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Artificial sweeteners, also called sugar substitutes, are compounds that serve as alternatives to sugar. They provide sweetness with fewer or no calories and have little or no effect on glucose (blood sugar) levels.
Sugar substitutes are much sweeter than sugar, oftentimes hundreds of times sweeter. As a result, they are used in smaller doses. Whereas a teaspoon of refined table sugar contains 16 calories, many sugar substitutes contain zero calories. However, patients should carefully read the label before buying a sugar substitute. Some of these products still contain small amounts of carbohydrates and proteins.
Food additives that have never been added or used in foods, including new sweeteners, must be approved by the U.S. Food and Drug Administration (FDA) as safe – and categorized as Generally Recognized as Safe (GRAS) – before they can be marketed in the United States. Artificial sweeteners that have met the criteria will have GRAS on the food label.
Sweeteners are divided into two categories – nutritive and nonnutritive. In general, nutritive sweeteners contain carbohydrates, calories and nutrients and provide energy for the body. Nonnutritive sweeteners do not provide these elements. The following chart provides information on the two types of sweeteners:
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Nutritive Sweeteners
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| Concentrated fruit juice. |
| Corn syrup. |
| Dextrose. Simple sugar found naturally in sweet fruits and honey. |
| Fructose. Simple sugar found naturally in sweet fruits and honey. |
| Honey. |
| Lactose. Sugar found in milk and dairy products. |
| Maple syrup. |
| Sugar alcohols, also called polyols. Alternative to table sugar derived from plant products such as fruits. Sugar alcohols are broken down by the body and provide about half the calories of sugar. Excess consumption may have a laxative effect. |
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Nonnutritive Sweeteners
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| Acesulfame potassium (acesulfame-K). This artificial sweetener tastes 200 times sweeter than sugar, and heating does not reduce its power to sweeten. Acesulfame-K has no calories. |
| Aspartame. A combination of two amino acids (phenylalanine and aspartic acid) combined with methanol that is about 200 times sweeter than sugar. |
| Saccharin. Between 300 and 700 times sweeter than sugar, with zero calories. |
| Sucralose. The only artificial sweetener made from sugar, sucralose is not metabolized by the body. Because it cannot be digested, it does not contribute any calories to a person’s diet. Sucralose is 600 times sweeter than sugar. |
Nonnutritive artificial sweeteners generally do not affect blood glucose because they do not contain carbohydrates. However, some sugar substitutes do contain carbohydrates that can boost blood glucose levels. People with diabetes must examine food labels to determine the sugar and carbohydrate levels in foods with artificial sweeteners.
Experts advise people with diabetes not to drink soda, or to drink diet sodas, which have sugar substitutes. Juices that are 100 percent fruit “juice” may be less harmful to blood glucose levels than fruit “drinks,” “punch,” “cocktail” or other variations. These beverages have more carbohydrates than real juice. Consumption of high-fructose corn syrup in soft drinks and many other foods has soared in recent decades and according to some researchers has contributed to the epidemic of obesity.
Patients also should be careful when shopping for “fat-free” or “low-fat” products, as these often contain higher sugar content or added carbohydrates.
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