We help you weigh the pros and cons
By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic - Expert Column
Honestly, who doesn't have a sweet tooth? We are born that way -- liking the taste sensation of sweetness. We have scores of taste buds dedicated only to tasting sweetness.
And boy, do we like our sugar. Within a year's time, Americans basically eat their weight in sugar. According to the U.S. Department of Agriculture, in 2002 the average American consumed 146 pounds of sugar (including sugar, corn sweeteners, honey, and syrups).
Most of us who are trying to keep extra pounds off want to have our cake and eat it, too: We want the sweetness of sugar but without the calories. The way I see it, if we are trying to cut calories from sugar, we have a couple of options:
- Option 1: We can decrease the amount of sugar we eat by enjoying smaller portions of sugar-laden food and drinks and by adding less sugar when we prepare sweet items.
- Option 2: We can turn to artificial sweeteners.
Lots of us are going for Option 2. The amount of artificially sweetened products consumed by Americans has doubled in just 10 years. Artificial sweeteners come in handy if you are trying to reduce your calories from sugar, if you have diabetes and are trying to maintain normal blood sugar -- and if you happen to like the taste of diet soda because regular soda is too darn sweet.
I'm in this last group. I simply do not like the taste of regular soda, so I enjoy one can of diet cola (caffeine free) a day -- usually in the afternoon.
But Can They Really Help With Weight Loss?
- The use of aspartame was linked to better weight maintenance.
- When artificially sweetened beverages were substituted for regular, sweetened beverages (and total calories were not restricted), people ended up eating fewer calories and weighing less.
A Harvard Medical School study reported similar results in 1997. Researchers told obese women to either consume aspartame-sweetened foods or eliminate them for 16 weeks of a weight-reduction program. What happened? The women who were consuming the artificial sweetener lost significantly more weight and regained significantly less weight during the maintenance and follow-up phase.
Which One Is Right for You?
With so many artificial sweeteners out there these days, how do you know which one to buy? Here's how they differ, and the pros and cons of each type.
Splenda contains the artificial sweetener sucralose along with maltodextrin, which adds bulk so Splenda can be substituted cup-for-cup for sugar in recipes. Sucralose is 600 times sweeter than sugar. To make sucralose, they take a cane sugar molecule and substitute three hydrogen-oxygen groups with three chlorine atoms.
Baking tip: After experimenting with Splenda in recipes, I have found the results are usually successful when I use half sugar and half Splenda.
- Sucralose has no calories, is not considered a carbohydrate by the body, and has no effect on blood sugar levels.
- You can bake with Splenda. Heat doesn't lessen the sweet taste.
- When it comes to baking and cooking, Splenda appears to be the best sweetener for the job.
- Of all the artificial sweeteners, Splenda has caused the least controversy from watchdog or consumer groups.
- After more than 110 studies, the FDA concluded sucralose was found to have no toxic or carcinogenic effects and to pose no reproductive or neurologic risk to humans.
- The bulking agents used in Splenda can add around 12 calories per tablespoon of the mixture (although the package does not list these calories).
- Splenda can change the texture in baking recipes and can add an ''artificial'' taste when used as the only sweetener in the recipe.
- Some critics claim that preliminary animal research has linked Splenda to organ damage.
Saccharin (Sweet'N Low)
Saccharin, which is 300 times sweeter than sugar, is an organic molecule made from petroleum.
- Heat doesn't affect its sweetness.
- After bladder cancer was found in male lab rats that were fed huge amounts of saccharin, the FDA proposed a ban on saccharin in 1977. But no ban was enacted, and the warning label on saccharin was dropped in 2000.
- Since 1981, government reports have listed saccharin as an ''anticipated human carcinogen.'' Although studies of heavy saccharin users don't support any link with cancer, certain subgroups, like male heavy smokers, may be at increased risk.
- The American Medical Association's Council on Scientific Affairs suggests that parents and caregivers limit young children's intake of saccharin, since little information is available on how it might affect them.
- Because saccharin can cross the placenta, the Council on Scientific Affairs suggests that women use saccharin carefully during pregnancy.
Aspartame (NutraSweet and Equal)
You would never guess that one of the most popular artificial sweeteners is actually a combination of two amino acids: phenylalanine and aspartic acid, which are then combined with methanol. It is 180-200 times sweeter than sugar.
Some 70% of our aspartame intake is from soft drinks. The FDA has set the acceptable daily intake (ADI) at 50 mg per kilogram of body weight. For most of us, this probably translates to about four (12-ounce) cans of diet soda or nine (8-ounce) glasses of fruit drink made from powder. The ADI is the estimated amount a person can safely consume every day over a lifetime.
- Each gram of aspartame has 4 calories, but it adds almost no calories to foods or drinks since we need only a tiny amount of aspartame to mimic the sweetness of sugar.
- The FDA has evaluated aspartame use in food and beverages 26 times since the sweetener was first approved in 1981. In 1996, the FDA approved its use as a general-purpose sweetener in foods and beverages.
- In 1985, the AMA's Council on Scientific Affairs concluded that ''available evidence suggests that consumption of aspartame by normal humans is safe and is not associated with serious adverse health effects.''
- Use of aspartame within the FDA guidelines appears safe for pregnant women.
- People born with a condition called phenylketonuria cannot metabolize the amino acid phenylalanine.
- Aspartame breaks down in liquids that are exposed to heat. So we can't bake or cook with it.
- Some people claim they have had allergic reactions to aspartame, ranging from skin reactions to respiratory problems. But this has been difficult to confirm in studies.
- Some people have reported central nervous system side effects, like headaches, dizziness and mood changes, after consuming aspartame. But after reviewing 600 of these complaints, the CDC concluded there was no association. (The Environmental Nutrition newsletter later reported that the CDC was leaving open the possibility that a small group of people is very sensitive to aspartame.)
Acesulfame-K (Sunette or Sweet One)
Acesulfame-K (the ''K'' refers to mineral potassium) is 200 times sweeter than sugar. It is approved by the FDA as a tabletop sweetener and an additive to desserts, confections, and alcoholic beverages.
- It doesn't increase the risk of cancer, according to government agencies.
- It doesn't affect blood-sugar levels.
- It can be used in cooking and baking.
- It isn't broken down by the body during digestion and is excreted from the body unchanged.
- Combining it with other artificial sweeteners can increase the overall sweetness and decrease the bitter taste.
- The use of acesulfame-K within FDA guidelines appears safe for pregnant women.
- When used on its own, this sweetener can have a bitter taste.
- The Washington-based consumer group Center for Science in the Public Interest believes the safety tests on acesulfame-K were poorly conducted and did not properly assess the sweetener's cancer-causing potential.
Stevia is an herb that is 250 to 300 times sweeter than sugar, and calorie-free. It comes from a plant in South America. You'll find it in the herbal section of health food stores, sold as a powdered extract or in liquid form.
- Stevia has been used in South America for centuries. It's been used in Japan for the past 30 years as well.
- Stevia has not gone through the FDA approval process for use as an artificial sweetener since it's sold as a dietary supplement, not a sweetener, in the U.S.
- Research done in the 1980s suggested that DNA changes occurred when stevia was tested with a certain bacteria. The FDA believes stevia's safety has not been proven.
These sugar alcohols are found in nature (in plant foods such as fruits and berries) and are also commercially made for use as sweeteners. They are absorbed slowly, and part of them isn't absorbed at all -- which is why consuming large amounts can lead to diarrhea.
- Sorbitol has received the ''Generally Recognized As Safe'' designation from the FDA.
- Some people experience a laxative effect if they consume more than 49 grams of sorbitol or more than 19 grams of mannitol.
The Bottom Line
Remember: Everything in moderation. We can't just put all our weight-loss eggs in the artificial-sweetener basket. In other words, don't expect that simply switching to sugar-free products will help you lose weight and keep it off. This should be just one piece of your plan to start living healthy -- by eating right, avoiding overeating, and exercising as much as possible.
And in my opinion, no artificial sweetener should be consumed in excess. To be extra safe, you could try following the FDA guidelines for pregnant women and children.
Environmental Nutrition suggests we limit ourselves to a couple servings a day of foods and beverages containing aspartame. This "one-diet-soda-a-day" drinker couldn't agree more.
Published February 20, 2004
Sources: Obesity Reviews, May 2003. American Journal of Clinical Nutrition, February 1997. Environmental Nutrition, October 2002. Journal of the American Dietetic Association, May 1998. Journal of the American Medical Association, 1985; vol 254. American Journal of Clinical Nutrition, 1986; vol 43. Environmental Nutrition newsletter, September 1998. Food and Chemical Toxicology, 2000; vol 38 Suppl 2.