Artificial sweeteners

Nutrition Health Review, Summer, 1994

The use of dietetic candy, cookies, and other "diabetic" foods is usually misleading. These foods may not contain sugar but they are very often high in calories because of basic ingredients.

Many diabetics are misled by the implied benefits, and often will eat these products in addition to regular meals. The only sweetening agent that has neither nutritive nor caloric value is saccharin.

Several additives that are used in foods as sugar substitutes should be better understood. Among the best known are:

Fructose: Found naturally in many fresh fruits and vegetables. Its content in honey may be as much as 40%. (To be remembered is the fact that refined sugar is half fructose and half glucose.) Fructose is supposed to be sweeter than sugar.

When ingested, it is absorbed slowly in the upper bowel, and is largely unchanged. About 10% is broken down into glucose and lactate, carried by the portal vein to the liver, where most of its metabolism takes place. Fructose permeates the liver cells without the aid of insulin. The metablic process, however, cannot continue without insulin, so people who think fructose makes no demand on the pancreas are mistaken.

The advantages of substituting fructose for diabetic control are ultimately few.

Sorbitol: Often used in ice cream, chewing gum and many prepared foods. It is a polyalcohol present in plants, fruits, and seaweeds. Sorbitol is absorbed from the intestine more slowly than fructose and is rapidly oxidized to fructose.

The rationale for its use arises from the assumption that the liver is relieved of a need for insulin to process the substance. It does, however, metabolize into fructose.

Xylitol: Another sugar alcohol with an action similar to that of fructose.

It is favored because some research has indicated dental caries are not caused by its use. Large amounts should be avoided because osmotic diarrhea can occur.

Mannitol: Derived from fructose and said to have equivalent properties.

Saccharin: A white crystalline compound, synthetically produced, that is many times sweeter than table sugar.

Rumors persist that prolonged use, in large quantities, may cause bladder cancer. However, the Food and Drug Administration has indicated that firm evidence is lacking.

Aspartame: Supposedly 200 times sweeter than table sugar. It has been approved by government agencies for use in cereals, soft drinks, beverages, instant coffee, non-dairy toppings and many other food products.

Aspartame is made by combining two naturally occurring amino acids (L-aspartic acid and methyl ester of phenylalanine). The caloric value is small, and the effect on glucose tolerance is considered unquantitative.

Aspartame is supplied under the name of NutraSweet[R] and Equal[R]. Its critics claim that asthma sufferers and people struggling with respiratory disorders have experienced serious side effects.

Aspartame is toxic to individuals who have the inherited disease phenylketonuria in which particular chemical actions are hindered (phenylalanine hydroxylase activity).