The safety of sweeteners

The desire for sweet foods in humans is undeniable. However, the preferred level of sweetness varies among individuals. This difference of preference can be attributed to the complex interaction between genetics and environmental exposure (the amount of sweetness in our diets from a young age).

The “slimming food industry” has over the years developed a variety of non- nutritive or high intensity artificial sweeteners. This is to satisfy the need for sweetness, while at the same time offer individuals a way to cut their energy intake (calories) as the sweeteners contain little or no energy when consumed. These sweeteners have subsequently been used by people with diabetes, as they do not affect blood glucose levels in the same way that sugar does.

There are numerous sweeteners on the South African market. The most popular being Sorbitol, Xylitol, Acelfame K Aspartame, Saccharine, Stevia and Sucralose. Mannitol and Maltitol are used in manufacturing of products and are not available to be used as a single sweetener. Manufacturers often use a combination of sweeteners such in the case of cold drinks where Aspartame, Acelfame K and Sucralose are used.

The main concern for most people (apart from the taste) is the safety of using these sweeteners. This is due to consistent information claiming a variety of harmful conditions when consuming these sweeteners. The “side effects” can vary from headaches, increased appetite, weight gain, developing cancer and cognitive defects (such as Attention Deficit Hyper Activity Disorder(ADHD)), epileptic fits and changes in memory and moods.

What we do know from convincing evidence since 2012?

The American Academy of Nutrition in 2012 published a Position paper on the use of both sugars and sweeteners after reviewing all the evidence and numerous toxicology studies done at the time regarding the health aspects of sweeteners. The Academy reviewed over 129 studies on the effects of sweeteners on people’s health. The paper was conclusive that sweeteners do not cause any harmful effects and recommended that it was safe to be consumed in recommended quantities. In the case of consuming aspartame consequent elevated plasma levels of tyrosine and phenylalanine (these are amino acids) also did not cause any harmful effects. This information is consistent with the message promoted by other health bodies around the world including the American Institute for Cancer Research (AICR) and the European Society for the Study of Diabetes. (ESSD)

What is new and the essence of emerging evidence since?

Recent research however, is suggesting potential harmful effects of consuming particularly sucralose and saccharine. The researchers are suggesting that the use of these specific sweeteners can affect the way our bodies respond to eating carbohydrate rich foods. They suggest that sucralose can potentially cause metabolic derangement through the following mechanisms.

1. Sweeteners can interfere with sweet taste receptors in the gastro intestinal tract. This can potentially affect the physiological learned responses that control glucose metabolism, energy intake and the feeling of satiety.
2. Studies have shown that sweetener consumption can increase the risk for our ability to metabolise glucose by changing the compositions and number of flora or bacteria in our gastro intestinal tract. These studies have found that some humans were affected by the use of sweeteners, while others’ gut flora stayed unchanged. This means (as in most research) that the mechanism on how we are effected is more complex than initially thought.

The current state of affairs

As with good medical research, it takes time to observe conclusive evidence and many questions at this stage remain unanswered. We do not know if and how the use of sweeteners affects the different areas in the brain responsible for the feeling of hunger and satiety? We also don’t understand if the use of sweeteners on its own, such as used in beverages (tea/ coffee/ cold drinks), affect us differently when compared to consumption with a meal or as part of food. The exact amount of sweeter considered to be safe or to potentially harmful is also not clear. In terms of glucose metabolism, a large variety of sweeteners have not been tested to date.

What should we do?

1. Use a variety of sweeteners. Contradicting to the current popular information available, there are no evidence proving one sweetener to be better, more natural, or healthier that the other.
2. As for the use of sugar – the conventional advice (that might sound boring) applies namely – use all type of sweeteners in moderation. Our threshold of experiencing sweetness increases the more sugar or sweeteners we consume. The more we consume the more we want, and we easily form habits and expectations around foods and drinks. Once the mid -afternoon break involves a trip to the vending machine for a cold drink it easily becomes a daily habit. Always try to keep the awareness of the frequency and quantity of consumption of both sugars and sweeteners.
3. The best advice is to consume less sweet foods and drinks. If one can start to enjoy foods and beverages without any sugar or added sweeteners, then one could be assured that any potential health risks are avoided. Start to replace the cold drink with a jug of water with fresh lemon, mint of cut up fruit added. The fruitful flavor it creates is delicious. Replace normal tea and coffee with a variety of herbal and spicy teas that can be enjoyed hot or cold with slices of lemon, fresh orange, ginger or mint (without honey sugar or sweetener).