From: www.dlife.com
What does it mean when the package says "sugar free?"
By Alice Lesch Kelly
Scoop on Sugar Substitutes It's a myth that people with diabetes can't
eat any sugar. You can have foods and drinks sweetened with sugar if you
work them into a smart eating plan that takes all your carbohydrates into account. Having too many sweets can push blood sugar out of your target
range, however, so sugar substitutes are sometimes a good way to satisfy
your sweet tooth while maintaining good control.
Two types of sugar substitutes are available:
Non-caloric sweeteners. These artificial sweeteners contain no calories
and no carbohydrates, and they do not raise blood sugar levels. They
are used to sweeten beverages, desserts, and candies. Some but not all
can be used in cooking and baking. Non-caloric sweeteners include
aspartame (NutraSweet, Equal), saccharin (Sweet'N Low, Sweet Twin,
and Necta Sweet), acesulfame K (Sunett and Sweet One), neotame (not
yet marketed under a brand name), and sucralose (Splenda).
Some people with diabetes believe that artificial sweeteners do raise
their blood sugar, but there is no research showing this, according to Christine Gerbstadt, M.D., R.D., C.D.E., a spokesperson for the American Dietetic Association (ADA). If blood sugar jumps after you eat an
artificially sweetened food, the culprit may be other ingredients in
the food, such as caffeine, carbohydrates, or protein. Even stress
can hike blood sugar.
Reduced-calorie sweeteners. These sweeteners are known as sugar alcohols,
even though they contain no alcohol. Although they are made by chemically altering natural sugar, they are metabolized very differently. They do
contain carbohydrates and some calories, although less than real sugar.
They are found primarily in packaged foods such as cookies, gum, and
candy. Reduced-calorie sweeteners include sorbitol, mannitol, lactitiol, maltitol, xylitol, isomalt, erythritol, and hydrogenated starch
hydrolysates.
Sugar alcohols do raise blood sugar, and the American Diabetes Association recommends subtracting half of the sugar alcohol grams when you compute
a food's total carbohydrate count. For example, if a cereal bar has
6 grams of sugar alcohol and a total of 15 grams of carbohydrates,
you would count it as 12 grams of carbohydrates (15 - 3 = 12).
Are they safe?
The Food and Drug Administration considers these artificial sweeteners
safe. In the past, saccharin was believed to cause bladder cancer, but
further research determined that it poses no danger for humans.
Aspartame has been accused of causing headaches. However, there are no
reliable studies that prove this claim. The only people who are advised
to avoid aspartame completely are those with a rare inherited disorder
called PKU (phenylketonuria).
As with any foods, moderation is the best policy when it comes to
artificial sweeteners, says Gerbstadt. "A diet excessively high in
foods with artificial sweeteners tends to leave less room for vegetables,
whole grains, protein-rich foods, and the judicious use of fruits."
There's also the issue of training your palate to need less sweetness
in foods; if you artificially sweeten everything, you won't ever learn
to like things unsweetened.
Artificial sweeteners aren't for everyone, says Amy Jamieson-Petonic,
R.D., an ADA spokesperson. "Some people have trouble tolerating them,"
she says. For example, sugar alcohols "may cause gastrointestinal
side-effects such as bloating, flatulence, or diarrhea." If you find
that a particular sweetener bothers you, avoid it and try using a
different one.
As you decide what artificially sweetened foods to include in your
diet, remember that food labels claiming a food is sugar-free can
be misleading. "Sugar-free" doesn't necessarily mean calorie-free
or carbohydrate-free — these foods may still have significant
amounts of carbohydrates and calories, either because they are
sweetened with sugar alcohols or other non-sugar sweeteners or
because they contain other high-carbohydrate ingredients. Pay
attention to the total carbohydrate content listed on the food
label.
Alternatives to artificial sweeteners
You may want to try other diabetes-friendly sweeteners, such as:
* Agave nectar: This natural sweetener, which comes from the agave
plant, is much sweeter than sugar, so a little goes a long way. Many
people find it has a smaller impact on blood sugar than other
sweeteners. It does contain carbohydrates, however, so try it and
test vigilantly afterward.
* Stevia: This naturally sweet herb, which does not raise blood sugar
levels, cannot be sold in the U.S. as a sweetener because it has not
been declared safe by the FDA. But it is available as an herbal
supplement in health food stores.
* Natural flavorings. Very small amounts of flavorings such as vanilla
extract, almond extract, lemon, lime, or cinnamon can add flavor to
unsweetened foods and give the impression of sweetness.
SOURCES:
U.S. Food and Drug Administration FDA Consumer Magazine article: Artificial Sweeteners: No Calories … Sweet! July-August 2006. (Accessed 5/2/2008).
U.S. Food and Drug Administration FDA Consumer Magazine. November-December 1999, revised December 2004 and February 2006. Sugar Substitutes: Americans Opt for Sweetness and Lite. (Accessed 12/7/07).
National Cancer Institute factsheet: Artificial Sweeteners and Cancer: Questions and Answers. (Acessed 12/7/07).
American Diabetes Association article, "Sweeteners and Desserts." (Accessed 12/7/07).
American Dietetic Association position statement. Use of Nutritive and Nonnutritive Sweeteners. (Accessed 12/20/07).
MayoClinic.com article. Artificial sweeteners: Any affect on blood sugar? (Accessed 12/17/07).
E-mail message. Gerbstadt, Christine. Message to the author, 12/17/07 and 5/2/08.
E-mail message. Jamieson-Petonic, Amy. Message to the author, 12/20/07.
Last Modified Date: June 3, 2008
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