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Sweeteners

As the name implies, sweeteners are ingredients that add sweetness to foods. Sweeteners are ingredients in soft drinks, desserts, candies and pastries. They are often added to cereals, pasta sauces, mixed dishes, soups and a variety of other foods.

There are 2 categories of sweeteners: nutritive (those which have calories) and nonnutritive (those without calories). Nutritive sweeteners include sugars and sugar alcohols. Since these sweeteners contribute calories to the diet that contain few vitamins or minerals, they are called "empty" calorie foods. In moderation, they are considered safe for consumption during pregnancy and lactation provided they are not contributing to excess weight gain. Women with carbohydrate intolerance such as gestational diabetes, diabetes mellitus, or insulin resistance (common in polycystic ovarian syndrome) need to limit their use of nutritive sweeteners.

Nonnutritive sweeteners do not add calories to the diet and include saccharin, acesulfame K, aspartame, and cyclamate. Research on the effect of normal daily intakes of nonnutritive sweeteners on the health and development of offspring are limited. However, current data suggest that use of acesulfame K and aspartame are safe, even at high levels of intake. Studies on saccharin and cyclamate are less convincing. Data on saccharin suggest that a person is most vulnerable to development of saccharin associated bladder cancer when they are exposed to high saccharin intakes in utero and throughout their lives. Cyclamate has also been linked to cancer and is currently banned in the United States. As research on saccharin and cyclamate shows a risk, it is recommended that during pregnancy and lactation careful use if any of these nonnutritive sweeteners be considered.

Nutritive Sweeteners - Sugars

All sugars contain 4 calories per gram and there are 4 grams of carbohydrate per level teaspoon. In the context of a healthy overall diet, good blood sugar control and when eaten in moderation with a mixed meal, these sweeteners do not cause special problems for people with carbohydrate intolerance. They may be used. However, total carbohydrate is of concern in the diet. It is important to recognize that these sweeteners add carbohydrate to food, whereas nonnutritive sweeteners do not.

Sugar Name
Description
Sucrose This form of carbohydrate is found in table sugar, raw sugar, cane sugar, powdered sugar and brown sugar. It is also the primary sugar in molasses. Sucrose is 50% glucose and 50% fructose.
Dextrose
Another name for glucose.
Honey Honey is 35% glucose and 40% fructose, a close relative to Honey sucrose.
High Fructose
Corn Syrup
Less expensive and sweeter than sucrose, it is primarily glucose. It is usually found in sodas and soft drinks
Corn Syrup
Or Corn Sugar
Derived from cornstarch, this sugar is high in glucose.
Fructose Fructose sweetener, fruit sugar. Because fructose is sweeter than sucrose, less can be used in recipes. For that reason, it may be a better sweetener choice for people with carbohydrate intolerance.
Maltose Found in malt, beer and ales, this sugar is formed from 2 glucose molecules. It is potent and adds quickly to the blood glucose pool.


Nutritive Sweeteners- Sugar Alcohols

Sugar alcohols are added to foods as alternative sweeteners, and often the foods with these sweeteners are called sugar free. Technically, they are not sugars. But, they have calories. They are readily converted to glucose in the liver, especially when blood sugar is already high and carbohydrate intolerance is out-of-control. They can also be converted to fat, and may contribute to high triglycerides or weight gain. They are known for their potent laxative effect when eaten in excess.

Sugar Name
Description
Sorbitol Derived from glucose; this sweetener is 60% as sweet as sucrose.
Xylitol Derived from xylose, it is equal in sweetness to sucrose.
Isomalt Derived from sucrose; it is about 60% as sweet as sucrose.
Mannitol Derived from mannose; it is about 70% as sweet as sucrose.
Hydrogenated Starch
Hydrolysates (HSH)
Derived from corn, wheat or potato starches. These sweeteners range from 40% to 90% as sweet as sucrose.


Nonnutritive Sweeteners

Nonnutritive sweeteners are added in very small amounts to foods for a significant sweetening effect. These sweeteners have been approved for use in a number of dietetic or reduced-calorie foods and beverages. While safety is a concern, only minute amounts are necessary. However, cautious use of saccharin and cyclamate is indicated as they may cause potential health risks for the fetus and research is limited on their safety during pregnancy. For people with carbohydrate intolerance during pregnancy, the nonnutritive sweeteners acesulfame K and aspartame can be helpful in keeping total carbohydrate lower in the diet.

Sweetener Description
Saccharin

Saccharin is about 300 times as sweet as sucrose. It has been in use since the late 1800s and is a popular tabletop sweetener. In the 1970's, its safety was questioned in the United States because of studies suggesting an increased risk of bladder cancer in male rats given very high levels of saccharin. Later, the research design was called into question and its conclusions refuted. It is now determined that up to 1 gram per day of saccharin poses no health risks to adults.

While there is no evidence of harmful effects reported, recent studies show that saccharin does cross the placenta and may be of concern to some women during pregnancy. High saccharin intakes in utero and throughout life have been linked to increased risk of developing bladder cancer.

Acesulfame K

Acesulfame Potassium (K) is 200 times as sweet as sucrose. It is heat stable so, unlike aspartame, it can be used in cooking. It is added to dry mixes for sugar free gelatins, puddings and beverages. It can also be used in baked goods. In Canada and Europe it is approved for soft drinks.

There are no safety concerns raised about Acesulfame K. It has been deemed safe for all age groups.

Aspartame

Aspartame is 200 times sweeter than sucrose. It became available as a tabletop sweetener in the 1970s and is now added to thousands of foods. It is not stable in heat nor for long periods in liquid form. While the U.S. Food and Drug Administration stated that high heat or long storage times could decrease the quality of the food products, they concluded that this did not pose a health risk.

Methanol, a by-product of aspartame breakdown, is the concern. However, as a comparison, 1 liter of beverage sweetened with aspartame can produce up to 58 mg of methanol. The average amount of methanol in fruit juice is 140 mg per liter, or 3 times the amount found in the aspartame-sweetened beverage. The FDA has approved aspartame for use during pregnancy and lactation.

The Center for Disease Control did state that some individuals might be unusually sensitive to aspartame. Anyone who experiences a reaction to aspartame is encouraged to document it and discuss it with his or her physician. Phenylalanine is a component of aspartame that should be avoided by individuals with a rare metabolic disorder called phenylketonuria (PKU). Phenylalanine does cross the placenta and has been a concern in producing PKU in offspring. However, even at high levels of intake placental transport of this substance does not appear to be clinically harmful.

Sucralose Sucralose is a non-caloric sweetener that is made from sugar. It was approved in April of 1998 for use as a table top sweetener. It is now used to sweeten products in more than 30 countries. Sucralose is 600 times sweeter than sugar and it is heat-stable, which means in can be used for baked goods. Sucralose has no effect on blood sugar, offers no calories and is deemed safe for use with all populations, including pregnant and lactating women as well as children.
Cyclamate Cyclamate is 30 times sweeter than sucrose and had been used in foods since the 1950s. It was removed from food products in the USA and Canada by the 1970s because several animal studies suggested it posed an increased cancer risk. While it is completely banned in the USA, it is available in Canada as a tabletop sweetener. Studies in the 1960s that resulted in the cyclamate ban have since been questioned. The scientific community is reviewing more current data that may support cyclamate approval again. The maximum daily limit suggested is 1.5 grams per day.

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