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Which Sweetener Do You Prefer?

November is National Diabetes Month, reminding me of candy, sweet treats and sweeteners. Reaching for a packet of sweetener for your cup of coffee or glass of iced tea, which color do you look for? White, pink, blue, yellow, or green? You can choose a white packet containing sugar or various colored packets, each with their own sugar substitute.

We also buy foods that contain sweeteners. One study looked at sweeteners in foods purchased by Americans between the years of 2005 and 2009. The researchers tracked the purchase of “uniquely formulated foods”, meaning foods that did not include any raw foods or food with only one ingredient, such as apples or eggs. This study found that 75% of those “uniquely formulated foods” had some type of sweetener added to them. Yikes!

In that study, sweeteners were divided into two types: caloric sweeteners (CS) and non-caloric sweeteners (NCS). The five most common caloric sweeteners found in the “uniquely formulated foods” in order of most common to least common were corn syrup, sorghum, cane sugar, high fructose corn syrup, and fruit juice concentrate. 53% of baby food formulas, 75% of salad dressings and dips and 78% of vegetable juices contained at least one added sweetener.

The non-caloric sweeteners included saccharine, known as Sweet’N Low® and packaged in pink packets, sucralose or Splenda® which is sold in yellow packets, and aspartame or NutraSweet® available in blue packets. Although NCS sweeteners were found in only 1% of foods and beverages, over the course of the study Americans chose more NCS-containing foods and beverages every year. In 2006 Americans selected food products with NCS 13.3% of the time in 2006, increasing to 15.2% by 2009.

Non-calorie sweeteners have been used for decades as food additives and are considered safe. Research published in the October 2014 issue of Nature magazine shows disturbing new information that may challenge that assumption. Samples of three commonly used non-calorie sweeteners and sugar were given to mice. Aspartame, saccharine and sucralose somehow changed the makeup of intestinal bacteria of the mice while sugar had no effect. But the startling finding was the mice that had their gut bacteria change also showed changes in their ability to handle sugar. In the affected mice, their blood sugars rose higher after they ate and dropped back to normal levels much more slowly, a pattern called glucose intolerance associated with an increased risk of becoming diabetic.

When researchers introduced samples of the changed mice’s gut bacteria into normal mice, the new mice’s gut bacteria changed too. And when it did, so did the same pattern of glucose intolerance occurred. Trying the same experiment on a small group of humans, only a few of them showed changes in their gut bacteria. But the ones who did also showed the same pattern of glucose intolerance seen in the affected mice. Although the effect of these sweeteners on gut bacteria doesn’t happen consistently in humans it could explain why switching from using sugar to a NCS have not had consistently helpful effects in weight reduction or controlling blood sugars in diabetics.

Today, new options like stevia and xylitol join older sweeteners like saccharin, sucralose, and aspartame. Stevia is a calorie-free sweetener from a plant native to South America in the crysthanthemum family, related to ragweed. Originally approved as a dietary supplement to improve blood pressure and diabetes control, stevia was approved for use as a food additive in 2008 and is marketed as the sweetener Truvia®. Often blended with other sweeteners stevia also comes as individual servings in green packets.

Xylitol is a low-calorie sweetener extracted from natural sources such as corn. Because of its protective effect on tooth enamel, xylitol is added to sugarless gum and mints and is marketed as a sugar substitute for baking. Xylitol may be a dentist’s friend but it’s a dog owner’s nightmare. Xylitol is deadly to dogs, causing very low blood sugar, liver damage and liver failure. In dogs, eating xylitol triggers their pancreas to dump out insulin, which drops their blood sugar so low they have seizures. There is no safe dose for dogs; even a small amount can be fatal.

What color packet should you reach for to sweeten your coffee or tea? Non-calorie sweeteners, long considered a safe alternative to sugar might actually cause problems in some of us, and xylitol definitely causes trouble for dogs.

You can also check out Kenneth Chang’s post in the New York Times’ blog Well, as he comments about the effects of some artificial sweeteners in humans here:

And if you have dogs as pets, PELASE say NO to xylitol.

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  • ABOUT DR. LOUISE

    Dr. Achey graduated from Washington State University’s school of pharmacy in 1979, and completed her Doctor of Pharmacy from Idaho State University in 1994.

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