Sweet nothings not all sweeteners are Equal

by David Schardt

he artificial sweetener business only a tiny risk to any given person. per day for people who eat a must be a pretty good place to be The potential problems arise when tens 2,000-calorie . That’s 40 grams, Tthese days. Thanks to the of millions of people consume the about as much as you’d get from one epidemic, a growing number of people sweetener for years. That’s why the 12-ounce soft drink or two six-ounce are trying to cut calories. That means government should require better fruit-on-the-bottom yogurts. more “diet” this and “no--added” studies on some sweeteners and should Here’s a scorecard showing which that. And the low-carb craze has left ban others. artificial sweeteners are safe...and manufacturers scrambling to be And remember: real sugar is hardly a which are questionable. With that in the first on their block to take the sugar toxic chemical. The problem is the hand, you can check our “Sweet vs. out of everything from chocolate to large amounts that Americans eat. The Sweet” chart (p. 11) to see which sweet- ketchup to Bloody Mary mix. U.S. Department of Agriculture has sug- eners are in which . The result? We’re eating more low- gested a limit of ten teaspoons of added calorie sweeteners than ever before. Yet not all sugar substitutes are Equal, so to speak. Safe ■ and are safe. ■ Sugar alcohols and tagatose, while safe, may give you the runs if you eat too much. Sucralose ■ probably is safe. Also known as: Splenda. ■ Acesulfame and stevia may or may What is it? Sugar () chemically combined with . Its “made from not be safe; there’s not enough good sugar” label slogan is technically true, but misleading. research to tell. Why it’s low-calorie: Our bodies can’t burn sucralose for energy. ■ isn’t safe (though the risk Safety: Sucralose passed all safety tests in animal studies. is small). Comments: There is no reason to suspect that sucralose causes any harm. If you drink diet soda or chew gum (sugarless or regular), you’ll have a hard time avoiding aspartame and acesul- Neotame fame. And if you’re a fan of “light” What is it? A synthetic derivative of a combination of aspartic and yogurt, you’ll be getting either aspar- , the same two amino that are used to make aspartame. tame or sucralose. The bond between the amino acids is harder to break down than aspartame’s, That’s because manufacturers choose so neotame is more stable. sugar substitutes depending on the food. Some are used in baked goods Why it’s low-calorie: Our bodies can’t metabolize neotame, and only tiny because they withstand heat better. amounts are needed to sweeten foods. Some are used in yogurt because they Safety: Unlike aspartame, neotame isn’t broken down in the body into the can survive in an acidic environment. phenylalanine, which is toxic to people with the rare disorder phenyl- Some lose their in the syrup ketonuria (PKU). Animal and human studies have raised no safety concerns. used to make fountain sodas, but are Comments: Neotame is so new that it hasn’t yet appeared in any foods. It’s fine for bottled or canned soft drinks. always possible that once millions of consumers start eating neotame, some Just keep in mind that even an people may turn out to be sensitive to it.

Photos: Nick Waring. unsafe sweetener like saccharin poses

8 ACTION HEALTHLETTER ■ MAY 2004 Safe, but large amounts can cause diarrhea Sugar Alcohols Tagatose

Also known as: , , mannitol, Also known as: Naturlose. , , , erythritol, What is it? A hydrogenated starch hydrolysates. “mirror-image” form What are they? Sugar alcohols aren’t sugar of sugar that’s and won’t make you tipsy. They’re made by manufactured from adding atoms to sugars. For exam- milk sugar (lactose). ple, adding hydrogen to makes Why it’s low- sorbitol. calorie: Unlike Why they’re low-calorie: Some sugar sugar, tagatose alcohols are absorbed better than others. Erythritol, which is largely unab- can’t be digested sorbed, has virtually no calories, while maltitol and hydrogenated starch by in the hydrolysates are absorbed enough to provide three-quarters the calories intestines. Most of sugar. passes through the Safety: Too much sugar alcohol traveling unabsorbed through the intesti- body unabsorbed. nal tract can cause bloating, gas, and diarrhea. Unfortunately, the FDA only Safety: Because requires a “laxative effect” warning notice on labels if consumers could tagatose isn’t well- ingest 50 grams of sorbitol or 20 grams of mannitol from the food in a day. absorbed, consuming But just 10 grams of sorbitol, for example, can cause GI distress. (If sugar large amounts can alcohols have made you sick, send a letter to CSPI—JE, Suite 300, 1875 Conn. cause flatulence, rum- Ave. N.W., Washington DC 20009. We’ll forward it to the FDA.) bling noises, bloating, and Comments: Sugar alcohols don’t raise blood sugar as rapidly as sugar nausea. Studies have raised no other does, yet they’re as bulky as sugar. So they can be used tablespoon-for- safety concerns. tablespoon to replace the sugar that’s been removed from lower-carb Comments: Tagatose is so new that foods. But while they may have a minimal impact on your blood sugar, you’re only likely to find it in one food— they may have more than a minimal impact on your waistline and hips. Diet Pepsi Slurpees sold at 7-Eleven.

Probably safe, but certain people should avoid

the 11 who were “very sure” they were sensitive. That Aspartame suggests that some people react to aspartame, though fewer than the number who believe they do. Also known as: Equal, The most serious charge—that aspartame increases the NutraSweet, NatraTaste. risk of cancer—has never been proved. Among the many What is it? A synthetic deriva- animal studies on aspartame, only one hints at an tive of a combination of the increased risk. amino acids and There’s no foundation to claims floating around the phenylalanine. Internet that aspartame causes everything from Why it’s low-calorie: Only tiny amounts of aspartame are Alzheimer’s disease to multiple sclerosis. needed to sweeten foods. Comments: Clouds hang over both aspartame and Safety: People with the rare disorder acesulfame, but researchers have done more—and bet- (PKU) can’t metabolize phenylalanine, so they should avoid ter—studies on aspartame. Even so, because aspartame aspartame. is used in so many foods, the FDA should err on the side Whether aspartame causes headaches is unclear. of caution and require non-industry-funded studies to An industry-funded study of people who complained of resolve any questions about aspartame’s safety. aspartame-induced headaches concluded that it doesn’t. People who believe they suffer from headaches or But an independent test in 1994 of 26 similar people other symptoms after consuming foods that contain found that the sweetener was linked to symptoms in aspartame should avoid the sweetener. ›››› NUTRITION ACTION HEALTHLETTER ■ MAY 2004 9 Inadequately tested Unsafe Acesulfame Saccharin

Also known as: Sweet One, Also known as: Sweet ‘N Low. Sunett, . What is it? A synthetic chemical What is it? A synthetic chemical. that was discovered in 1879 when a researcher at Johns Why it’s low-calorie: Our bodies can’t metabolize acesulfame. Hopkins University in Baltimore Safety: The safety of acesulfame (pronounced ace-SULL-fame) noticed that a compound he rests on three animal studies conducted in the mid-1970s. The spilled on his hand tasted sweet. first was inconclusive because it found a variety of tumors both in Why it’s low-calorie: Our bod- mice fed acesulfame and in control mice fed acesulfame-free diets. ies can’t metabolize saccharin, The second was so plagued with sick animals that the FDA tossed and only tiny amounts are out the results as unreliable. needed to sweeten foods. In the third study, female rats fed acesulfame were twice as likely Safety: In 1977, the FDA tried to to develop breast tumors as control rats. While most of the tumors ban saccharin because animal were benign, there were some malignant tumors—one in the 60 studies showed that it caused control rats, two in the 60 rats given low doses of acesulfame, and cancer of the bladder, uterus, ovaries, skin, three in the 60 rats given high doses of acesulfame. The sweet- and other organs. Bowing to pressure from ener’s manufacturer argued that acesulfame seemed to cause more the diet- and dieters, Congress tumors only because the control rats happened to remain unusu- intervened to keep saccharin on the market, ally tumor-free. The FDA bought the company’s interpretation though with a warning notice on the label. and refused to require more safety testing. (At the time, saccharin was the only high- Comments: Acesulfame should be better tested. Until then, try potency sweetener.) to avoid it. In the late 1990s, the Calorie Control Council—which represents the low-calorie food and beverage industry—convinced the FDA and the National Institutes of Health Stevia (NIH) that the main health concern about saccharin was bladder cancer in male rats, Also known as: Sweet Leaf, Honey but that people didn’t develop bladder can- Leaf. cer through the same mechanism as the rats. In 2000, over the objections of a number of What is it? An extract from a shrub scientists, the NIH removed saccharin from its that grows in Brazil and Paraguay. list of and Congress removed the Why it’s low-calorie: Our bodies requirement for warning notices. can’t metabolize stevia. Yet last year the National Cancer Institute Safety: When male rats were fed noted that one of its own studies—the best high doses of stevioside (stevia’s active ingredient) for 22 months, human study of saccharin use ever done— they produced fewer sperm and there was increased cell prolifera- had found “some evidence of an increased tion in their testicles, which could cause infertility. And when risk of bladder cancer” in heavy saccharin female hamsters were fed large amounts of a derivative of stevio- users, “particularly for those who heavily side, they had fewer and smaller offspring. That—combined with ingested the sweetener as a table top sweet- the absence of other animal studies that are normally required ener or through diet sodas.” “Heavy” meant for food additives—led the FDA, Health Canada, the European “six or more servings of or Union, and the World Health Organization to conclude that stevia two or more eight-ounce servings of diet shouldn’t be allowed in food. drink daily.” Comments: Just because saccharin no Comments: Stevia can’t be used as an ingredient in food. But it longer carries a warning doesn’t erase the evi- can be sold as a supplement, since safety rules for supplements are dence that it may cause cancer in humans. looser than for foods. Stevia is promoted by the health-food indus- try as a natural alternative to synthetic sweeteners like saccharin, aspartame, and sucralose. But “natural” doesn’t automatically mean “safe.” For the chemical structures of the sweeteners described in this article, see www.cspinet.org/sweetatoms.

10 NUTRITION ACTION HEALTHLETTER ■ MAY 2004 Sweet vs. Sweet

Don’t expect the same sugar substitutes in all light yogurts, all no-sugar-added ice creams, all diet soft drinks, or all gums. Ingredients vary from brand to brand, and sometimes

Other Drinks Acesulfame from to flavor. While you should always read food Sucralose Sugar Alcohols Aspartame Saccharin Tagatose labels before buying, here’s a little crib sheet that you can Diet Nestea Lemon Tea ■ ■ Diet Snapple, except Apple and Lime Green take to the store with you. Tea1 ■ Diet Snapple, Apple or Lime Green Tea ■ ■ Diet V8 Splash1 ■ ■ Folgers Café Latté1 ■ ■

Acesulfame General Foods Sugar Free Free Frozen Desserts Aspartame Saccharin Sucralose Sugar Alcohols Tagatose International Coffees1 ■ ■ Atkins Endulge Ice Cream1 ■ ■ 1 Nestlé Fat Free or No Sugar Added Baskin Robbins No Sugar Added Ice Cream ■■■ Hot Cocoa Mix ■ ■ 1 Baskin Robbins Truly Free Frozen Yogurt ■■■ Ocean Spray Light, except Cranberry Cocktail1 ■ 1 Ben & Jerry’s Carb Karma Ice Cream ■ ■ ■ Ocean Spray Light Cranberry Cocktail ■ ■ 1 Ben & Jerry’s No Sugar Added Ice Cream ■ ■ ■ Swiss Miss Fat Free Hot Cocoa Mix ■ ■ 1 Breyers Carb Smart Ice Cream ■ ■ ■ Tropicana Light ’n Healthy Orange Juice ■ Breyers No Sugar Added Ice Cream1 ■■■ Cookies & Candy Carb Solutions Ice Cream1 ■ ■ Hershey’s Sugar Free Chocolate Candy1 ■ ■ Edy’s or Dreyer’s No Sugar Added Ice Cream1 ■ ■ ■ Russell Stover Low Carb Chocolate Candy1 ■ ■ Eskimo Pie No Sugar Added Reduced Fat Vanilla Ice Cream Bars ■■ SnackWell’s Sugar Free Chocolate Chip Cookies ■ ■ ■ Healthy Choice No Sugar Added Ice Cream, SnackWell’s Sugar Free Chocolate Sandwich except Chocolate Fudge Brownie1 ■■ Cookies ■ ■■■ Healthy Choice No Sugar Added SnackWell’s Sugar Free Fudge Brownie Cookies ■ ■ Chocolate Fudge Brownie Ice Cream ■■■ ■ ■■ ■ ■ ■ SnackWell’s Sugar Free Lemon Creme Cookies Klondike Carb Smart Fudge or Ice Cream Bar SnackWell’s Sugar Free Oatmeal Cookies ■ ■ Klondike Reduced Fat & Calorie No Sugar SnackWell’s Sugar Free Shortbread Cookies ■ ■ Added Slim-a-Bear ■■ TCBY No Sugar Added Nonfat Frozen Yogurt1 ■■ Miscellaneous Smart Ones Reduced Fat Atkins Morning Start Cereal1 ■ Ice Cream ■ ■ Fiber One Bran Cereal ■ Yogurt Log Cabin Sugar Free Syrup ■ ■ Breyers Light Fat Free Yogurt1 ■ Smuckers Sugar Free Breakfast Syrup ■■■ Dannon Light ‘n Fit Carb Control Yogurt1 ■ Smuckers Sugar Free Preserves1 ■ Dannon Light ‘n Fit Yogurt1 ■ Sugar Free Jell-O or Jell-O Pudding1 ■ ■ 1 Yoplait Light Fat Free Yogurt ■ Gum Soda Dentyne Ice, Eclipse, Extra, Freedent, Orbit, or Trident1 ■■■ 7-Eleven Diet Pepsi Slurpee ■■ Doublemint or Winterfresh ■ ■ Diet 7UP or Diet Vanilla Coke ■ ■ Ice Breakers1 ■ ■■■ (from fountain) ■ ■ Juicy Fruit (original) ■ ■ Diet Coke or Diet Pepsi ■ Diet Dr Pepper or Diet Mountain Dew ■ Tabletop Sweeteners Diet Mountain Dew Code Red ■ ■ Equal, NutraSweet, or NatraTaste ■ Diet Pepsi (from fountain) ■ ■ Splenda ■ Diet Rite ■ ■ Sweet ‘N Low ■ Fresca, Diet Sierra Mist, or Diet Sprite ■ ■ 1entire line. Pepsi One, Diet Vanilla Pepsi, or Diet Wild Source: manufacturers. Cherry Pepsi ■ ■ The information for this chart was compiled by Heather Jones. TAB ■ ■

NUTRITION ACTION HEALTHLETTER ■ MAY 2004 11