Sweet Substitutions: A Guide to Safely Using Sugar Substitutes

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This guest post was excerpted from "The African American Guide to Living Well with Diabetes" by Constance Brown-Riggs, MSEd, RD, an award winning registered dietitian, certified diabetes educator, and national spokesperson for the Academy of Nutrition and Dietetics.

Are you confused about the best “sweetener” to use? Everywhere you look, there seems to be talk about sugar and sugar substitutes. In this post I am clearing up the confusion for you and providing a simple breakdown of common sweeteners.

Sugar alcohols, also referred to as polyols, are one type of reduced calorie sweetener. They have about 2 calories per gram – half the calories of table sugar. Contrary to their name, polyols are not sugar or alcohol the way we think of them. When you’re reading labels, you’ll recognize them easily because their names always end in “ol” – sorbitol, xylitol, erythritol, maltitol, mannitol. Keep an eye out for these because they should be used in moderation. Using large amounts of sorbitol (more than 50 grams a day) or mannitol (more than 20 grams a day) can cause diarrhea and upset stomach.

Sugar Substitutes

Low-calorie sweeteners are also known as sugar substitutes. They provide practically no calories and won’t increase your blood glucose levels. There are lots of them on the market these days – in prepared foods, in food and drink mixes, and packaged to be added to food like sugar. Common sugar substitutes include:

  • Aspartame: A combination of the amino acids phenylalanine and aspartic acid, it’s 220 times sweeter than sugar. Brand names are NutraSweet, Equal, and NutraTaste, and you’ll find it in low-calorie beverages and dry drink mixes, chewing gum, candy, gelatins, dessert mixes, puddings and fillings, frozen desserts, and yogurt. People with phenylketonuria (PKU), a rare genetic condition that affects metabolism, should not use aspartame.
  • Acesulfame KM (also called acesulfame potassium or ace-K) is 200 times sweeter than sugar. Packaged under the brand names Sweet One, Sunette, and Swiss Sweet, it’s used in cooking, baking, and as a table top sweetener, and it can be found in desserts, puddings, soft drinks, candies, and canned foods.
  • Saccharin has been used as a no-calorie sweetener for over 100 years, most popularly in little pink packets of Sweet ’n Low. Three hundred times sweeter than sugar, saccharin can be found in sugar-free foods and beverages including baked goods, jams, chewing gum, canned fruit, candy, dessert toppings and salad dressing. Its other brand names are Sugar Twin and Necta Sweet. The ADI for saccharin is 5 mg/kg body weight per day. A 150 pound person can safely consume 8½ packets every day.
  • Sucralose is made from sugar but is 600 times sweeter than sugar. Sucralose, brand named Splenda can be found in a broad range of foods, beverages and table top sweeteners.
  • Neotame is the newest food ingredient that can be used as a sweetener and flavor enhancer, and it’s a whopping 8,000 times sweeter than sugar. You’ll find it in baked goods, soft drinks, chewing gum, frosting, frozen desserts, jams and jellies, gelatins, puddings, processed fruit and fruit juices, and syrups. It can be used alone or blended with other nonnutritive or nutritive sweeteners.
  • Rebiana is the name for rebaudioside A, an extract from the leaves of the stevia plant. It’s 200 times sweeter than table sugar and can be found in a variety of foods and beverages and in tabletop sweeteners under the brand names Truvia and PureVia.

Sugar Substitute Safety

Some years ago, saccharin and other artificial sweeteners were linked with cancer, causing quite a scare among diabetes patients who had come to rely on the little pink packets to sweeten their coffee and tea. Researchers went into overdrive trying to determine whether the experiments that caused cancer in lab rats actually translated into human health. They found no definitive connection.

The National Cancer Institute issued an official statement that rules out any connection between artificial sweeteners and cancers. (For details, go to www.cancer.gov.) Even so, there are limits on how much of a given artificial sweetener a person should consume each day. In most cases, it’s far more than a person would want or need, but it’s helpful to keep track of how much you’re consuming. Here’s a way to look at it:

Acceptable daily intake (ADI) = Equivalent for 150-pound person

  • Aspartame 50 mg/kg of body weight = 15 cans of soda
  • Acesulfame K 15 mg/kg of body weight = 25 cans of soda
  • Saccharin 5 mg/kg of body weight = 8 ½ packets
  • Sucralose 5 mg/kg of body weight = 5 cans of soda
  • Neotame 2 mg/kg of body weight = 22 cans of soda
  • Rebiana 12 mg/kg of body weight = 24 8 oz. servings of soda

Just because artificial sweeteners have been pronounced safe and they have the benefit of not affecting your glucose, doesn’t mean that you have to use sugar substitutes in great quantities – or at all. If you’d rather go the natural sweetener route – or if you just don’t like the taste of faux sugar – you can work nutritive sweeteners into your diet. Just work closely with your diabetes healthcare provider, keep a careful eye on your blood sugar and balance your diet carefully.

Constance Brown-Riggs, MSEd, RD, is the author of "The African American Guide to Living Well with Diabetes," New Page Books, 2010. She also wrote "Eating Soulfully and Healthfully with Diabetes."

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