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Artificial sweeteners: Understanding these and other sugar substitutes

Sugar alcohols and novel sweeteners

Sugar alcohols (polyols) are carbohydrates that occur naturally in certain fruits and vegetables, but they also can be manufactured. They're not considered intense sweeteners, because they aren't sweeter than sugar — in fact, some are less sweet than sugar. Sugar alcohols aren't considered noncaloric or non-nutritive sweeteners because they contain calories. But they're lower in calories than is regular sugar, making them an attractive alternative. Despite their name, sugar alcohols aren't alcoholic. They don't contain ethanol, which is found in alcoholic beverages.

Novel sweeteners are combinations of various types of sweeteners. Novel sweeteners, such as stevia, are hard to fit into one particular category because of what they're made from and how they're made.

As with artificial sweeteners, the FDA regulates the use of sugar alcohols. Approved sugar alcohols and novel sweeteners include:

  • Erythritol
  • Hydrogenated starch hydrolysates
  • Isomalt
  • Lactitol
  • Maltitol
  • Mannitol
  • Sorbitol
  • Xylitol
  • Stevia preparations that are highly refined (Pure Via, Truvia)

Note that the FDA has not approved the use of whole-leaf stevia or crude stevia extracts for use as a sweetener. Rather, only certain highly refined stevia preparations can be used in food products. Stevia also is available as a dietary supplement.

Tagatose and trehalose are considered novel sweeteners because of their chemical structure. They're categorized by the FDA as GRAS substances. Tagatose is a low-carbohydrate sweetener similar to fructose that occurs naturally but is also manufactured from lactose in dairy products. Foods containing tagatose can't be labeled as "sugar-free." Trehalose is found naturally in mushrooms.

Uses for sugar alcohols
Sugar alcohols generally aren't used when you prepare food at home. Rather, they are found in many processed foods and other products, usually replacing sugar on an equal basis. When added to foods, sugar alcohols add sweetness, bulk and texture. They also help food stay moist, prevent browning when heated, and add a cooling sensation to products.

Sugar alcohols are used in a broad range of products, including chocolate, candy, frozen desserts, chewing gum, toothpaste, mouthwash, baked goods and fruit spreads. Sugar alcohols are often combined with artificial sweeteners in products to enhance sweetness. Check the food label to help see if a product contains sugar alcohols. Food labels may list the specific name, such as xylitol, or simply use the general term "sugar alcohol."

Possible health benefits of sugar alcohols

  • Weight control. Sugar alcohols are considered nutritive sweeteners because they contribute calories to your diet. Still, sugar alcohols have fewer calories than does regular sugar — about 2 calories per gram on average. This means that sugar alcohols can be considered lower calorie sweeteners, and they may aid weight-control efforts.
  • Diabetes. Unlike artificial sweeteners, sugar alcohols can raise blood sugar levels because they're carbohydrates. But because your body doesn't completely absorb sugar alcohols, their effect on blood sugar is less than that of other sugars. Different sugar alcohols can affect blood sugar differently. You can consume sugar alcohols if you have diabetes but you still must pay attention to the total amount of carbohydrates in your meals and snacks. Talk to your doctor or dietitian for guidance.
  • Dental cavities. Sugar alcohols don't promote cavities.

Possible health concerns with sugar alcohols
As with artificial sweeteners, the FDA regulates sugar alcohols as food additives. Sugar alcohols typically are labeled as "generally recognized as safe" (GRAS) and don't require FDA approval before sale.

There are few health concerns associated with sugar alcohols. When eaten in large amounts, usually more than 50 grams but sometimes as little as 10 grams, sugar alcohols can have a laxative effect, causing bloating, intestinal gas and diarrhea. Product labels may carry a warning about this potential laxative effect.

Natural sweeteners

Natural sweeteners are sugar substitutes that are often promoted as healthier options than processed table sugar or other sugar substitutes. But even these so-called natural sweeteners often undergo processing and refining, including agave nectar.

Among the natural sweeteners that the FDA recognizes as being generally safe for consumption are:

  • Date sugar
  • Grape juice concentrate
  • Honey
  • Maple sugar
  • Maple syrup
  • Molasses
  • Agave nectar

Uses for natural sweeteners
Natural sweeteners have a variety of uses both at home and in processed foods. They are sometimes known as added sugars because they're added to foods during processing. They may be used to sweeten drinks such as tea and cocktails, in desserts, as pancake and waffle toppings, on cereals, and for baking, for example.

Possible health benefits of natural sweeteners
Although natural sugar substitutes may seem healthier than processed table sugar, their vitamin and mineral content isn't significantly different from that of sugar. Honey and sugar, for instance, are nutritionally similar, and both end up in your body as glucose and fructose. Choose a natural sweetener based on how it tastes and its uses, rather than on its health claims.

  • Weight control. Natural sweeteners, like sugar alcohols, are considered nutritive sweeteners because they contribute calories to your diet. In fact, they contain the same amount of calories as does regular table sugar. If your goal is weight control, products sweetened with natural sweeteners may not help since they add the same amount of calories to your diet as table sugar.
  • Diabetes. Natural sweeteners can raise your blood sugar, just as table sugar can. Some proponents of agave nectar, also called agave syrup, say that it's a low-glycemic sweetener and doesn't cause blood sugar spikes. However, scientific evidence doesn't support such claims about agave nectar. Agave nectar can trigger a need for insulin.
  • Tooth decay. Natural sweeteners can contribute to cavities.

Possible health concerns with natural sweeteners
So-called natural sweeteners are generally safe. But there's no health advantage to consuming added sugar of any type. And consuming too much added sugar, even natural sweeteners, can lead to health problems such as tooth decay, poor nutrition, weight gain and increased triglycerides. Also, be aware that honey can contain small amounts of bacterial spores that can produce botulism toxin. Because of that, honey shouldn't be given to babies less than 1 year old.

Moderation is key with artificial sweeteners and sugar substitutes

When choosing sugar substitutes, it pays to be a savvy consumer. Get informed and look beyond the hype. While artificial sweeteners and sugar substitutes may help with weight management, they aren't a magic bullet and should be used only in moderation. Just because a food is marketed as sugar-free doesn't mean it's free of calories. If you eat too many sugar-free foods, you can still gain weight if they have other ingredients that contain calories. And remember that processed foods, which often contain sugar substitutes, generally don't offer the same health benefits as do whole foods, such as fruits and vegetables.

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MY00073 Oct. 9, 2010

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