cancer by causing mutations in the cells. Other studies linked stevia to reduced sperm counts in rats that were fed high dosages.

Bottom Line: This one’s not that great, especially if it can’t even get by the FDA.

SUGAR ALCOHOLS OR POLYOLS (Sorbitol, Isomalt, Maltitol, Mannitol, and Xylitol)
These sugar alcohols, commonly found in chewing gum and candy, are derived from sugar. They’re typically combined with other artificial sweeteners or used to give foods the bulk and texture of sugar. Sugar alcohols do have calories and are absorbed and metabolized (unlike most other artificial sweeteners).

The Rumors: Although there are no cancer claims, sugar alcohols supposedly have diuretic or laxative properties, and in large doses, can cause severe diarrhea and laxative symptoms.

The Research: The rumors are fairly accurate. In fact, the FDA is reviewing the claims regarding severe diarrhea and gastrointestinal discomfort. Foods that contain these additives in large amounts per serving must include a warning label — “may have a laxative effect.”

Bottom Line: Unless you have stomach issues (or irritable bowel syndrome), these don’t seem as worrisome — especially since they’re used in small quantities.

DIETER’S DELIGHT
Most of the recent studies show that using high intensity sweeteners is helpful for those trying to lose weight. “Consumers want to manage their energy intake, but they also want tasty foods that satisfy their cravings for sweets — these sweeteners are a partial solution,” says Vicky Duffy, Ph.D., R.D., a nutrition professor at University of Connecticut. Additionally, there was a rumor that artificial sweeteners raised insulin levels and caused hunger — this has been proven inaccurate.

RISKY BUSINESS
Artificial sweeteners go through rigorous testing by the FDA and must be approved as a food additive. In fact, for each approved sweetener, the FDA has established Acceptable Daily Intake (ADI) amounts, which are set at a level 100 times LESS than that which could potentially cause harm in animals. Not only that, in calculating these ADI’s, the FDA makes the assumption that you will be consuming the artificial sweetener every day for the rest of your life.

“Even though there is tremendous controversy surrounding many of these sweeteners, much of the clinical research demonstrates that they are generally safe (even the potentially unsafe ones are reasonably safe in small quantities). The risk of harm from these sweeteners is very low, especially compared to other risks,” says George Gray, Ph.D., director of the Harvard Center for Risk Analysis.

But other experts have a more conservative perspective. “Although the risk might be minimal when it comes to cancer, keep in mind that the less you consume, the better off you are. This means there is no acceptable level,” says Dr. Jacobson. “You have a choice as a consumer, and you don’t need the artificial sweeteners that could possibly cause cancer [saccharin, and without more testing, Ace-K] — especially since there are others available that are perfectly safe.”






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