Whenever things say ‘diet’ or ‘sugar-free’ there is a pretty good chance there are artificial sweeteners added instead of sugar. Personally, I would rather eat something that has real sugar, just less of it, than products with chemicals added to make things taste sweet. Here’s a breakdown of different sweeteners and why I choose to avoid them.
There is much controversy around how aspartame came about. It was actually discovered in 1966 when scientists were in search of an ulcer medication. It was approved in 1974 by the FDA as a food additive. After approval, it was retracted based on public concern of aspartame causing brain tumors in rats. There was an FDA task force set up to examine aspartame and they found that the company had undertaken fraudulent product testing, knowingly misrepresented findings, and possibly withheld adverse effects information. I won’t go into all the politics that followed, but eventually in 1981 aspartame was approved for use again with no concern for public complaints or the objections of three FDA scientists who were concerned about brain tumor studies.
Aspartame (found in Nutra-Sweet® and Equal®) is made of three components – aspartic acid, phenylalanine, and methanol. The body breaks methanol down into formaldehyde (aka embalming fluid and a carcinogen!), formic acid, and DKP (diketopiperazine) – a compound that causes brain tumors. In high amounts, these products can produce blindness or other eye damage, and neurological damage. As mentioned above, it may also be linked to cancer. There are other side effects that go along with aspartame and there may even be a whole set of symptoms known as aspartame disease. Symptoms can include: headaches, confusion, depression, dizziness, convulsions, nausea, fatigue, chest tightness, shortness of breath, and diarrhea.
Another artificial sweetener is sucralose (Splenda®). Sucralose is made by turning sugar into a chlorocarbon in a five-step process. Animal studies with sucralose have shown shrunken thymus glands, enlarged liver and kidneys, reduced growth rate, decrease in red blood cells, and decreased fetal weights. There have been no long term studies of sucralose in humans. There is some information to suggest that sucralose forms trace amounts of a mutagenic agent. Side effects reported with sucralose include anxiety, depression, migraines, bloating, abdominal pain, gas, heart palpitations, and joint pain.
Saccharin is found in Sweet N’ Low® and is the oldest sugar alternative found today. Saccharin was classified as a carcinogen in the 1960s, there have since been conflicting reports. Saccharin belongs to the sulfonamaide group of compounds so can cause allergic reactions in people with sulfa allergies. You should avoid saccharin if you are pregnant since it passes through the placenta. It also passes through breast milk and should be avoided if you are breastfeeding. Saccharin has been shown to cause muscle dysfunction and irritability in infants.
Xylitol is another sweetener. It is thought to be safe for human consumption at this time, however, I still prefer natural if possible. It is a processed sugar and there are no long term studies on it. Of note, it is extremely toxic to pets and since it is found in a variety of products (even liquid medications) it is important to read labels before giving anything to pets! Liquid medications for children that are thought to be safe for animals may now contain xylitol so it’s best to ask your pharmacist for a complete list of ingredients in these products.
Drinking diet sodas has not even been shown to help with weight loss. In fact, artificial sweeteners may contribute to weight gain! This is because the sweet taste (hundreds of times as sweet as sugar) does not have the associated calories with it that our brain expects which may throw off our bodies capabilities to regulate energy balance. This may cause us to crave more calories.
Stevia is recognized as being safe. There were a few concerns about potential to interfere with reproductive health as well as potential for carcinogenicity, but none of these claims have been proven and stevia has a great safety profile in Japan where it has been used for over thirty years. In moderation stevia is most likely safe.
Even some sugar-free gums contain artificial sweeteners which is dangerous because they are absorbed right into the mucous membranes of your mouth directly into your blood stream. Many things on the market (yogurt, candy, supplements, etc) contain these dangerous ingredients, so please read labels carefully!
In pharmacy school we are taught to counsel our patients with diabetes to drink diet sodas instead of regular. To me, this is absurd and I will never recommend a diet product for any patient at any point! Instead of soda, drink water, that’s my idea of a ‘diet’ drink!
Excessive sugar is not good for you, but some natural sweeteners that are most likely safe are plain sugar, stevia, chicory root, and Lo Han.