diabetes diet artificial sweeteners natural sweeteners
Reading Time: 4 minutes

They are known by many names —artificial sweeteners, low-calorie sweeteners, non-nutritive sweeteners or intense sweeteners.

Artificial sweeteners are sweetening agents that are nearly 300 to 13,000 times sweeter than your table sugar or sucrose. This is the reason artificial sweeteners have become popular as sugar substitutes. They are also believed to suppress hunger and appetite. And this makes it popular with people who wish to lose weight, manage their diabetes or metabolic diseases.

Although FDA has approved some artificial sweeteners for human consumption and labelled them ‘generally safe’, they need to be consumed in specific quantities that do not cause any adverse effects. Every person has a different energy or calorie needs based on age, sex, nutritional status, and physical activity. This means that if you wish to consume artificial sweeteners, your daily allowance will be based on these factors. There is no one-size-fits-all quantity that you can consume.

But how safe are they?

Artificial sweeteners have gone a step further from being simply sugar substitutes. They are now being marketed as healthy sugar substitutes. But is replacing sugar with artificial sweeteners really healthy and beneficial? In people with diabetes, too much consumption of artificial sweeteners may actually lead to rise in blood glucose. Some studies even found that extensive use of artificial sweeteners may increase the risk of bladder cancer, coronary heart disease and chronic kidney disease.

What does the research say?    

The nutrition guidelines suggest that while consumption of artificial sweeteners should be a part of the overall healthy diet, he non-nutritive sweeteners cannot be used to replace nutrient‑dense foods such as milk and fruits. Although artificial sweeteners can help in limiting calorie intake and act as a means to manage weight or blood glucose, its efficacy in weight loss or diabetes control is not yet established.

How does it compare to natural sweeteners?

Sugar substitutes can either be synthetic or of natural origin. Natural sweeteners are obtained from sources such as plants, fruits or honey and have been a part of the human diet for a very long time. In fact, natural sweeteners were the only sweetening agents known to man till sucrose or the table sugar became popular at the beginning of the 20th century. Natural sweeteners do not result in blood glucose rise due to their low glycemic index. Natural sweetening agents are also absorbed much slowly by the body as compared to regular sugar. Thus, natural sweeteners like honey, fruit pulps, dates, palm sugar and others are considered beneficial for people with diabetes. Stevia is one of the most popular natural sweeteners. Its sweet taste is regarded as ‘just right’ and it provides zero calories. Stevia also is believed to maintain blood glucose and so is preferred by people with diabetes.

diabetes diet artificial sweeteners natural sweeteners 2

When trying to make lifestyle changes, it is easy to look towards synthetic solutions that offer the benefit of taste without the cost of added calories. But the argument between artificial and natural sweeteners is a skewed debate. It’s imperative to know what you are putting into your body.    

Here’s the dope on 5 of the most common synthetic artificial sweeteners;

1. Aspartame

Aspartame was discovered in 1965 and is nearly 200 times sweeter than sugar. The unique property of aspartame is that it gets metabolised into its basic components such as amino acids, aspartic acid, phenylalanine and a small amount of ethanol. These compounds are also found in other food items such as meat, milk, fruits, and vegetables.

  • The acceptable daily limit: 50 mg/Kg of body weight/day
  • Possible side-effects: Chronic fatigue, brain tumour, allergic reactions
  • Brands available in India: Equal, Sugar-Free Gold

2. Saccharin

Saccharin has been in use as a non-caloric sweetener for more than a century now. It was the first artificial sweetener that was synthesized in 1879. It is nearly 300 times sweeter than the sugar. In animal studies, saccharine has shown a risk of causing cancer. However, this has not been considered in humans as yet as it causes cancer through a non-DNA-reactive mechanism.

  • The acceptable daily limit:  5 mg/Kg of body weight/day
  • Possible side effects:  Bladder cancer, Glucose intolerance
  • Brands available in India: Sweet n Low, Sugar-Free

3. Sucralose

Sucralose is about 600 times sweeter than sugar. Due to its heat stability, sucralose can also be used in baked products. Sucralose is used commonly in food items such as ice cream, dairy, beverages, bakery, and Indian sweets.

  • The acceptable daily limit:  5 mg/Kg of body weight/day
  • Possible side effects:  May affect insulin sensitivity
  • Brands available in India: Splenda, Sugar-Free Natura, Elata, Zero

4. Acesulfame K (potassium)

Acesulfame K has good solubility. It is 200 times sweeter than sugar and is used commonly to impart a sweet taste to liquid non-alcoholic beverages.

  • The acceptable daily limit:  15 mg/Kg of body weight/day
  • Possible side effects:  Carcinogenic
  • Brand available in India: Sunett,  Sweet One

5. Neotame

Neotame is 8,000 times sweeter than sugar and is chemically related to aspartame. It is used very rarely as compared to the other artificial sweeteners.

  • The acceptable daily limit:  18 mg/Kg of body weight/day
  • Possible side effects:  Neurotoxicity

References:

  1. Sharma A1, Amarnath S. Artificial sweeteners as a sugar substitute: Are they really safe? Indian J Pharmacol. 2016; 48(3):237-240.  
  2. Purohit V , Mishra S. The truth about artificial sweeteners – Are they good for diabetics? Indian Heart J. 2018; 70(1):197-199.  
  3. Brown RJ, de Banate MA, Rother KI. Artificial sweeteners: a systematic review of metabolic effects in youth. Int J Pediatr Obes. 2010; 5(4):305-312.
  4. Suez J, Korem T. Non-caloric artificial sweeteners and the microbiome: findings and challenges. Gut Microbes. 2015; 6(2):149-155.  
  5. Tandel KR. Sugar substitutes: Health controversy over perceived benefits. J Pharmacol Pharmacother. 2011;2(4):236-243.  
  6. Sanchari Chattopadhyay, Utpal Raychaudhuri. Artificial sweeteners – a review. J Food Sci Technol. 2014 Apr; 51(4): 611–621.
  7. Chow KF. A Review of Excessive Sugar Metabolism on Oral and General Health. Chin J Dent Res. 2017;20(4):193-198.
  8. Grembecka M. Natural sweeteners in a human diet. Rocz Panstw Zakl Hig. 2015;66(3):195-202.
  9. Barpete PK, Singh S. Artificial Sweeteners: A Market Watch https://www.farmavita.net/documents/ARTIFICIAL+SWEETENERS.pdf
  10. Kirtida R. Tandel. Sugar substitutes: Health controversy over perceived benefits http://insightalpha.com/news_test.php?cid=81&sid=1&nid=510 (Indian names brand)

Loved this article? Don't forget to share it!

Disclaimer: The information provided in this article is for patient awareness only. This has been written by qualified experts and scientifically validated by them. Wellthy or it’s partners/subsidiaries shall not be responsible for the content provided by these experts. This article is not a replacement for a doctor’s advice. Please always check with your doctor before trying anything suggested on this article/website.