From food and drink to toothpaste, vitamin pills and medicines, more products than ever have sweeteners added to make them palatable.
Now, with Public Health England challenging makers of goods including cakes, chocolate and breakfast cereals to cut sugar content 20% by 2020, their use in our diets is set to soar.
Yet many of us will remember sweeteners being linked to cancer scares in the 1990s – and they continue to confuse and divide opinion today.
So are they the guilt-free way to satisfy a sweet tooth or are we eating our way to an early grave?
Aspartame, which is around 200 times sweeter than sugar, has been accused of causing cancer since its approval for use in Europe in the 1980s.
Back then it was linked to brain tumours, lymphomas and leukaemia in test animals who were fed high levels.
While there have been no tests on humans, a US National Cancer Institute study of 500,000 people who either drank aspartame drinks or didn’t, concluded there were no observed increases in these cancers. This and other research has led Cancer Research UK to declare: “Large studies have provided strong evidence artificial sweeteners are safe.” Hardly any aspartame enters the bloodstream as it is quickly broken down in digestion.
Stevia-based sweeteners are around 200 to 300 times sweeter than sugar and are extracted from the leaves of a small shrub.
By comparison, sweeteners created in a laboratory, such as sucralose, certainly sound less natural. But while steviol glycosides start their life in a plant, they must be purified using methods involving chemicals like methanol – so they aren’t as “simple” as they sound. However, both types are deemed safe by experts.
Random controlled studies, the most reliable, show people using intense sweeteners in drinks have found no difference in their weight – and even some weight loss – compared to non-sweetener drinkers.
But weight can pile on if we think: “I’ve been ‘good’, so I can have a treat.” Don’t be fooled into thinking it’s OK to have a bar of chocolate just because you’ve opted for a Diet Coke.
If you regularly use sweeteners – adding them to tea and coffee for example – your sugar receptors may become over-
stimulated, says Dr David Ludwig, a
nutrition professor at Harvard School of Public Health.
Your tolerance for more complex tastes could also be affected. So as naturally sweet foods, such as mangos, bananas and pineapple start to be bland, you may notice bitter-tasting veg such as kale and broccoli become “downright unpalatable” says David.
Like all other food additives – including preservatives, colours and antioxidants – sweeteners undergo a rigorous assessment by both the UK Government Food Standards Agency and European Food Safety Authority. Only if they pass safety criteria do they get an E number. So having this is a sign of safety, rather than an indication that a compound is “bad”.
After evaluating intense sweeteners, the EFSA set an acceptable daily intake (ADI) – the maximum considered safe to consume every day through your life without appreciable risk – and it is surprisingly generous.
For example, the ADI for aspartame is 40mg per kilogram of body weight. A 330ml can of diet drink containing this sweetener could be expected to provide around 125mg, which means a 10st woman could put away 19 cans a day for her entire life without coming to harm (as a result of the sweetener, at least).
Regulating blood glucose levels in sufferers is important to prevent risk of diabetes-related health complications.
Since artificial sweeteners are metabolised more slowly, replacing sugar with an artificial sweetener may help stabilise blood glucose levels over a longer period, says the British Dietetic Association. The European Food Standards Agency has confirmed non-nutritive sweeteners may help in the reduction of blood glucose response after eating. The BDA also says intense sweeteners may help with weight loss or weight maintenance in people with Type 2 and offer better diabetes control.
So the evidence to date suggests artificial sweeteners are safe for diabetics when consumed within the ADI.
While sugar gives us four calories per gram – and intense sweeteners like aspartame, saccharin, sucralose and Stevia are virtually calorie free – there’s another group of sweeteners known as “sugar alcohols” which lie between the two. Unlike intense sweetener, sugar alcohols can be used to provide “bulk” for recipes – i.e. they can replace sugar when baking. This group includes sorbitol, which contains 2.6kcal per gram and xylitol, which has 2.4kcal per gram.
The good news is neither intense nor bulk sweeteners raise blood sugar levels sharply after consumption, or cause tooth decay. In the case of xylitol, research has shown it can actually help prevent it.
In 2008, a study in the British Medical Journal revealed too much sorbitol (also found naturally in fruit like prunes) could trigger bloating, diarrhoea and extreme weight loss.
Sugar alcohols may work as a laxative as they draw water into the large intestine, stimulating bowel movements.
Those in the study who saw these side effects were consuming 15 to 20 sticks of sugar-free gum per day – although most people could tolerate up to 40g of sorbitol without suffering any unpleasant effects.
Recent laboratory work and some studies on animals have shown sucralose, aspartame and saccharin may have negative effects on the balance and diversity of gut bacteria, says Professor Tim Spector, of King’s College London, in the BMJ in June.
It is hard to predict whether this also occurs in humans and, if it does, whether it has any detrimental effect on our health. However, it’s something to keep an eye on as research continues.
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