5.7 – The Food Industry and Sugar Substitutes
Learning Objectives
- Discuss the usefulness (or lack thereof) of consuming foods containing sugar substitutes
- Explain the difference between a nutritive and non-nutritive sweetener.
In the food industry, both simple and complex carbohydrates are utilized to give foods a wide spectrum of functional attributes, including increased sweetness, viscosity, bulk, coating ability, solubility, consistency, texture, body, and browning capacity. The differences in chemical structure between the different carbohydrates confer their varied functional uses in foods. Starches, gums, and pectins are used as thickening agents in making jam, cakes, cookies, noodles, canned products, imitation cheeses, and a variety of other foods. Molecular gastronomists use slow-releasing carbohydrates, such as alginate, to give shape and texture to their fascinating food creations (Video 5.8.1). Adding fiber to foods increases bulk. Simple sugars are used not only for adding sweetness, but also to add texture, consistency, and browning. In ice cream, the combination of sucrose and corn syrup imparts sweetness as well as a glossy appearance and smooth texture. Added sugars include white, brown, and raw sugar, corn syrup, H.F.C.S., malt, and maple syrups, liquid fructose, honey, molasses, agave nectar, and crystal dextrose. We refer to these sweetening agents as nutritive sweeteners as they provide energy when digested.
Video 5.8.1: Ferran Adrian Demonstrates Alginates
Watch this video to see how molecular gastronomist Ferran Adrian uses the polysaccharide alginate to give shape and texture to olive puree.
Due to the potential health consequences of consuming too many added sugars, food manufacturers use sugar substitutes or non-nutritive sweeteners (do not contribute energy when digested) to replace sugar in many foods and beverages. Sugar substitutes may be from natural sources or artificially made. Those that are artificially made are called artificial sweeteners and must be approved by the FDA for use in foods and beverages. The artificial sweeteners approved by the FDA are saccharin, aspartame, acesulfame potassium, neotame, and sucralose. Stevia is an example of a naturally-derived sugar substitute. It comes from a plant commonly known as sugarleaf and does not require FDA approval. Sugar alcohols, such as xylitol, sorbitol, erythritol, and mannitol, are carbohydrates that occur naturally in some fruits and vegetables. However, they are industrially synthesized with yeast and other microbes for use as food additives.
The FDA requires that foods disclose the fact that they contain sugar alcohols, but does not require scientific testing of it. (Though many of them have undergone studies anyway.) In comparison to sucrose, artificial sweeteners are significantly sweeter (in fact, by several hundred times), but sugar alcohols are more often less sweet than sucrose (Table 5.8.1). Artificial sweeteners and Stevia are not digested or absorbed in significant amounts and therefore are not a significant source of calories in the diet. Sugar alcohols are somewhat digested and absorbed and, on average, contribute about 2 kilocalories/gram, which is about one-half of the calories in sucrose (4 kilocalories/gram). These attributes make sugar substitutes attractive for many people—especially those who want to lose weight and/or better manage their blood-glucose levels.
Benefits of Sugar Substitutes
Consuming foods and beverages containing sugar substitutes may benefit health by reducing the consumption of simple sugars, which are higher in calories, cause tooth decay, and are potentially linked to chronic disease. Artificial sweeteners are basically non-nutrients though not all are completely calorie-free. However, because they are so intense in sweetness they are added in very small amounts to foods and beverages. Artificial sweeteners and sugar alcohols are not “fermentable sugars” and therefore they do not cause tooth decay. Chewing gum with artificial sweeteners is the only proven benefit of artificial sweeteners as it has been shown that artificial sweeteners promote oral health. The American Dental Association (ADA) allows manufacturers of chewing gum to label packages with an ADA seal if they have convincing scientific evidence demonstrating their product either reduces plaque acids, cavities, or gum disease or promotes tooth remineralization.
There is limited scientific evidence that consuming products with artificial sweeteners decreases weight. In fact, some studies suggest that the intense sweetness of these products increases the appetite for sweet foods and may lead to increased weight gain. Also, there is very limited evidence that suggests artificial sweeteners lower blood-glucose levels. Additionally, many foods and beverages containing artificial sweeteners and sugar alcohols are still empty-calorie foods (i.e. chewing sugarless gum or drinking diet soda pop) that are not going to improve your blood-glucose levels or your health. There is some evidence that sugar substitutes including stevia alter the gut microbiome in mice. Whether this effect would be similar in humans remains to be researched.
Health Concerns
The most common side effect of consuming products containing sugar alcohols is gastrointestinal upset, a result of their incomplete digestion. Since the introduction of sugar substitutes to the food and beverage markets, the public has expressed concern about their safety. The health concerns of sugar substitutes originally stemmed from scientific studies, which were misinterpreted by both scientists and the public. Observational studies have also identified potential issues with the intake of artificially sweetened beverages.
In the early 1970s, scientific studies were published that demonstrated that high doses of saccharine caused bladder tumors in rats. This information fueled the still-ongoing debate about the health consequences of all artificial sweeteners. In actuality, the results from the early studies were completely irrelevant to humans. The large doses (2.5 percent of diet) of saccharine caused a pellet to form in the rat’s bladder. That pellet chronically irritated the bladder wall, eventually resulting in tumor development. Since this study, scientific investigation in rats, monkeys, and humans have not found any relationship between saccharine consumption and bladder cancer. In 2000, saccharin was removed from the US National Toxicology Program’s list of potential carcinogens.1
There have been health concerns over other artificial sweeteners, most notably aspartame (sold under the trade names of NutraSweet and Equal). The first misconception regarding aspartame was that it was linked with an increase in the incidence of brain tumors in the United States. It was subsequently discovered that the increase in brain tumors started eight years prior to the introduction of aspartame to the market. Today, aspartame is accused of causing brain damage, autism, emotional disorders, and a myriad of other disorders and diseases. Some even believe aspartame is part of a governmental conspiracy to make people dumber. The reality is there is no good scientific evidence backing any of these accusations, and that aspartame has been the most scientifically tested food additive. It is approved for use as an artificial sweetener in over ninety countries.
Aspartame is made by joining aspartic acid and phenylalanine to amino acids. When digested, it is broken down into aspartic acid, phenylalanine, and methanol. People who have the rare genetic disorder phenylketonuria (PKU) have to avoid products containing aspartame. Individuals who have PKU do not have a functional enzyme that converts phenylalanine to the amino acid tyrosine. This causes a build-up of phenylalanine and its metabolic products in the body. If PKU is not treated, the build-up of phenylalanine causes progressive brain damage and seizures. The FDA requires products that contain aspartame to state on the product label, “Phenylketonurics: Contains Phenylalanine.” For more details on sugar substitutes please refer to Table 5.8.2.
Several large observational studies have examined risks associated with the consumption of diet soda consumption and strokes, dementia, Alzheimer’s disease, metabolic syndrome, type 2 diabetes, and myocardial infarction. Other longitudinal studies have not seen these increased risks for cardiovascular disease.2,3,4,5,6 Wersching et al. discussed this issue in more detail in their commentary here.7
1 National Cancer Institute. “Artificial Sweeteners and Cancer.” Accessed June 20, 2019.
2 Lutsey PL, Steffen LM, Stevens J. Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study.Circulation. 2008; 117:754–761. Accessed July 1, 2019.
3 Dhingra R, Sullivan L, Jacques PF, Wang TJ, Fox CS, Meigs JB, . Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community.Circulation. 2007; 116:480–488. Accessed July 1, 2019.
4 Nettleton JA, Lutsey PL, Wang Y, Lima JA, Michos ED, Jacobs DR. Diet soda intake and risk of incident metabolic syndrome and type 2 diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).Diabetes Care. 2009; 32:688–694. Accessed July 1, 2019.
5 Gardener H, Rundek T, Markert M, Wright CB, Elkind MS, Sacco RL. Diet soft drink consumption is associated with an increased risk of vascular events in the Northern Manhattan Study.J Gen Intern Med. 2012; 27:1120–1126. Accessed July 1, 2019.
6 Pase MP, Himali JJ, Beiser AS, Aparicio HJ, Satizabal CL, Vasan RS, . Sugar- and artificially sweetened beverages and the risks of incident stroke and dementia: a prospective cohort study.Stroke. 2017; 48(5):1139–1146. Accessed July 1, 2019.
7 Wersching, H.,Gardener, H, and Saccho, RL. Sugar-Sweetened and Artificially Sweetened Beverages in Relation to Stroke and Dementia; Are Soft Drinks Hard on the Brain? Stroke. 2017, 48 (5) 1129-1131. Accessed July 1, 2019.
Bottom Line Regarding artificially sweetened food and beverages
Most of these foods and beverages do not contribute nutrients for health. If you choose to use these products, you may want to refer to this article from the Food and Drug Administration (F.D.A.), “Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States“. The article includes a table that lists the number of tabletop sweetener packets equal to the Acceptable Daily Intake(A.D.I.) for each sweetener.
We know that limiting the consumption of these products will not harm you. If possible, reduce the use of these products. One method of reducing intake of artificially sweetened beverages is by trying one of these beverages instead:
- Substitute tap water or seltzer water
- Decaffeinated or regular coffee
- Herbal, black or green tea
- Try herb or fruit-infused water. Some combinations might include cucumber and mint, citrus fruit, watermelon or pineapple, and basil. Make sure all produce is washed and of high quality. Infuse for 1-2 hours at room temperature or 3-4 hours in the refrigerator. Remove the fruit or herbs as they can break down in the water and store covered in the refrigerator for up to 6 days. Fruit-infused water is not pasteurized and could grow bacteria if left at room temperature. Removing the rinds of fruits will reduce bitterness. Read more about making your own infused water here.
Aspartame
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Aspartame | NutraSweet, Equal | 4 kcal/g | Composed of two amino acids. (phenylalanine + aspartic acid) + menthol. To hundred times sweeter than sucrose | FDA set maximum Acceptable Daily Intakes (ADI) as 50 mg/kg body weight = 16 12 oz. diet soft drinks for adults. *Cannot be used in products requiring cooking.* People with PKU should not consume aspartame. | Children have potential to reach ADI if consuming many beverages, desserts, frozen desserts, and gums containing aspartame routinely. | Beverages, gelatin desserts, gums, fruit spreads. |
Saccharin
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Saccharin | Sweet ‘n’ Low | 0 kcal/g | Discovered in 1878. The basic substance is benzoic sulfinide. Three hundred times sweeter than sucrose. | ADI: 5 mg/kg body weight. *Can be used in cooking.* | 1970s, high doses of saccharin associated with bladder cancer in laboratory animals. In 1977, FDA proposed banning saccharin from use in food: protest launched by consumer & interest groups, warning label listed on products about saccharin and cancer risk in animals until 2001 when studies concluded that it did not cause cancer in humans. |
General purpose sweetener in all foods and beverages. Sold as Sweet ‘n’ Low in United States; also found in cosmetics and pharmaceutical products. |
Acesulfame K
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Acesulfame K | Sunnette, Sweet One | 0 kcal/g | Discovered in 1967. Composed of an organic salt, potassium (K). Structure is very similar to saccharin’s. It passes through the body unchanged which means it does not provide energy. Two hundred times sweeter than sucrose. | ADI: 15 mg/kg body weight. Body cannot digest it. *Can be used in cooking.* | None | Chewing gum, powdered beverage mixes, nondairy creamers, gelatins, puddings, instant teas and coffees. |
Cyclamates
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Cyclamates | Sugar Twin (Canada only) | 0 kcal/g | Thirty times sweeter than sucrose. Discovered in 1937. | No ADI available. | 1949, cyclamate approved by FDA for use. Cyclamate was classified as GRAS (Generally Recognized As Safe) until 1970 when it was removed from GRAS status and banned from use in all food and beverage products within the United States on the basis of one study that indicated it caused bladder cancer in rats. Approval still pending for use in the United States since the ban. Canada and other countries use this type of sweetener. | Recommended as a substitute for table sugar for diabetics in 1950s, baked goods. |
Sucralose
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Sucralose | Splenda | 1 Splenda packet contains 3.31 calories = 1g | First discovered in 1976. Approved for use in 1998 in the United States and in 1991 in Canada. Derived from sucrose in which three of its hydroxyl (OH) groups are replaced by chlorine (Cl−). Six hundred times sweeter than sugar. | ADI: 5 mg/kg body weight. *Can be used in cooking. |
None | General purpose sweetener, baked goods, beverages, gelatin desserts, frozen dairy desserts, canned fruits, salad dressings, dietary supplements; currently recommended as a replacement for table sugar and additive for diabetics. |
Stevioside
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Stevioside | Stevia, Sweet Leaf | N/A | Derived from stevia plant found in South America. Stevia rebaudianan leaves. | Classified as GRAS. Considered to be a dietary supplement and approved not as an additive, but as a dietary supplement. | Used sparingly, stevia may do little harm, but FDA could not approve extensive use of this sweetener due to concerns regarding its effect on reproduction, cancer development, and energy metabolism. | Sold in health food stores as a dietary supplement. |
Sucrose
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Sucrose | Sugar | ~4 kcal/g | Extracted from either sugar beets or sugar cane, which is then purified and crystallized. | It is illegal to sell true raw sugar in the United States because when raw it contains dirt and insect parts, as well as other byproducts. Raw sugar products sold in the United States have actually gone through more than half of the same steps in the refining process as table sugar. | Over-consumption has been linked to several health effects such as tooth decay or dental caries and contributes to increased risk for chronic diseases. | Biscuits, cookies, cakes, pies, candy canes, ice cream, sorbets, and as a food preservative. |
Honey
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Honey | Honey | 3 kcal/g | Made from sucrose. Contains nectar of flowering plants. Made by bees. Sucrose is fructose + glucose; however, honey contains more calories than sucrose because honey is denser. | *Considered safe for baking and cooking. Infants under twelve months old should not be given honey because their digestive tracts cannot handle the bacteria found in honey. Older children and adults are immune to these effects. Honey contains some harmful bacteria that can cause fatal food poisoning in infants. | None | Sweeteners in various foods and beverages such as sodas, teas, alcoholic beverages, and baked goods. |
High Fructose Corn Syrup
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| H.F.C.S. | High Fructose Corn Syrup | Dry form: 4 kcal/g; Liquid form: 3 kcal/g | Corn is milled to produce corn starch, then the corn starch is further processed to yield corn syrup. | None. | Controversial because it is found ubiquitously in processed food products, which could lead to over-consumption. Study results are varied regarding its role in chronic disease. | Soft drinks, desserts, candies, jellies. |
Sugar Alcohols
| Sweetener | Trade Name(s) | Calories | Source/Origin | Consumer Recommendations | Controversial Issues | Product Uses |
|---|---|---|---|---|---|---|
| Sugar Alcohols | Sorbital, Xylitol, Mannitol | 2–4 kcal/g. Not calorie free | Sugar alcohols. Sorbitol is derived from glucose. | Less likely to cause tooth decay than sucrose. Sugar alcohols have a laxative effect. | May cause diarrhea and gastrointestinal distress if consumed in large amounts. | Provide bulk and sweetness in the following sugar-free items: cookies, jams, jellies, chewing gum, candies, mints,pharmaceutical and oral health products. |
Key takeaways
- Food manufacturers use sugar substitutes or non-nutritive sweeteners (do not contribute energy when digested) to replace sugar in many foods and beverages.
- Sugar substitutes may be from natural sources or artificially made. Those that are artificially made are called artificial sweeteners and must be approved by the FDA for use in foods and beverages.
- Stevia is an example of a naturally-derived sugar substitute. It comes from a plant commonly known as sugarleaf and does not require FDA approval.
- Sugar alcohols, such as xylitol, sorbitol, erythritol, and mannitol, are carbohydrates that occur naturally in some fruits and vegetables.
- Consuming foods and beverages containing sugar substitutes may benefit health by reducing the consumption of simple sugars, however, as most of these products are not contributing nutrients reducing consumption of both added sugars and artificial sweeteners is best.
- Minimize the use of artificially sweetened beverages until further research is done. Substitute water, unsweetened coffee, or tea.
- Chewing gum with artificial sweeteners is the only proven benefit of artificial sweeteners in that artificial sweeteners promote oral health.
