Sugar substitutes should be used in moderation, experts say

Contra Costa Times (MCT) - Robert Steiner of Pleasant Hill, Calif., manages his weight and general health by limiting his sugar consumption. As such, he's used sugar substitutes for years to sweeten his yogurt, cereal and coffee. First it was saccharin, which he found a bit sickening, he says. So he was glad when aspartame, and, later, sucralose, hit the market.

Trouble is, he feels that none of them tastes like sugar.

"Real sugar has a distinctive taste that I like," says Steiner, who mixes sucralose with sugar, partially losing the low-calorie benefit. "So if a sweetener that tastes like sugar but lacks its calories comes on the market, I'll buy it."

That time may be now. Last month, the Food and Drug Administration approved stevia, a zero-calorie sweetener derived from a Paraguayan plant, as a food additive. The sugar substitute goes by the brand name Truvia from the Coca-Cola Co. and PureVia from PepsiCo. Both companies are rolling out beverages now. The sweet part, rebiana, comes from the stevia's leaves and has been used as a sweetener in Asia for years. Here in the United States, however, stevia was classified as a supplement and confined to the shelves of health food stores. All of that is about to change.

Of larger concern to consumers and nutritionists is the abuse of sugar substitutes, and the evolution of the candy-colored packets. According to a Mintel report, 87 percent of Americans use sugar substitutes, and 60 percent of them are concerned about the safety of sweeteners. Saccharin, found in Sweet'N Low, was discovered in 1879 by researchers at Johns Hopkins University. It was intended for diabetics to sweeten foods and beverages without the glucose reaction associated with sugar. Still, its use was fairly limited until the two World Wars, when sugar rationing created a tremendous need for a substitute.

The pink packet delivered. And, by the fad-diet-and-exercise-crazes of the 1980s and '90s, blue and yellow versions followed. Today, sucralose, which is in Splenda, comes in bulk for baking. There are even fiber-fortified versions. And, for Coke and Pepsi, the idea of billing a diet soda as "natural" is surely a marketing dream.

SAFE, NOT, SAFE, NOT, SAFE

But since their inception, sugar substitutes, including saccharin and aspartame, which is in Equal and NutraSweet, have been linked and unlinked by the FDA to many serious health problems, including cancer. Saccharin was first listed as a carcinogen in 1981 but was removed in 2000 because the cancerous bladder tumors it caused in rats was found to not apply in humans. Still, for every study pegging a malady to sweeteners, there are studies proving sweeteners are healthful in moderation. The FDA even approves adequate daily intake for sugar substitutes.

The ADI is the maximum amount considered safe to eat each day during one's lifetime. ADIs are intended to be 100 times less than the smallest amount that might cause health concerns. For instance, a person weighing 150 pounds (68 kilograms) should not consume more than six cans of diet soda containing sucralose per day (go to www.fda.gov for a complete list).

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When it comes to sweeteners, dietitian Nora Norback of Kaiser Permanente in Richmond, Calif., believes we've strayed too far off the sugar path, especially since two-thirds of the United States population is considered overweight. Diets high in refined sugars are partly to blame.

"It's great that there are sugar alternatives out there, but the American Dietetic Association's position is that consumers use these products in moderation," Norback says. "It's the total diet that makes the difference. And natural does not mean healthy."

Furthermore, years of consuming sugar substitutes has done nothing to curb diabetes, Norback says. In fact, according to the American Diabetes Association, the incidence of diabetes has increased from 6.5 percent of the population in 1998 to 7.8 percent today. Diabetes involves a host of other factors, but it's clear that our relationship with sweet has gotten a little exploited, Norback says.

While she might recommend sugar substitutes for diabetics or those who need to cut calories, Norback's biggest message is for people to change the relationship they have with sweets. "Evolutionwise, that sweet taste has had a good association, from breast milk to fruit. But it's been so exploited that we think everything has to taste sweet."

LOOK TO NATURE

The solution, she says, is that we need to learn to like food the way nature intended again. In other words, don't sprinkle artificial sweeteners on your fruit. It's already sweet. Or, if you put sweetener on your yogurt because it's too tart, shop around for a milder yogurt, Norback says. Coffee too bitter? Find a weaker brand instead of adding four packets of sucralose, which is 600 times sweeter than sugar.

Still, it's hard to live without a little sweetness. Pam Roosma of Lodi, Calif., has been using the NowFoods brand of stevia since 2005 in her coffee, tea and fruit smoothies as way to watch her weight. "I use it because it's natural," she says. "I drank Diet Coke every day for 10 years, and once I got off the aspartame, all the floaters in my eyes disappeared."

Five years ago, Susan Stafford of Orinda, Calif., ended her relationship with sugar substitutes for good. She had problems with her ears that she and her doctor at least partially attributed to fake sweeteners.

Stafford used two packets of Sweet'N Low in her morning coffee for the better part of the 1980s. When her doctor urged her to stop, she saw a food allergist in the 1990s who suggested she try stevia. She found the taste dreadful, she says. Finally, in 2003, she weaned herself off refined sugar for good. She says she's felt great as a result.

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"When I do want something I put a tiny dab of brown sugar in my coffee and call it a day," she says.

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© 2009, Contra Costa Times (Walnut Creek, Calif.).