Sweeter (and Better) Than Sugar? Two doctors take a close look at artificial sweeteners

We'd love to know what your favorite sweetener is, and why. Please use the comments section below to tell us.

Artificial sweetener comes in many varieties. Some are much sweeter than others.

May 1, 2008

Most people are aware of the health hazards that come with sugar consumption. Still, sugar restriction is difficult for our generation, which has developed a strong sweet tooth. However, for those who want to or must limit sugar, there is an extensive variety of sugar substitutes on the market.

There is much confusion as to the safety, and the pros and cons, of these sugar substitutes. Often, consumers are faced with a full dictionary of names and terms, and making the right choice becomes very difficult.

As a general rule, and regardless of which sugar substitute you use, it is best to curb your sweet tooth. Most of us can no longer perceive the natural sweetness in foods such as almonds or snap peas, for instance. By bombarding the sweet receptors of the tongue with high-intensity sweetness, we overwhelm that natural perception ability. By cutting down on sweets and additives, life loses nothing of its sweetness. On the contrary, you can discover a new dimension to the natural flavors in many of your favorite foods.

Sugar, of course, has an entire spectrum of metabolic consequences apart from its sweetness: elevated blood sugar, which is itself harmful to the kidney’s filtering apparatus, excess insulin in the blood to counter that elevated blood sugar, which has a Pandora’s Box of associated problems. There are a hundred reasons to avoid eating much sugar.

As to artificial sweeteners, they all have their drawbacks: bitter aftertaste, bloating and gas, excitotoxic potential for the brain and nervous system, allergic reactions, etc. According to many doctors, for most people, Splenda is the best choice if used in moderation, but there are definitely some people who cannot use it. Of the sugar alcohols, many notorious for unpleasant intestinal side effects, probably erythritol (sold as Z Sweet) and xylitol (sold under a variety of names and in bulk bags in many health food stores) have the fewest of these side effects, if used in moderation. The sweet herb, stevia, and even plain old saccharine don’t have a lot of intestinal side effects, but do have a bitter aftertaste if you use even slightly too much.

The best advice is to find the artificial (or natural in the case of stevia) non-sugar sweetener you tolerate best and not use much of it. Bit by bit taper down the amount of sweetness you add to foods and let the natural sweetness shine through.

The following is a short reference glossary of alternative sweeteners. Much of this information comes from an American Association of Cereal Chemists book, called “Sweeteners: Alternative,” by Amy L. Nelson (Eagen Press, St. Paul, Minnesota).

Acesulfame K: An accident of chemistry, discovered in 1967 by a Hoechst Company researcher in Germany, who noticed a sweet taste on his fingers, while reacting a couple of chemicals. (As you’ll see from the entries that follow, this is how more than a few artificial sweeteners got discovered. There seems to be a pattern among chemists to stick their fingers in their mouths, a habit that seems to violate every basic tenant of safe laboratory behavior.)

Acesulfame potassium, or AceK as it is often called, is a synthetic, white, crystalline powder about 200 times sweeter than sucrose. Positives include having no demonstrated health risks so far (approved in the United States in 1988) and good stability. It’s not thought to decompose and is excreted unchanged from the GI tract. Drawbacks: really no serious ones, except that it is truly “artificial,” which, by itself, is enough to turn some people off. It’s sold commercially under the name Sunette. Most doctors believe there is no problem with its use in moderation, as all sweeteners should be used.

Aspartame: Sold under the brand name NutraSweet, the compound was also an accidental discovery in 1965 by a chemist at Searle & Company. (Another finger sucker, apparently.) It is a synthetic, white, crystalline powder, made of two amino acids (L-aspartic acid and L-phenylalanine) with about 160-220 times the sweetness of sucrose. Positives include a clean taste without metallic bitterness.

Drawbacks include its notorious instability in acidic aqueous solutions or when heated, at which point it loses its sweetness and potentially becomes toxic. When the molecule breaks apart, one potential decomposition compound is methanol or wood alcohol – the stuff sometimes found in moonshine that makes you go blind if you drink it. Just image what could be happening to those aspartame molecules inside all those cans of diet soda in the back of a delivery truck on a sweltering August day in Atlanta Anecdotal drawbacks include severe stomach cramping, sleeplessness, hives, emotional disturbance and memory loss. There’s some evidence (again, anecdotal) that these potential ills might even be of greater risk to people on a low-carb dietary structure

Cyclamate: Another accidental discovery, in 1937 by a graduate student at the University of Illinois. Cyclamate is a synthetic, white, crystalline powder about 30 times sweeter than sucrose. Drawbacks include a bitter-tasting breakdown product and questionable health risk. Based on studies in the late 1960s that suggested the product might cause bladder cancer in rats, cyclamate was banned in the United States in 1970, never to return. Subsequent studies in the 50-plus countries that didn’t ban the product showed no carcinogenic potential, but its petition for reinstatement in the United States still languishes 25 years later.

Erythritol: A naturally occurring sugar alcohol (found in small quantities in mushrooms, pears, melons, grapes and wine) that is produced commercially by fermentation of table sugar (or other sugars) in a process somewhat akin to making yogurt. It’s only about 70 percent as sweet as sugar, but has only a fraction (about 0.2) of a calorie per gram  -- basically low enough to qualify it as “zero calories.”

Erythritol is a small molecule, rapidly absorbed by the small intestine, meaning little of it gets to the colon to cause the typical intestinal misery common to other sugar alcohols. On the good side, research has shown that more than 90 percent of what’s absorbed is excreted unchanged in the urine within 24 hours. (That does beg the question of what happens to the other 10%, but let’s not split hairs.) Positives: Most people feel it has a clean taste. Some perceive a slight cold, faintly metallic taste that disappears to a large extent when it’s added to a food or beverage

Saccharine (Sweet ’n' Low): Discovered, again by accident, in 1878 at a Johns Hopkins University laboratory, saccharine is a synthetic, white, crystalline powder 300-600 times sweeter than sucrose. Drawbacks include bitter aftertaste.. The substance had been shown in a 1977 Canadian study to cause bladder cancer in male rats fed an amount of saccharine equal on a human scale to that in 800 to 1,000 cans of diet soda per day. Subsequent study on humans has failed to show a connection to cancer. According to Ms. Nelson’s book, President Theodore Roosevelt, who championed the cause of keeping saccharine available to the American consumer, is said to have remarked, “Anyone who says saccharin is injurious to health is an idiot!”

Sorbitol, Mannitol and Maltitol: All are sugar alcohols produced by the fermentation of corn, wheat or potato starch into either a crystalline powder or a syrup. Depending on how the starch is broken down (by which enzymatic reaction and for how long) the same starch can yield any of these sugar alcohols. Glucose converts to sorbitol, mannose to mannitol, and maltose to maltitol. None are as sweet as sugar, though maltitol comes closest at 90 percent.

Positives: they have fewer calories than sugar (about 1.5 to 2.5 per gram versus the 4 per gram in sugar). Drawbacks: All these sugar alcohols cause the notorious intestinal side effects common to the group – rumbling, gas, bloating, and often diarrhea – if consumed in more than small amounts, which limits their usefulness. Although some food purveyors will completely subtract all grams of any sugar alcohol they use in a product from the carb total, that’s probably not entirely kosher, since some portion of the substance does get absorbed (although there’s no good data on how much of which one) and therefore has to at least count as calories in.

Although not double-blind, placebo-controlled research data, it’s long been advised to count sugar alcohols as contributing about a third of a gram of carb per gram of sugar alcohol (or 3 grams for every 10), which serves to curb intake somewhat in people watching their carbs.

Stevia: This sweetener was first extracted in the early 1900s from the leaves of a South American plant, Stevia rebaudiniana, but had been used as an herb for centuries before that to sweeten bitter medicines. The leaves are about 30 times sweeter than sucrose and the purified extract (the stuff sold in little green packets in stores nowadays) is about 200 times sweeter. Positives include its natural origins and purported safety, demonstrated by its lengthy use in folk medicine.

Drawbacks include its bitter afterbite, which make it difficult to cook with, since just enough to make a dish properly sweet is a molecule away from the too much that makes it bitter. A good Stevia cookbook is a worthwhile purchase for anyone wanting to use this product. Stevia extract has been denied GRAS (Generally Recognized As Safe) status from the FDA and, therefore, can only be sold as a dietary supplement, not a sweetener. Go figure.  

Sucralose (Splenda): One of the few artificial sweeteners actually developed on purpose (by researchers at Queen Elizabeth College in London), sucralose is a synthetic compound made directly from the sugar molecule by selectively replacing three hydroxyl (-OH) groups with chlorine (-Cl) molecules to produce a substance about 400 to 800 times sweeter than the sucrose molecule it came from.

Positives include its clean taste, stability both in solutions across a wide range of pH values and at high temperatures. Additionally, it is minimally metabolized, being mostly excreted in the stool unchanged – i.e. with all its added chlorine molecules still bound in their positions, not wandering around in the body somewhere as some alarmists would have you believe. To date, we have seen no credible evidence (either with our own eyes or in published controlled studies) to indict this sweetener as a health risk. Therefore Splenda in its little yellow packets or in bulk packages is fine, used in moderation, as all sweeteners should be.

Tagatose: Derived from the milk sugar lactose, this sweetener is slightly less sweet than sucrose (about 92 percent as sweet). Positives include having only 1.5 calories per gram versus 4 for table sugar and honey (so although not no calorie, it’s low calorie), not rotting your teeth, and exerting a pre-biotic effect in the gut by stimulating the cells of the colon to crank up their production of butyrate (a short chain fatty acid) that helps nourish both the colonocytes and the friendly bacteria there.

Drawbacks: Makers suggest that it is metabolized in a manner similar to fructose (which might not be a good thing) but is only partially absorbed. About 15 to 20% is absorbed and the balance flows on downstream to cause all the same intestinal effects as other partially absorbable carbohydrates – namely, gas, bloating, and diarrhea – if used to excess. It’s marketed in the United States in a product called Shugr.

Xylitol: A sugar alcohol, derived from xylan (a complex sugar chain, sort of like cellulose, which is found in corncobs, straw, almond shells and birch bark) which is then broken down into individual units of a simple sugar, called xylose, which are then hydrogenated to make xylitol. Positives are that its sweetness is exactly equal to sugar (but only half the calories) and so measures exactly like sugar, spoon for spoon, making for easy recipe conversion. Additionally, there are a pretty good number of research studies that point to its actually being of some health benefit for preventing cavities and ear infections in children.

Drawbacks: Users have reported the typical intestinal side effects of sugar alcohols, such as gas, bloating, rumbling and diarrhea, although some people aver having less misery with it than with other sugar alcohols, except, perhaps, erythritol. Additionally, some users perceive a slight cold, faintly metallic quality to its taste, although other people describe it as a clean taste. Once only found in chewing gum, it’s now being manufactured in bulk and in individual single-serving packets. If you tolerate using it, and many people do, it’s probably among the least offensive of the sugar alcohols.

Each of the five FDA-approved non-nutritive sweeteners (sucralose, acesulfame-K, saccharin, aspartame and neotame) provide no carbs to foods. It should be noted that all “consumer” versions of the high-intensity sweeteners (those with sweetness hundreds of times greater than sucrose) require a bulking agent to be used.  This is because it would be difficult for any consumer to measure out an amount that would provide the desired sweetness.  For example, less than 1/100 of a teaspoon is needed for any of these sweeteners to provide a sweetness equivalent to a teaspoon of sugar.  

Most of what’s in the little packets of any color is the bulking agent, most often maltodextrin and/or dextrose.  They still qualify to be called “no calorie” sweeteners, because the amount of bulking agent is not great, having fewer than 5 calories per serving.  When manufacturers use non-nutritive sweeteners in beverages and other food products, they indeed are carb-free, as they contain no bulking agent.

For carb counters it is recommended to count the half a gram of carbohydrate in each Splenda packet, and 24 grams of carbohydrate in a cup of granular Splenda.

Enjoy life’s sweetness in the best of health!

(Reprinted with permission from Going ForWarD – FWD, a New York-based magazine published by Friends With Diabetes International, which helps Jews with diabetes adhere to kosher dietary laws. Its website is located at www.friendswithdiabetes.org. Drs Eades are the authors of the diet plan “Protein Power” and the “Protein Power Lifeplan” and the FWD-recommended carb-counting book “The Protein Power Lifeplan Gram Counter.” Other titles of theirs include “The Low Carb Comfort Cookbook,” “Staying Power,” “The 30 Day Low-Carb Diet Solution” and “The Slow Burn Fitness Revolution.” Their blog is located at www.proteinpower.com)

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Posted by lichauco on 1 May 2008

My favorites are sucalose (Splenda) and cyclamates. I used to live in Vermont and we went to canada to get cyclamates. It tastes ok is cheap. The US study was scewed since the rats tested would have had to drink an equivalent of 300 cans of diet soda a day for 30 years.

Posted by Ellis2ca on 2 May 2008

Re: Sucralose (Splenda) Since when is CHLORINE a GOOD THING for our health? I quote "sucralose is a synthetic compound made directly from the sugar molecule by selectively replacing three hydroxyl (-OH) groups with chlorine (-Cl) molecules..." I much prefer oxygen and hydrogen than CHLORINE, and I don't think this is a good sugar substitute. - Ellis

Posted by righnote on 2 May 2008

Don't go near aspartame, that's for sure.


Posted by jprice60 on 2 May 2008

I have had Type II for almost 4 years. Was never a big sweet eater. Did like milk chocolate. I have made Splenda my choice for sweetening coffee. With the proper low Carb Diet, my A1c has been 5.6 for last two lab tests. Never above 6.0 before that. Not on meds still holding my own.

Posted by Anonymous on 2 May 2008

How about Isomalt? I use DiabetiSweet and it is based on it.

Posted by Anonymous on 2 May 2008

Diabetisweet is another sugar alcohol, it has a glycemic index of 9 and 2.1 calories per gram. It is also the only sweetener (that I know of) that comes in a 'brown sugar' version. You can add just a little molasses (14g carb/Tablespoon) to any other sweetener to make one yourself, though, it wouldn't take much. I use mostly Sweetzfree (liquid sucralose,) liquid Now Stevia Extract (not glycerite) and powdered (in the blender) erythritol, I usually use a combination of sweeteners to avoid aftertaste and bitterness and it depends on the recipe which ones I use. Maltitol and sorbitol seem to cause a relatively small delayed rise in BG for me.
I want to know more about polydextrose, I see it used in commercial no-sugar-added jams.

Posted by Anonymous on 2 May 2008

What is methanol and does it pose a problem in consuming aspartame?

Upon digestion, aspartame breaks down into its components - the amino acids, aspartic acid and phenylalanine, and methanol - which are then absorbed and used into the body. These components are used in the body in exactly the same ways as when they are also derived from common foods and beverages. Neither aspartame nor its components accumulate in the body over time.

Methanol is a natural and harmless breakdown product of many commonly consumed foods and is part of the normal diet. The methanol produced during the digestion of aspartame is identical to that which is obtained in much larger amounts from many fruits, vegetables and their juices. In fact, a glass of tomato juice provides 6 times as much methanol as an equal amount of beverage sweetened with aspartame.

Regardless of its source, methanol is further broken down through normal body processes. Numerous scientific studies have shown that the methanol derived from aspartame could not possibly reach harmful levels.

NutraSweet Product Info: See all 1 results …

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Posted by Anonymous on 2 May 2008

How is aspartame handled by the body?

Aspartame is made from aspartic acid and phenylalanine, as the methyl ester.

Upon digestion, aspartame breaks down into its components - the amino acids, aspartic acid and phenylalanine, and methanol - which are then absorbed into the blood. These components are used in the body in exactly the same ways as when they are also obtained from common foods and beverages. Neither aspartame nor its components accumulate in the body over time.

As can be seen in the charts below, the amount of aspartic acid, phenylalanine, and methanol produced during the digestion of aspartame is small compared to that which is obtained from common, everyday foods. In fact, a glass of tomato juice provides 6 times as much methanol as an equal amount of beverage sweetened with aspartame. A serving of skim milk provides about 6 times more phenylalanine and 13 times more aspartic acid than the same amount of beverage sweetened with aspartame.

Posted by Anonymous on 2 May 2008

From Splenda website:
Chlorine – As discussed earlier (see Description, Stability and ADME, pages 6-7), sucralose is
made from sugar by the substitution of chlorine atoms for hydroxyl groups on the sugar molecule.
Chemically, then, sucralose is a substituted (chlorinated) disaccharide and it is sometimes
referred to as a chlorinated carbohydrate. A very different class of compounds, called chlorinated
hydrocarbons, such as PCB, is known to exert toxic effects. Because of the similarity in names,
sucralose is sometimes confused as one of these types of compounds. However, sucralose is not
at all like these substances, which are highly fat soluble, accumulate in body fat stores, and build
up in the food chain leading to their toxic effects. Sucralose, in contrast, is extremely poorly
soluble in fats, does not bioaccumulate either in fat stores or in the food chain, is environmentally
safe, and has been shown to be safe for use in people at extremely high doses. As previously
discussed (see ADME, page 7), sucralose also does not undergo dechlorination and is not broken
down to smaller chlorinated compounds in vivo.

Posted by Anonymous on 3 May 2008

Since we were asked to provide our favorite sweeteners (as opposed to some of the other postings here), mine are: Sweet N Low because it dissolves easily in iced tea (but tastes bitter in other things), and AceK since it has no bitter aftertaste and doesn't break down with cooking. I don't care for Splenda since, to me, it has a bitter aftertaste.

Posted by Anonymous on 3 May 2008

I try to cut down on sweets, and eat more fruits and raw veggies instead of sweets. But I do use natural honey with milk in my coffee. Sometimes I use Ovaltine and milk in my coffee for a cocamocha flavor. Pretty good.

Posted by Anonymous on 5 May 2008

Aspartame is a scourge to all humanity, a new form of genocide. One supermarket chain in the UK got rid of it (ASDA is the name), and Ajinomoto, the world's largest manufacturer has so much money from killing so many people with their product, that they are taking ASDA to court, with potential damages in the millions, just because a grocer had the decency and good mercantile sense to promote the fact that they got rid of several bad chemicals in their offerings. What unmitigated gall on the part of Ajinomoto! An unspeakably evil company, in the same boat for Evil as G.D. Searle (the inventor and original patent holder) and that biggest corporate monster of them all, Monsanto, which also used to make Aspartame.

Diabetics should google HJ Roberts, Diabetes, and Aspartame as a search term and read his informative article. He is an internist in Florida who has written a 1038 page book, Aspartame Disease: An FDA Ignored Epidemic.

Posted by Anonymous on 5 May 2008

I like using liquid stevia from sweetleaf. i've tried other brands of stevia and didn't like them. it took some getting use to because if you don't get the right amount of stevia in you coffee or oatmeal it will have a bitter aftertaste.

Posted by Anonymous on 5 May 2008

Once again I'm disappointed in your magazine as it has past on "junk science" in your article's statement: "Just image what could be happening to those aspartame molecules inside all those cans of diet soda in the back of a delivery truck on a sweltering August day in Atlanta". This "alarmist", non-scientific, not evidence based information is meant to cause controversy, confuse people further and perpetuate ignorance. Is that what you are trying to do? I guess all the respected medical organizations that do the research on sugar substitutes are just wrong, misinformed or somehow working with the government to kill people. Over 200 scientific studies conducted by researchers at universities and health organizations throughout the world have established aspartames safety. The following are some of those organizations (some government agencies, some not): American Cancer Society, American Council on Science and Health, American Dietetic Association, American Heart Association, Asthma and Allergy Foundation of America, Calorie Control Council, Centers for Disease Control, International Food Information Council Foundation, Massachusetts Institute of Technology, Multiple Sclerosis Foundation, US Food and Drug Administration, US FDA's Center for Food Safety and Applied Nutrition, World Health Organization. Again, I'm so disappointed in your magazine. I'm considering canceling it because I want factual, science/evidenced based information, not this type of junk science.

Thank you for this great feedback! Since reading this comment, we have removed the offending three sentences which you refer to. You are right, this article is not the place to bring up sweetener controversy. We want this article to educate readers on the many different sweeteners. But we also want to give space for the controversy which surrounds aspartame (Nutrasweet). To read more about aspartame, see our article http://www.diabeteshealth.com/read/2002/08/01/3688.html

Posted by nikkipowers on 6 May 2008

I like diabetisweet. It measures cup for cup like sugar so subbing into recipes is easy. It comes in both regular and brown sugar. Its great to bake with and I buy it at Target. Around the holidays where I use so much of it, I buy it at diabeticpromotions.com where they sometimes have a deal on it.

Posted by Anonymous on 7 May 2008

What about Agave? Has anyone tried it? Dr. Oz who is frequently on Oprah says its his favorite sugar substitute and it is low on the glycemic index.

Posted by Anonymous on 9 May 2008

I find that commercial products that are artifically sweetened are way too sweet for me. I much prefer to eat fruits for my sweet treats. I would like to bring a frozen dinner (like Lean Cuisine) for lunch, but now they all seem to have a sweetened sauce on the meat and vegetables. I do not care for the sweet flavor this gives the meal.

When did we decide and who decided that everything must have a sweet taste to be good. I never use artificial sweeteners and do not cook with them either.

Posted by Nancy Reynolds on 4 July 2008

My husband is a diabetic. We use agave syrup and really like it. Fortunately we can buy it locally, but you can also purchase it over the internet. I use it to make cookies, and different desserts. We put it on our cereal. Actually, anywhere we would normally use sugar. Tastes great and doesn't effect his blood sugar.

Posted by Anonymous on 14 October 2008

aspartame is bad and should not be consumed in the U.S!!!!!!! It has effected many lives and has also effected me!!! it should be banned for life... stay away from the coke!!

Posted by Anonymous on 2 December 2008

There are a couple of other "brown sugar" substitutes available besides the Diabetisweet: Sugar Twin has one and Splenda has one. The Splenda "brown sugar" is my favorite.

Posted by Anonymous on 6 April 2009

this does not help at all

Posted by Anonymous on 28 August 2014

Beware: Xylitol is deadly to dogs. Never feed your dogs anything that contains xylitol, and if your dog can reach the counter, be sure not to leave foods with xylitol out.

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