Scoop on Sugar Substitutes it’s a myth that people with diabetes can’t eat any sugar. You can have foods and drinks sweetened with sugar if you work them into a smart eating plan that takes all your carbohydrates into account. Having too many sweets can push blood sugar out of your target range, however, so sugar substitutes are sometimes a good way to satisfy your sweet tooth while maintaining good control.
Two types of sugar substitutes are available:
Non-caloric sweeteners. These artificial sweeteners contain no calories and no carbohydrates, and they do not raise blood sugar levels. They are used to sweeten beverages, desserts, and candies. Some but not all can be used in cooking and baking. Non-caloric sweeteners include aspartame (NutraSweet, Equal), saccharin (Sweet’N Low, Sweet Twin,
nd Necta Sweet), acesulfame K (Sunett and Sweet One), neotame (not yet marketed under a brand name), and sucralose (Splenda).
Some people with diabetes believe that artificial sweeteners do raise their blood sugar, but there is no research showing this, according to Christine Gerbstadt, M.D., R.D., C.D.E., a spokesperson for the American Dietetic Association (ADA). If blood sugar jumps after you eat an artificially sweetened food, the culprit may be other ingredients in he food, such as caffeine, carbohydrates, or protein. Even stress
can hike blood sugar.
Reduced-calorie sweeteners. These sweeteners are known as sugar alcohols, even though they contain no alcohol. Although they are made by chemically altering natural sugar, they are metabolized very differently. They do contain carbohydrates and some calories, although less than real sugar. They are found primarily in packaged foods such as cookies, gum, and
candy. Reduced-calorie sweeteners include sorbitol, mannitol, lactitiol, maltitol, xylitol, isomalt, erythritol, and hydrogenated starch hydrolysates.
Sugar alcohols do raise blood sugar, and the American Diabetes Association recommends subtracting half of the sugar alcohol grams when you compute a food’s total carbohydrate count. For example, if a cereal bar has grams of sugar alcohol and a total of 15 grams of carbohydrates, you would count it as 12 grams of carbohydrates (15 – 3 = 12).
Are they safe?
The Food and Drug Administration considers these artificial sweeteners safe. In the past, saccharin was believed to cause bladder cancer,but further research determined that it poses no danger for humans.
Aspartame has been accused of causing headaches. However, there are no reliable studies that prove this claim. The only people who are advised to avoid aspartame completely are those with a rare inherited disorder called PKU (phenylketonuria).
As you decide what artificially sweetened foods to include in your
diet, remember that food labels claiming a food is sugar-free can
be misleading. “Sugar-free” doesn’t necessarily mean calorie-free or carbohydrate-free — these foods may still have significant
amounts of carbohydrates and calories, either because they are
sweetened with sugar alcohols or other non-sugar sweeteners or
because they contain other high-carbohydrate ingredients. Pay
attention to the total carbohydrate content listed on the food
label.
SOURCES:
U.S. Food and Drug Administration FDA Consumer Magazine article: Artificial Sweeteners: No Calories … Sweet! July-August 2006. (Accessed 5/2/2008).
U.S. Food and Drug Administration FDA Consumer Magazine. November-December 1999, revised December 2004 and February 2006. Sugar Substitutes: Americans Opt for Sweetness and Lite. (Accessed 12/7/07).
National Cancer Institute factsheet: Artificial Sweeteners and Cancer: Questions and Answers. (Acessed 12/7/07).
American Diabetes Association article, “Sweeteners and Desserts.” (Accessed 12/7/07).
American Dietetic Association position statement. Use of Nutritive and Nonnutritive Sweeteners. (Accessed 12/20/07).
MayoClinic.com article. Artificial sweeteners: Any affect on blood sugar? (Accessed 12/17/07).