Southport Magazine

THE CULPRITS: While there are limitations to probably each type of artificial sweetener, sugar substitute, and even sugar—a general rule applies to all: everything in moderation. Photo by Bethany Turner

Sugar in the American diet has been the subject of much discussion and controversy recently, as a record one out of three American adults is now at risk for development of Diabetes Mellitus Type II—an American epidemic! Although Diabetes Mellitus in itself is a topic for a completely different column, we know that in this disease state the hormone insulin, secreted by the pancreas, is not properly used by the cells. This causes higher-than-normal levels of blood glucose (sugar) in the body.

Excess sugar is implicated in tooth decay, weight gain and obesity, increased triglyceride levels leading to heart disease, as well as Diabetes Mellitus Type II and its related complications.

Sugar is a naturally occurring carbohydrate substance in many fruits and vegetables, refined grains, breads, cereals, rice and potatoes. Sugar provides no nutrients and is often linked to “empty calories.” It is estimated that the average American ingests greater than 150 pounds of sugar over the course of a year in one form or another. This correlates to about 30 teaspoons of sugar per day or nearly 500 calories. If one pound is a result of 3,500 extra calories, cutting out this level of sugar in one day would cause a weight decrease of one pound per week.

One contributor to our love of sugar has been the increased use of sugar in one form or another in almost all the processed foods we eat. As a result, foods taste better and we eat larger portions, leading to increased calorie intake.

For instance, high-fructose corn syrup (HFCS) is a corn-derived sweetener. HFCS has long been a subject of controversy. Metabolized in the liver, fructose is linked to excess fat deposition and fatty liver disease. Check your pantry, and you may find that your favorite cereal, BBQ sauce, salad dressing, or even whole-wheat cracker contains HFCS or corn syrup as an ingredient.

In addition, we have become a nation of “extra large” products. As fast-food restaurants have evolved, so has the sizing of their beverages. Commercial marketing has us drinking sport drinks at athletic events. In fact, it is believed that the greatest source of sugar in the American diet is sugar-sweetened beverages such as soda, juices and sport-drink products. A 12-ounce can of soda contains about eight teaspoons of sugar. Most restaurant sizes are greater than 12 ounces.

Thus, the concern over diabetes and obesity has led the way to the development of artificial sweeteners, sugar alcohols, and other sugar-substitute products.

ARTIFICIAL SWEETENERS

Artificial sweeteners are sugar substitutes with no calories and, therefore, no effect on blood sugar. The FDA has approved five artificial sweeteners. These include acesulfame (Sunett, Sweet One), aspartame (Equal, Nutrasweet), saccharin (Sweet’N Low, Sweet Twin), sucralose (Splenda) and neotame. Although these sugar substitutes are approved as food additives by the FDA, there is no “recommended daily allowance” for these substances.

These synthetic sugar substitutes are many times sweeter than sugar. As additives in many “sugar free” or “diet” products, they may be useful in weight loss and maintaining blood sugar levels for diabetics. However, because they are chemically modified, our bodies can have trouble breaking down the products (as seen in a University of Southampton study in which 3.3 to 7.2 percent of sucralose remained in subjects’ bodies after five days). We just weren’t built to fully process man-made chemicals.

It is advisable to check with your physician or registered dietician for assistance in selecting appropriate artificial sweetners. Though saccharin was connected with bladder cancer in research mice, artificial sweetners are generally accepted as safe in “limited quantities.”

SUGAR ALCOHOLS

Sugar alcohols are carbohydrates occurring naturally in fruits and vegetables which can also be made by man. In general, they are not sweeter than sugar. Sugar alcohols are also regulated by the FDA and classified as GRAS or “generally recognized as safe.” (Please see www.fda.gov for further information.) Examples include sorbitol, xylitol and lactitol. Sugar alcohols do contain sugar, therefore they do contain calories, although they are lower in calories than table sugar itself.

Although typically not used for home cooking, sugar alcohols are prevalent in processed foods, toothpaste, gums, and desserts. They add sweetness, texture and moisture to products. Check your food labels for “sugar alcohol” or compounds ending in “ol” such as xylitol or mannitol. Because sugar alcohols are a carbohydrate, their use can impact blood-sugar levels even though they are not completely absorbed by the body. Different sugar alcohols affect blood sugar differently, so monitoring is required when using with an American Diabetic Association diet for total carbohydrates. One negative impact is that sugar alcohols may have a laxative effect causing bloating, intestinal gas and diarrhea.

NATURAL SUGAR SUBSTITUTES

Stevia (such as in the brand Truvia) is another class of sweeteners formed through highly refined processing of the stevia plant. It is also GRAS by the FDA, however, the FDA has not approved use of the whole stevia plant leaf. Stevia is several hundred times sweeter than sugar.

Often, individuals load their diets with natural sweeteners such as honey, maple syrup, molasses or agave nectar. Nutritionists consider these natural sweeteners to be similar in effect to table sugar on diet since they are broken down into glucose for use by the cells. Often, these natural sweeteners are added in home use as toppings such as syrup on pancakes, baking, and to drinks like tea. In addition, honey can contain bacterial spores which may produce botulism toxin so should not be given to children less than one year of age.

THE VERDICT

The concern over use of sugar and sugar substitutes abounds in health literature. The level of sweetness given by artificial sweeteners may be changing the way we taste our food. With excessively sweeter substitutes compared to naturally occurring levels of sweetness in fruits and vegetables, are Americans giving up nutritionally sound choices in favor of artificially flavored and processed foods? How many people drink a diet soda so they feel justified in eating dessert? As we ingest this high level of sweetness, are we losing the correlation that sweet equals calories? Does that increased sweetness in fact cause us to crave sweets, choose sweets only, and gain weight? Does the brain actually respond in ways that are addictive to sweets as a result of this extreme level of sweetness? All of these areas are being researched.

So, what choices should you make? Sugar is naturally occurring in the form of whole fruits and vegetables. Eating the apple—instead of drinking the juice or purchasing the dried, processed and additionally sweetened apple rings—provides more nutrients and fiber. While sugar substitutes may be beneficial in weight management, moderation is the key in use of artificial sweeteners. Become a label reader! Foods labeled “sugar free” and “diet” may in fact be loaded with calories. Processed foods with artificial ingredients do not offer the same benefits as fruits, vegetables and whole-grain products.