I had a query from one of our members asking about health concerns with artificial sweeteners, so thought I’d explore the topic a bit for everyone’s benefit.
Through this blog I’ve tried to give you an overall view (by Dr Alan Barclay), a look at safety related issues for artificial sweeteners, a look at natural alternative sweeteners, and some ideas to sweeten up drinks and yogurts without upsetting your BGLs too much. Please let me know if any questions arise. Happy reading!
I thought a good starting place would be Dr Alan Barclay’s response to a similar question on p6 of the Spring 2013 issue of Diabetes Connect.
He writes, “It’s true that adding sugar to your cup of tea can add unwanted kilojoules as well as lead to tooth decay. In large enough quantities, all sugars also raise blood glucose levels are they are all ultimately converted to glucose in the body. Therefore replacing added sugar with an artificial sweetener, or more correctly a non-nutritive sweetener (NNS), will help to decrease kilojoule intake and reduce blood glucose levels.
“There is a lot of evidence that NNS do not raise blood glucose levels when substituted for added sugar. However, when it comes to body weight, the evidence is less clear. A recent US study concluded that there is not enough data “to determine conclusively whether the use of NNS … reduces added sugars or carbohydrate intakes, or benefits appetite, energy balance, body weight or cardiometabolic risk factors.”
“The reasons why NNS have not been proven to have the expected health benefits are complicated and at present we have little evidence in humans. There is very strong (level 1) evidence that sugars are not more fattening than starches. Remember too that refined starches and maltodextrins also contribute to tooth decay and raise blood glucose levels.
“Therefore, simply eating/drinking fewer added sugars and replacing them with NNS will not necessarily have any health benefits if you consume more other refined carbohydrates in the process. For example, if you decide to get the meal deal at your favourite fast food restaurant and opt for a diet soft drink and a large chips, you can very easily end up consuming more kilojoules and carbohydrate despite having less sugar. Health wise, you are actually worse off.”
In terms of safety, the Food Standards Association of Australia and New Zealand (FSANZ) says that a number of intense sweeteners are approved for use in Australia and New Zealand. These are alitame, acesulfame potassium (Ace K), aspartame, advantame, cyclamate, neotame, saccharin, sucralose, steviol glycosides and thaumatin. There’s a report on the FSANZ website that covers their research on the topic in more detail.
The Cancer Council of Australia in 2012 said there’s an unlikely risk (meaning ‘Unlikely risk of cancer’ includes situations in which there is exposure to an agent that may be carcinogenic (not yet established) or where there is little evidence to suggest the agent is carcinogenic. There is also inadequate evidence that the method of exposure would be likely to cause cancer) from consuming artificial sweeteners (apart from Aspartame). You can read more about that here.
If, however, you still have concerns about the safety of ‘artificial’ sweeteners, there are always some NATURAL LOW ENERGY SWEETENERS that you can choose from.
- ‘Stevia’ is an intense (200-300 times sweeter than sugar) and natural sweetener from a plant, that will not affect your blood sugar levels
- Sugar alternative products containing Stevia, including Natvia and products like Hermestas Stevia Sweet, also contain Erythritol to help balance the flavour and texture.
- Erythritol (food additive 968) is a naturally occurring carbohydrate that belongs to a family called ‘sugar alcohols’ that can be helpful in controlling blood sugar levels. Erythritol should not cause the gastrointestinal side-effects that are associated with other sugar alcohols.
- Xylitol (food additive 967) is also a naturally occurring ‘sugar alcohol’ that contains about 2/3 of the energy (‘calories’) of regular sugar, but has a very low GI making it helpful for blood sugar control (even though it is less helpful in weight loss than Stevia).
Choosing lower sugar options in foods and drinks can maintain your blood sugar levels and weight while still being enjoyable.
Here are some suggested alternatives for soft drinks and yogurts:
- Soda water or plain mineral water can be flavoured with a squeeze of fresh lemon/lime/orange juice. Add some grated zest from the skin, and grated fresh ginger can also spice it up.
- Mount Franklin produces a lightly sparkling mineral water with a hint of lemon essence – zero carbohydrate.
- Schweppes produces a natural mineral water in various citrus flavours with lower carbohydrate levels (~7.5g/100ml) than usual soft drinks (~11.5g/100ml). Remember to count the carbohydrates with this one, as it will raise your BSL.
- Freshly squeezed vegetable or watered down fruit juice (as there are still natural sugars in the fruit juices), are also good ideas.
- Choose a favourite herbal tea and refrigerate a jugful for a refreshing change to water. Add sparkling water to strong tea for a fizzy version.
Most flavoured yoghurts with no artificial sweeteners contain about 16g/100g of carbohydrate (that is 1 serve of carbohydrate per 100g of the yoghurt), so some ideas to limit the carbs include:
- Enjoy 100g of your favourite yoghurt for a one carbohydrate serve snack.
- Gippsland wildberry organic is 10.6g/100g in carbohydrates, so you could have a little more of this one.
- Jalna Biodynamic Organic Whole Milk or Fat Free (plain) yoghurt contains 6g/100g, so you could have 200g for a one carbohydrate serve snack. The Jalna flavoured varieties are higher in carb (~12g/100g), but still a bit better than most other yoghurts.
- Natural and Greek yoghurts (no flavour) contain ~6-8g/100g carbohydrate, so you could have twice the amount that you would have of a flavoured yoghurt (200g), and add your own low-carb toppings such as fresh or frozen berries, LSA mix or other nuts/seeds.
Sally is the Social Media Dietitian with Diabetes Counselling Online, owner of her own business and type 1 diabetic for over 30 years