Alternative sweeteners have been recommended for years by health professionals as a safe option for diabetics. Since foods containing glucose and sucrose must be restricted, diabetics need alternatives for sweetening foods and beverages. Unfortunately, some research has shown these alternative options might trigger side effects worse than the effects related to natural, but refined sugars.
There has been a great deal of research conducted concerning artificial sweetening alternatives. Researchers have asked if the sweeteners offer any real value for managing diabetes, if they are safe if they trigger side effects, if one is better than another, and whether or not the alternative sweeteners help diabetics stick to a restricted diet.
Unfortunately, few of the studies have been conclusive. At one time there was evidence non-caloric sweeteners might help dieters consume fewer calories, but more recent research indicates alternative sweeteners have the exact opposite effect. Some dieters even found their diets failed when they included diet soda and foods containing alternative sweeteners.
Ideally, diabetics could choose a no-calorie sweetener that does not raise blood glucose levels, tastes just as good as natural sugar, is convenient and inexpensive, is chemically stable and is completely safe, and triggers no side effects. None of the commercial no-calorie sweeteners fits this description, though in recent years, some natural no-calorie sweeteners have hit the market and provided a safer alternative.
Non-Caloric Sweetener Options
There are several sweeteners that are sold commercially and have no calories. Two of the most popular are aspartame and saccharin. Both have received varying reviews from health professionals and users, but research has yet to prove without a doubt that the sweeteners are dangerous for human consumption.
Aspartame is a nutritive protein that is produced from two amino acids. It is sold as a tabletop sweetener under the name Equal, and is also used in a variety of low-fat low-calorie and no-calorie products under the name NutraSweet. Aspartame is about 200 times sweeter than sucrose, so only small amounts are needed to achieve equivalent sweetness. It ranks high in taste tests among users and many report it lacks the bitter taste many artificial sweeteners produce. Despite aspartames versatility, it cannot be used in foods that require prolonged heat during the manufacturing process.
In addition to aspartames lack of stability, other concerns have been raised about its safety. There are concerns that aspartame:
Triggers dizziness, menstrual irregularities and headaches
Contains bi-products that are considered toxic
Could alter brain neurotransmitters, especially when consumed in conjunction with a high-carbohydrate diet
Could cause brain tumors and neurotoxicity, believed to be associated with the phenylalanine and aspartic acid content
Could harm people who suffer from phenylketonuria
Despite these concerns, the U.S. Food and Drug Administration has determined there is no cause for concern due to the fact these negative results came from studies utilizing only animal subjects given excessive doses of aspartame. Aspartame is considered safe by health officials for use by healthy adults and adults with diabetes, children, adolescents and lactating and pregnant women.
Saccharin was the first synthetic sugar substitute. It is sold under the commercial name Sweetn Low. It was widely used during World Wars I and II when there were sugar shortages. Saccharin also gained popularity as the only no-calorie sweetener available when cyclamate was banned in 1970. Saccharin is about 400 times sweetener than sucrose and is the least expensive of available alternative sweeteners. Many users report it creates a bitter aftertaste, but it is more stable than aspartame and can be used in many cooking applications.
For years saccharin products featured labels warning of its dangerous side effects, including the development of bladder cancer. A select committee on sugar substitutes of the American Diabetes Association, chaired by Ronald K. Kalkhoff, MD, reviewed the experimental data on saccharin available through May 1978 and determined based on evidence now available, there appears to be little justification for placing further governmental restrictions on the use of saccharin by the American public at the present time.
Many view the studies declaring saccharin safe as faulty and believe they fail to detect relatively weak carcinogens. Studies in animals have confirmed that large doses of saccharin (4-5% or above) are associated with an increased incidence of bladder cancer in male rats. As a matter of fact, the National Academy of Sciences (NAS) concluded in 1978 that saccharin was a carcinogen in animals and could potentially cause cancer in humans.
Despite varied opinions, in 2000, warning labels were removed from products containing saccharin. Scientists determined the rodent medical studies used to determine risks were not applicable to humans. Tumors that formed in rats being fed saccharin likely occurred due to the unique combination of high pH, high protein, and high calcium phosphate in their urine and were unlikely to occur in humans. Saccharin warning labels were removed from products after the Sweetness Act of 2000 passed in the United States and the U.S. Department of Health and Human Services removed saccharin from its list of known carcinogens. In 2010, the Environmental Protection Agency issued a statement that saccharin should not be considered a health hazard to human.
Despite the years of research, many still believe saccharin and various artificial sweeteners are dangerous. Though these products offer a no-calorie alternative for diabetics who must limit sugar, there are still concerns about their safety. Health professionals should still use caution in recommending these products to diabetics and base their recommendations on each patients specific needs.