Are Artificial Sweeteners Safe?

WebMD gets the low down on artificial sweeteners on the shelves and in the pipeline

By Denise Mann
WebMD Weight Loss Clinic - Feature

Reviewed By Brunilda Nazario, MD

March 23, 2005 -- The way artificial sweeteners were discovered could have been a scene out of the classic comedy The Nutty Professor.

In 1879, Ira Remsen, a researcher from Johns Hopkins University in Baltimore, Md., noticed that a derivative of coal tar he accidentally spilled on his hand tasted sweet. While he did not morph into the slim, but obnoxious Buddy Love as the characters played by Eddie Murphy and Jerry Lewis did in their film versions of the comedy, his spill set the stage for the development of saccharin -- an artificial sweetener known today to many seasoned dieters as Sweet-n-Low. This is now the most recognized name brand of the saccharin-based sugar substitutes.

Now more than 125 years later, saccharin is joined by a growing list of artificial sweeteners with varying chemical structures and uses including acesulfame potassium (Sunett); aspartame (NutraSweet or Equal); sacralose (SPLENDA), and D-Tagatose (Sugaree). And there's a whole host of new ones on the horizon.

These products substitute for sugar. For example, they can replace corn syrup, used in many sodas and sweetened drinks, and table sugars. However, the sweet remains in anything and everything from chocolate and ketchup to gum, ice cream, and soft drinks. But are artificial sweeteners safe? Can they help people shed extra weight? What role should they play in person's diet -- if any?

Here's what WebMD found out:

Artificial sweeteners, also called sugar substitutes, are compounds that offer the sweetness of sugar without the same calories. They are anywhere from 30 to 8,000 times sweeter than sugar and as a result, they have much fewer calories than foods made with table sugar (sucrose). Each gram of refined table sugar contains 4 calories. Many sugar substitutes have zero calories per gram.

"Artificial sweeteners can serve a definite purpose in weight loss and diabetes control," says New York City-based nutritionist Phyllis Roxland. "It enables people that are either carb-, sugar-, or calorie-conscious to take in a wider range of foods that they would either not be allowed to eat or could only eat in such teeny amounts that they were not satisfying." Roxland routinely counsels patients in the offices of Howard Shapiro, MD, a weight loss specialist and author of Picture Perfect Prescription.

In other words, artificial sweeteners allow people to stick to a good diet for a longer period of time, she says. In a diet, artificial sweeteners are considered "free foods." The sugar substitutes don't count as a carbohydrate, a fat, or any other exchange.

"These products can be useful when used appropriately for people like diabetics who need to control their sugar intake and in overweight people," agrees Ruth Kava, PhD, RD, director of nutrition for the American Council on Science and Health (ACSH) in New York City.

Artificial sweeteners do not affect blood sugar levels, but some foods containing artificial sweeteners can still affect blood sugar because of other carbohydrates or proteins in these foods. In other words, while foods that contain artificial sweeteners may be sugar-free, they may not be carbohydrate-free.

Just because a food contains artificial sweeteners instead of sugar is not carte blanche for grazing, Kava points out.

"The real key to weight loss is calories," Kava points out. "If you substitute a diet soda for a sugar soda, you save 100 calories, but if you eat 15 sugar-free cookies [which have calories] instead of two regular cookies, you may not be helping yourself at all," she says.

"If somebody is trying to lose weight and cut back on calories, artificial sweeteners can add flavor to unsweetened beverages or other products," says Michael F. Jacobson, PhD, executive director of the Center for Science in the Public Interest (CSPI) in Washington. That said, "somebody who consumes a lot of artificially sweetened foods should think twice about their diet and ought to be eating real food," he tells WebMD.

"I don't think [artificial sweeteners] are needed at all," he says. "I fear that in some cases people have a diet soda for lunch and then have a couple of tablespoons of ice cream -- giving up the saved calories," he says.

Using sugar substitutes instead of sugar can lower your risk of tooth decay, but "the acid in diet soda still could contribute to dental erosion," Jacobson points out.

Safety, particularly as it relates to cancer risk, is on many people's mind as a result of the saccharine saga, which began in the 1970s. In 1977, the U.S. Food and Drug Administration tried to ban this sweetener as animal studies showed that it caused cancer of the bladder, uterus, ovaries, skin, and other organs. But the food industry intervened, urging Congress to keep it on the market with a warning label that (until recently) read: "Use of this product may be hazardous to your health. This product contains saccharin, which has been determined to cause cancer in laboratory animals."


"One thing is clear, consumers embrace these sweeteners."



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