Sweet Nothings: Not All Sweeteners are Created Equal

Sweet nothings
not all sweeteners are Equal

by David Schardt

The artificial sweetener business only a tiny risk to any given person. sugars per day for people who eat a
must be a pretty good place to be The potential problems arise when tens 2,000-calorie diet. That’s 40 grams,
these days. Thanks to the obesity of millions of people consume the about as much as you’d get from one
epidemic, a growing number of people sweetener for years. That’s why the 12-ounce soft drink or two six-ounce
are trying to cut calories. That means government should require better fruit-on-the-bottom yogurts.
more “diet” this and “no-sugar-added” studies on some sweeteners and should
that. And the low-carb craze has left ban others. Here’s a scorecard showing which
food manufacturers scrambling to be artificial sweeteners are safe...and
the first on their block to take the sugar And remember: real sugar is hardly a which are questionable. With that in
out of everything from chocolate to toxic chemical. The problem is the hand, you can check our “Sweet vs.
ketchup to Bloody Mary mix. large amounts that Americans eat. The Sweet” chart (p. 11) to see which sweet-
U.S. Department of Agriculture has sug- eners are in which foods.
The result? We’re eating more low- gested a limit of ten teaspoons of added
calorie sweeteners than ever before.
Photos: Nick Waring. Yet not all sugar substitutes are Equal, Safe
so to speak.
Sucralose
■ Sucralose and neotame are safe.
Also known as: Splenda.
■ Sugar alcohols and tagatose, while What is it? Sugar (sucrose) chemically combined with chlorine. Its “made from
sugar” label slogan is technically true, but misleading.
safe, may give you the runs if you eat Why it’s low-calorie: Our bodies can’t burn sucralose for energy.
too much. Safety: Sucralose passed all safety tests in animal studies.
Comments: There is no reason to suspect that sucralose causes any harm.
■ Aspartame probably is safe.
Neotame
■ Acesulfame and stevia may or may
What is it? A synthetic derivative of a combination of aspartic acid and
not be safe; there’s not enough good phenylalanine, the same two amino acids that are used to make aspartame.
research to tell. The bond between the amino acids is harder to break down than aspartame’s,
so neotame is more stable.
■ Saccharin isn’t safe (though the risk Why it’s low-calorie: Our bodies can’t metabolize neotame, and only tiny
amounts are needed to sweeten foods.
is small). Safety: Unlike aspartame, neotame isn’t broken down in the body into the
amino acid phenylalanine, which is toxic to people with the rare disorder phenyl-
If you drink diet soda or chew gum ketonuria (PKU). Animal and human studies have raised no safety concerns.
(sugarless or regular), you’ll have a hard Comments: Neotame is so new that it hasn’t yet appeared in any foods. It’s
time avoiding aspartame and acesul- always possible that once millions of consumers start eating neotame, some
fame. And if you’re a fan of “light” people may turn out to be sensitive to it.
yogurt, you’ll be getting either aspar-
tame or sucralose.

That’s because manufacturers choose
sugar substitutes depending on the
food. Some are used in baked goods
because they withstand heat better.
Some are used in yogurt because they
can survive in an acidic environment.
Some lose their sweetness in the syrup
used to make fountain sodas, but are
fine for bottled or canned soft drinks.

Just keep in mind that even an
unsafe sweetener like saccharin poses

8 NUTRITION ACTION HEALTHLETTER ■ MAY 2004

Safe, but large amounts can cause diarrhea

Sugar Alcohols Tagatose

Also known as: sorbitol, xylitol, mannitol, Also known as: Naturlose.
maltitol, lactitol, isomalt, erythritol,
hydrogenated starch hydrolysates. What is it? A
“mirror-image” form
What are they? Sugar alcohols aren’t sugar of sugar that’s
and won’t make you tipsy. They’re made by manufactured from
adding hydrogen atoms to sugars. For exam- milk sugar (lactose).
ple, adding hydrogen to glucose makes
sorbitol. Why it’s low-
calorie: Unlike
Why they’re low-calorie: Some sugar sugar, tagatose
alcohols are absorbed better than others. Erythritol, which is largely unab- can’t be digested
sorbed, has virtually no calories, while maltitol and hydrogenated starch by enzymes in the
hydrolysates are absorbed enough to provide three-quarters the calories intestines. Most
of sugar. passes through the
body unabsorbed.
Safety: Too much sugar alcohol traveling unabsorbed through the intesti-
nal tract can cause bloating, gas, and diarrhea. Unfortunately, the FDA only Safety: Because
requires a “laxative effect” warning notice on labels if consumers could tagatose isn’t well-
ingest 50 grams of sorbitol or 20 grams of mannitol from the food in a day. absorbed, consuming
But just 10 grams of sorbitol, for example, can cause GI distress. (If sugar large amounts can
alcohols have made you sick, send a letter to CSPI—JE, Suite 300, 1875 Conn. cause flatulence, rum-
Ave. N.W., Washington DC 20009. We’ll forward it to the FDA.) bling noises, bloating, and
nausea. Studies have raised no other
Comments: Sugar alcohols don’t raise blood sugar as rapidly as sugar safety concerns.
does, yet they’re as bulky as sugar. So they can be used tablespoon-for-
tablespoon to replace the sugar that’s been removed from lower-carb Comments: Tagatose is so new that
foods. But while they may have a minimal impact on your blood sugar, you’re only likely to find it in one food—
they may have more than a minimal impact on your waistline and hips. Diet Pepsi Slurpees sold at 7-Eleven.

Probably safe, but certain people should avoid

Aspartame the 11 who were “very sure” they were sensitive. That
suggests that some people react to aspartame, though
Also known as: Equal, fewer than the number who believe they do.
NutraSweet, NatraTaste.
The most serious charge—that aspartame increases the
What is it? A synthetic deriva- risk of cancer—has never been proved. Among the many
tive of a combination of the animal studies on aspartame, only one hints at an
amino acids aspartic acid and increased risk.
phenylalanine.
There’s no foundation to claims floating around the
Why it’s low-calorie: Only tiny amounts of aspartame are Internet that aspartame causes everything from
needed to sweeten foods. Alzheimer’s disease to multiple sclerosis.

Safety: People with the rare disorder phenylketonuria Comments: Clouds hang over both aspartame and
(PKU) can’t metabolize phenylalanine, so they should avoid acesulfame, but researchers have done more—and bet-
aspartame. ter—studies on aspartame. Even so, because aspartame
is used in so many foods, the FDA should err on the side
Whether aspartame causes headaches is unclear. of caution and require non-industry-funded studies to
An industry-funded study of people who complained of resolve any questions about aspartame’s safety.
aspartame-induced headaches concluded that it doesn’t.
But an independent test in 1994 of 26 similar people People who believe they suffer from headaches or
found that the sweetener was linked to symptoms in other symptoms after consuming foods that contain
aspartame should avoid the sweetener.

››››

NUTRITION ACTION HEALTHLETTER ■ MAY 2004 9

Inadequately tested Unsafe

Acesulfame Saccharin

Also known as: Sweet One, Also known as: Sweet ‘N Low.
Sunett, acesulfame potassium.
What is it? A synthetic chemical
What is it? A synthetic chemical. that was discovered in 1879
when a researcher at Johns
Why it’s low-calorie: Our bodies can’t metabolize acesulfame. Hopkins University in Baltimore
noticed that a compound he
Safety: The safety of acesulfame (pronounced ace-SULL-fame) spilled on his hand tasted sweet.
rests on three animal studies conducted in the mid-1970s. The
first was inconclusive because it found a variety of tumors both in Why it’s low-calorie: Our bod-
mice fed acesulfame and in control mice fed acesulfame-free diets. ies can’t metabolize saccharin,
The second was so plagued with sick animals that the FDA tossed and only tiny amounts are
out the results as unreliable. needed to sweeten foods.

In the third study, female rats fed acesulfame were twice as likely Safety: In 1977, the FDA tried to
to develop breast tumors as control rats. While most of the tumors ban saccharin because animal
were benign, there were some malignant tumors—one in the 60 studies showed that it caused
control rats, two in the 60 rats given low doses of acesulfame, and cancer of the bladder, uterus, ovaries, skin,
three in the 60 rats given high doses of acesulfame. The sweet- and other organs. Bowing to pressure from
ener’s manufacturer argued that acesulfame seemed to cause more the diet-food industry and dieters, Congress
tumors only because the control rats happened to remain unusu- intervened to keep saccharin on the market,
ally tumor-free. The FDA bought the company’s interpretation though with a warning notice on the label.
and refused to require more safety testing. (At the time, saccharin was the only high-
potency sweetener.)
Comments: Acesulfame should be better tested. Until then, try
to avoid it. In the late 1990s, the Calorie Control
Council—which represents the low-calorie
Stevia food and beverage industry—convinced the
FDA and the National Institutes of Health
Also known as: Sweet Leaf, Honey (NIH) that the main health concern about
Leaf. saccharin was bladder cancer in male rats,
but that people didn’t develop bladder can-
What is it? An extract from a shrub cer through the same mechanism as the rats.
that grows in Brazil and Paraguay. In 2000, over the objections of a number of
scientists, the NIH removed saccharin from its
Why it’s low-calorie: Our bodies list of carcinogens and Congress removed the
can’t metabolize stevia. requirement for warning notices.

Safety: When male rats were fed Yet last year the National Cancer Institute
high doses of stevioside (stevia’s active ingredient) for 22 months, noted that one of its own studies—the best
they produced fewer sperm and there was increased cell prolifera- human study of saccharin use ever done—
tion in their testicles, which could cause infertility. And when had found “some evidence of an increased
female hamsters were fed large amounts of a derivative of stevio- risk of bladder cancer” in heavy saccharin
side, they had fewer and smaller offspring. That—combined with users, “particularly for those who heavily
the absence of other animal studies that are normally required ingested the sweetener as a table top sweet-
for food additives—led the FDA, Health Canada, the European ener or through diet sodas.” “Heavy” meant
Union, and the World Health Organization to conclude that stevia “six or more servings of sugar substitute or
shouldn’t be allowed in food. two or more eight-ounce servings of diet
drink daily.”
Comments: Stevia can’t be used as an ingredient in food. But it
can be sold as a supplement, since safety rules for supplements are Comments: Just because saccharin no
looser than for foods. Stevia is promoted by the health-food indus- longer carries a warning doesn’t erase the evi-
try as a natural alternative to synthetic sweeteners like saccharin, dence that it may cause cancer in humans.
aspartame, and sucralose. But “natural” doesn’t automatically
mean “safe.” For the chemical structures of
the sweeteners described in this article,
10 N U T R I T I O N A C T I O N H E A L T H L E T T E R ■ M A Y 2 0 0 4
see www.cspinet.org/sweetatoms.

Sweet vs. Sweet SucraloseOther Drinks
TSauggaatrosAlecohols
Don’t expect the same sugar substitutes in all light yogurts, AspartameDiet Nestea Lemon Tea ■■
all no-sugar-added ice creams, all diet soft drinks, or all SAaccecshulafrianme ■
gums. Ingredients vary from brand to brand, and sometimes ■■
from flavor to flavor. While you should always read food Sucralose
labels before buying, here’s a little crib sheet that you can TSauggaatrosAlecohols ■
take to the store with you. SAAasccpecsahrultafariamnmee■■
Diet Snapple, except Apple and Lime Green ■■
Tea1
■
Diet Snapple, Apple or Lime Green Tea ■ ■
Diet V8 Splash1 ■
Folgers Café Latté1
■
Frozen Desserts General Foods Sugar Free Fat Free ■■
International Coffees1 ■
Atkins Endulge Ice Cream1 ■■
■
Baskin Robbins No Sugar Added Ice Cream1 ■ ■■ Nestlé Fat Free or No Sugar Added ■ ■■
■■ Hot Cocoa Mix ■
■ ■■
Baskin Robbins Truly Free Frozen Yogurt1 ■ ■Ocean Spray Light, except Cranberry Cocktail1
■ ■■
Ben & Jerry’s Carb Karma Ice Cream1 ■■ ■ Ocean Spray Light Cranberry Cocktail ■ ■■
■■ ■■
Ben & Jerry’s No Sugar Added Ice Cream1 ■■ Swiss Miss Fat Free Hot Cocoa Mix ■ ■
■ ■
Breyers Carb Smart Ice Cream1 ■■ ■ Tropicana Light ’n Healthy Orange Juice ■
■ ■
Breyers No Sugar Added Ice Cream1 ■ ■■ Cookies & Candy

Carb Solutions Ice Cream1 ■■ ■ Hershey’s Sugar Free Chocolate Candy1 ■■
■
■ ■Edy’s or Dreyer’s No Sugar Added Ice Cream1 ■ ■ ■Russell Stover Low Carb Chocolate Candy1

Eskimo Pie No Sugar Added Reduced Fat ■ ■ ■SnackWell’s Sugar Free Chocolate Chip Cookies
Vanilla Ice Cream Bars

Healthy Choice No Sugar Added Ice Cream, ■ SnackWell’s Sugar Free Chocolate Sandwich ■■
except Chocolate Fudge Brownie1
Cookies

Healthy Choice No Sugar Added ■ ■ ■SnackWell’s Sugar Free Fudge Brownie Cookies
Chocolate Fudge Brownie Ice Cream ■ ■SnackWell’s Sugar Free Lemon Creme Cookies

■ ■Klondike Carb Smart Fudge or Ice Cream Bar SnackWell’s Sugar Free Oatmeal Cookies ■■

Klondike Reduced Fat & Calorie No Sugar ■ ■ ■SnackWell’s Sugar Free Shortbread Cookies
Added Slim-a-Bear ■
Miscellaneous
TCBY No Sugar Added Nonfat Frozen Yogurt1
Atkins Morning Start Cereal1
Weight Watchers Smart Ones Reduced Fat ■■ Fiber One Bran Cereal ■
Ice Cream Log Cabin Sugar Free Syrup ■■
Smuckers Sugar Free Breakfast Syrup
Yogurt ■ ■ Smuckers Sugar Free Preserves1 ■
■ Sugar Free Jell-O or Jell-O Pudding1
Breyers Light Fat Free Yogurt1 ■
Dannon Light ‘n Fit Carb Control Yogurt1 Gum
Dannon Light ‘n Fit Yogurt1
Yoplait Light Fat Free Yogurt1 Dentyne Ice, Eclipse, Extra, Freedent, Orbit,
or Trident1
Soda ■■ ■
■■ Doublemint or Winterfresh ■■
7-Eleven Diet Pepsi Slurpee ■■ Ice Breakers1 ■
Diet 7UP or Diet Vanilla Coke ■ Juicy Fruit (original)
Diet Coke (from fountain) ■
Diet Coke or Diet Pepsi ■■ Tabletop Sweeteners ■
Diet Dr Pepper or Diet Mountain Dew ■■
Diet Mountain Dew Code Red Equal, NutraSweet, or NatraTaste
Diet Pepsi (from fountain) ■■ Splenda
Diet Rite ■■ Sweet ‘N Low
Fresca, Diet Sierra Mist, or Diet Sprite ■■
Pepsi One, Diet Vanilla Pepsi, or Diet Wild ■■ 1entire line.
Source: manufacturers.
Cherry Pepsi The information for this chart was compiled by Heather Jones.
TAB

N U T R I T I O N A C T I O N H E A L T H L E T T E R ■ M A Y 2 0 0 4 11