From diet sodas to nonfat yogurts and cereals, these days there’s a sugar-free alternative to just about everything. In most cases, we have artificial sweeteners to thank for that.
On paper, sweeteners are a miracle ingredient, helping us to reduce our caloric intake and protect tooth enamel, while avoiding sugar-induced energy crashes and the accompanying mood dips. But a wave of new evidence suggesting these calorie-free additives may contain underlying health risks is sparking a backlash, and not for the first time.
This week, the World Health Organization said long-term use of artificial sweeteners (NSS) could increase the risk of various health problems including type 2 diabetes and cardiovascular disease and does not help people managing your weight for an extended period.
Another study of 4,000 people released earlier this month, in Nature journal, linked erythritol, a popular sugar substitute, to increased risk of blood clots. In 2022, the results of a nine-year study of 103,000 French adults led to a similar conclusion: Researchers linked aspartame to an increased risk of stroke, concluding that sweeteners shouldn’t be considered a healthy alternative, and sugar safe. So should we get sugar cubes instead?
Even the experts seem to have mixed opinions. In response to the French study, Helena Gibson-Moore, nutritionist at the British Nutrition Foundation, acknowledged that there can be mixed messages about the safety and health effects of artificial (or low-calorie) sweeteners, which can lead to confusion among consumers. This is often because the messages are based on evidence from individual studies, rather than the totality of evidence.
It’s worth remembering that studies of even this size are limited, he added, and there could be many other factors that lead a study participant to suffer from adverse symptoms. Others have pointed out that you would have to consume an extreme amount of sweetener every day to put yourself at risk (or be very unlucky). One message that nutritionists seem to agree on is the time-honoured recommendation of everything in moderation.
Understanding sweeteners
Sweeteners were used during the sugar shortages of World War I and World War II, later becoming more popular due to the diet culture of the 1960s when they were marketed for weight loss. But their story goes back even further, to 1879, when a US scientist experimenting with coal tar derivatives accidentally tasted some of the chemicals he had been working with on his hands, leading to the development of saccharin.
There are now several types of low calorie sweeteners approved for use in the UK, but those most commonly used in food and drink include aspartame, saccharin, sorbitol, sucralose and stevia. In toothpaste, chewing gum, and mouthwash, it’s most likely to be xylitol.
For a long time, scientists believed that most sweeteners are pretty much the same thing and have no nutritional impact on the body. But recent studies have shown that this may not exactly be the case. If your brain detects something sweet—whether it’s natural sugars, artificial sweeteners, or something else—it sends a signal for our bodies to react in some way, says Duane Mellor, a registered dietitian who teaches nutrition to undergraduate students. medicine at Aston University. Whether or not that reaction is significant is a different matter, he explains.
Additionally, different sweeteners trigger different signals: Aspartame, which is broken down in the body, has a different effect than others like saccharin, Mellor adds as an example, and this may have other effects on the bacteria in our gut microbiome.
The biggest shift in thinking in recent times, he explains, is a shift in the thinking of nutritionists. Rather than viewing sweeteners as a wholesale sugar substitute, we should be using them as part of a stepwise approach in working to reduce our sugar intake overall.
In other words, replacing that daily can of sugary Cola with two cans of Diet Zero or Alternative Zero gets big favor from the experts. Drinking a few cans of Diet Cola as a way to kick the habit is a far better, if less appealing, option.
Additionally, sweeteners may be guilty of luring many of us into a false sense of security when it comes to healthy living. Guidance published by WHO last year on the use of sweeteners in the context of reducing type 2 diabetes concluded that there was no evidence that replacing sugar with sweeteners contributes to weight loss.
The paper was controversial, Mellor notes, but the fact remains: When it comes to having a balanced and nutritious diet, indulging in sugar-free chocolates isn’t enough. It’s what we eat around those sweeteners that matters, he says. There’s no question that sweeteners can be beneficial, she adds, and for diabetics who can’t take sugar they provide a safer treatment. But consumers should be aware of the pros and cons.
Are natural alternatives better?
Syrups made from fruit and flowers are increasingly popular for use in baked goods, hot beverages and other forms of desserts. Agave nectar, for example, has a milder flavor than honey, and molasses and maple syrup are both popular vegan alternatives to honey. The sugar in these may not be refined, but it’s still high.
With any of these options, it’s important to remember that your body is still processing sugar and sweetness, says Dr. Mellor. A dash of honey to sweeten something like tea is fine, he suggests, but agave in particular is very high in fructose, which in large quantities is difficult for the intestines to absorb and can have a laxative effect. It also converts to fat faster than other sugars.
It’s important to think about the amounts involved, so you shouldn’t need as much agave as regular honey in your tea or porridge. An even better option is to experiment with herbs and spices—according to Mellor, it’s often a different flavor, and not sweetness, that the body really craves.
Ground ginger, cinnamon, and nutmeg are all strong, sweet flavors that can tempt the body to satisfy a sweet tooth. Similarly, Mellor recommends adding black pepper to fruits like strawberries — it stimulates the taste buds in the same way sugar does.
He concludes: Sweeteners, fruit, sugar are all good in moderation. It’s important to enjoy your food and think of new flavors. We don’t always need to reach for that sugary hit.
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