Sweet fixes to good health

Be it to control their blood sugar levels or to cut down on calorie intake by the fitness conscious, more and more people are turning away from table sugar and opting for sugar substitutes, otherwise called as sweeteners. These substitutes provide fewer calories than sugar and help to control weight and are especially useful in the management of diabetes. At the same time, sweeteners have been found to have a number of disadvantages, one being increased craving for sweets.

There are two types of sweeteners, nutritive and non-nutritive. Nutritive sweeteners are represented by fructose, maltose, honey, lactose and polyols like sorbitol, xylitol and mannitol. They provide the same or fewer calories than sugar but do not increase blood sugar levels and have some nutritive values. Non-nutritive sweeteners include saccharin, aspartame, sucralose, acesulfame-K, stevioside and cyclamates. These provide negligible calories but have no nutritive value. Most sweeteners are of high intensity because they can provide the same sweetness as sugar even in very small quantities. The FDA in USA has banned cyclamates in view of the suspicion of induced cancer in experimental animals.

Non-nutritive sweeteners
Saccharin is 200 to 700 times sweeter than sugar and has no calories. It is the oldest and the best researched and cheapest of all artificial sweeteners. Aspartame is widely used all over the world and is slowly replacing saccharin. It is 200 times sweeter than sugar. Due to the phenylalanine component, children with phenylketonuria should avoid or restrict use of aspartame.

Nutritive sweeteners
The most popular of these is levulose (fructose or fruit sugar). Natural sources of fructose include fruits, vegetables and honey. Levulose is 1.7 times sweeter than sucrose, provides four calories per gram but has a much lower glycemic index. Sugar alcohol-based sweeteners like sorbitol, xylitol and mannitol, which are not yet popular in India, are carbohydrates that are not completely absorbed by the body. However, these sweeteners have been shown to cause gastrointestinal problems and can cause diarrhoea if used in large quantities.

There is a lot of confusion and misconceptions regarding artificial sweeteners, with so many products in the market. Nowadays artificial sweeteners are used in abundance in almost every “diet” drink, “lite” yoghurts and “low-carb” products. While for a diabetic, non-nutritive sweeteners can be used, nutritive sweeteners like fructose based products can be consumed only if the blood sugar is under good control. However, if artificial sweeteners are used, ensure you read food labels and monitor blood sugar levels regularly. It’s unlikely that one can control diabetes and lose weight by using sugar substitutes — to do that, one simply needs to eat fewer calories and increase physical activity.

The writer is chairman and diabetologist, Dr Mohan’s Diabetes Specialities Centre, Chennai and Hyderabad

Ideal choice

Sweeteners should ideally:
* Be sweet, closely resembling the sweetness of sugar.
* Not raise the blood glucose levels.
* Require only a small amount to create sweetness.
* Be heat stable.
* Not cause any side effects.
* Be safe for consumption by all age groups, including children.

Sweet substitute

Q Are artificial sweeteners safe during pregnancy?
No study till date has shown any adverse effect of artificial sweeteners on the foetus. Nevertheless, most experts working with pregnant women do not recommend using artificial sweeteners during pregnancy. If pregnant women are using artificial sweeteners, it is always best to consult the care provider on which sweetener can be used and how much should be consumed. Until more conclusive studies have been conducted, it is better to avoid artificial sweeteners if you are pregnant.

Q Are artificial sweeteners safe for children?
No. They are not approved for children below 12 years of age and it is therefore best to avoid using them on children.