Of Sugar and Substitutes

May 1, 2022 Return

Sugar is an inseparable ingredient in the food we consume. However, too much sugar is not ideal for our health and teeth. Hence, sugar substitutes continue to entice consumers. Generally, any sweeteners other than the regular table sugar are considered as sugar substitutes. Table 1 shows several types of sugar substitutes available currently.

**Table 1: Types of sugar substitutes**
Sugar substitutes	Examples	Definition	Uses	Concerns
Artificial sweeteners	Acesulfame potassium (Sweet One, Sunett) Aspartame (Equal, Nutrasweet) Neotame Saccharin (Sweet’NLow, SugarTwin) Sucralose (Splenda)	Synthetic sugar substitutes, but may also be derived from natural substances. Also known as intense sweeteners in view of their sweetness which is many times sweeter than regular sugar.	Attractive alternatives to sugar as they add no/ negligible calories. Only a fraction is needed compared with the quantity of sugar you would usually use for sweetness.	An acceptable daily intake (ADI) for artificial sweeteners has been established (Table 2). ADI is the maximum quantity considered safe to consume each day over your lifetime. ADI is approximately 100 times less than the smallest amount that may cause health concerns.
Sugar alcohols	Erythritol Isomalt Lactitol Maltitol Mannitol Sorbitol Xylitol	Naturally present in certain vegetables and fruits, but may also be manufactured. They are not intense sweeteners as they are not sweeter than sugar (some are less sweet than sugar). They are not alcoholic, despite their name – “sugar alcohols”.	They contain less calories than regular sugar. Approximately 2 kcal/g of sugar alcohols on average as compared to 4 kcal/g of regular sugar. Found in candy, chewing gum, frozen desserts, toothpaste, mouthwash and fruits spread.	Sugar alcohols may have a laxative effect, which lead to softer stools or even diarrhoea.
Novel sweeteners	Stevia extracts (Pure Via, Truvia) Tagatose (Naturlose) Trehalose	Stevia: Considered as novel sweeteners because of the difficulty to fit into one specific category based on how they are made and what they are made from. Tagatose and Trehalose: Considered as novel sweeteners because of their chemical structure. Tagatose: a low-carbohydrate sweetener similar to fructose that is present naturally, but may also be manufactured from lactose in dairy products. Trehalose is naturally occurring in mushrooms, a disaccharide that comprises two glucose moieties linked in an unusual way.	Stevia: Used as a sweetener in Japan, China, Russia, Korea, Brazil, Indonesia, Argentina, Paraguay and Malaysia. Tagatose: Used in candies, cereals, chewing gum and frozen dairy desserts Trehalose: Used to preserve the structure and texture of frozen vegetables and fruits, to add thickness to fillings and purees and to enhance flavours of dried fruits.	Stevia was approved as dietary supplement in 1994 but not a food additive, and was granted ‘Generally Recognized As Safe’ status by U.S. Food and Drug Administration in December 2008. Tagatose may cause gastrointestinal discomfort if consumed in large quantities.
Natural sweeteners	Agave nectar Date sugar Fruit juice concentrate Honey Maple syrup Molasses	Sugar substitutes that are frequently promoted as healthier options than regular sugar. They are not significantly different from that of sugar. For instance, honey and regular sugar, both end up as fructose and glucose.	Added to food during processing. Used to sweeten beverages, in desserts, toppings for pancakes and waffles.	So-called natural sweeteners are usually safe. However, consuming too much natural sweeteners may lead to tooth decay and weight gain.

**Table 2: Acceptable Daily Intake for artificial sweeteners**
Sweetener	Caloric value (kcal/g)	Date approved	ADI	Number of times sweeter than sucrose
Acesulfame potassium	0	1988	Approved as food additive 15mg/ kg body weight/day	200
Aspartame	4	1981	Approved as food additive 50mg/ kg body weight/ day	180
Neotame	0	2002	Approved as food additive 18mg/person/day	7000
Saccharin	0	In use before the Food Additives Amendment of 1958	Permitted for use under an interim regulation	300
Sucralose	0	1998	Approved as food additive 5mg/ kg body weight/ day	300

Note: ADI= Acceptable daily intake established by the U.S. Food and Drug Administration.

Although Aspartame provides 4 kcal/g, the amount of Aspartame used in food and drinks is so little that its calorie contribution is negligible.

Health benefits

Dental care

Sugar substitutes, unlike sugar, do not promote the development of dental caries. The microflora of dental plaque produces little or no decay-promoting acid in reaction to sugar substitutes.

Weight loss

Most sugar substitutes are lower in calories than sugar is. Substituting regular sugar (4 kcal/ g) with other sugar subsitutes (lower in calories than regular sugar) allows individuals to consume the same food they normally would, with a lower calorie intake. For instance, most of the generally used sugar alcohols provide lower calories, as follows:

Erythritol 0.2 kcal/g
Isomalt 2.0 kcal/g
Lactitol 2.0 kcal/g
Maltitol 2.1 kcal/g
Mannitol 1.6 kcal/g
Sorbitol 2.6 kcal/g
Xylitol 2.4 kcal/g

Diabetes mellitus

Most sugar substitutes are metabolised more slowly, allowing blood sugar levels to stabilised over time. Hence, they may be beneficial for patients with diabetes mellitus.

In conclusion, sugar substitutes should be used only in moderation. Sugar substitutes, as their name implies, are simply to substitute one addiction (regular sugar) with another. That being said, you may train your taste buds to enjoy less sweet food over time. By progressively reducing the quantity of sugar you consume, you may alter the way your taste buds perceive food. For instance, you may cut down the quantity of sugar in your morning coffee or tea, from 1 teaspoon to ½ teaspoon.

References:

Manfred Kroger, Kathleen Meister and Ruth Kava. (2006). Low calorie sweeteners and other sugar substitutes: A review of the safety issues. Comprehensive Reviews in Food Science and Food Safety, Vol. 5, 35-47.

Kritida R. Tandel. (2011). Sugar substitutes: Health controversies over perceived benefits. J Pharmacol Pharmacother., 2(4), 236-243.

U.S. Food and Drug Administration. (2001). Agency response letter. GRAS Notice No. GRN 000045. 5 Oct. Rockville, Md.: USFDA.

McNutt K. (2000). What clients need to know about sugar replacers? J Am Diet Assoc., 100, 466-469.

If you like this article, do subscribe here.