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  • With Mayo Clinic nutritionists

    Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

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  • June 10, 2008

    Sugar substitutes stir sweet debate

    By Jennifer Nelson, M.S., R.D. and Katherine Zeratsky, R.D.

48 comments posted

In my 30 years of practice, the number one subject that triggers the most controversy is that of low or no calorie sweeteners.

People seem to take sweeteners personally — responding in angst, argument or even anger. How can a substitute for sugar (that has a measly 16 calories per teaspoon) create such an uproar? Enter the blog! At last a medium where dialogue can reign.

What triggered my interest in discussing this subject was a study by Swithers and Davidson in the February 2008 issue of "Behavioral Neuroscience."

We know that sweet taste from sugar is a powerful trigger that prompts the mind and body to eat and to process calories. However, when the researchers fed rats a food sweetened with a no calorie sweetener — food that was actually lower in total calories — the rats actually ate more food and gained more weight than rats given sugar sweetened food that was higher in total calories. In addition to eating more of the no-calorie sweetened food, the rats also adjusted their body processes to burn fewer calories — contributing to increased body weight and fat.

They discuss the potential implications of their findings:  the increases in the numbers of Americans consuming products containing low/no calorie sweeteners from about 70 million in 1987 to about 160 million in 2000, and that low/no calorie sweeteners abound in a wide variety of foods (especially in the form of soft drinks). That the incidence of obesity has also increased dramatically during this period, from about 16 percent of the population to about 30 percent.

They also site a recent human study from the July 31, 2007, issue of "Circulation" that suggested that intake of one or more regular or diet soft drinks was associated with a greater than 50 percent incidence of metabolic syndrome (obesity, inches around the abdomen, higher fasting blood sugar and fat levels, and higher blood pressure).

Could it be that low/no-calorie sweeteners (and foods containing them) fake us into consuming and conserving more calories than if we simply eat the food that has the real (calorie-containing) sugar in it?

My take? Low/no calorie sweetened foods sometimes offer a lower calorie alternative to foods sweetened with sugar (check the label to make sure). There are studies that also show that low/no calorie sweetened foods are helpful for controlling weight. The rat study gave me pause though.

For me — I'll take sugar-sweetened items on special occasions and in moderation. We get ample "sugar" naturally from whole foods and don't need sweets every meal, every day. Safety of these low/no calorie sweeteners? I'm going to save this topic for another time.

Your take on low/no calorie sweeteners? Angst? Argument? Anger? I want to hear from you.

- Jennifer

48 comments posted

blog index

  • June 19, 2008 11:15 a.m.

    I use Stevia. It is natural and does not raise your blood sugar. You can buy it at health food stores.

    - Madia

  • June 18, 2008 10:32 p.m.

    Aftedr being diagnosed with type 2 diabetes 3 yrs ago, my Dr. told me to switch from aspartame to splenda. I've noticed that after consuming anything with splenda, I get flush attacks; similar to hot flashes. I have stopped using splenda and drinking plain water several times a day. It also curbs my appetite. My Dr. also suggested using a teaspoonful of peanut butter in my morning oatmeal instead of sugar or sub. It also adds some protein since I can't eat eggs due to the cholesterol. I seldom crave sweets anymore drinking water.

    - Beth

  • June 18, 2008 1:04 p.m.

    I read this report and stopped eating and drinking anything with artificial sweetners and/or high fructose corn syrup in it as soon as I heard. I was only having one diet soda and one "light" yogurt most days. I started to drink tea with a small amount of sugar and my yogurt the same way. My weight loss and maintanance efforts are more successful and I don't crave sweets anymore.

    - Bernadette

  • June 18, 2008 12:57 p.m.

    My reason for no-cal sweeteners is diabetes.

    - Dan

  • June 18, 2008 9:47 a.m.

    I notice that sweetners often make food too sweet, more than just sugar would. My choice of sweetner is Splenda, because I can use just a bit for the sweet tastes I crave. I agree that sweet tasting food makes me want to eat more and that is a problem. Being diabetic, it is important that I balance my meals with calories/carbs and fat in the correct amounts. Since I am not a dietician, it's hard and sometimes very frustrating. I am sure I am not alone. So sweetners are the answer for me,in extremely small amounts.

    - Helen S.

  • June 18, 2008 8:46 a.m.

    I knew there was a rat in all this sugar-sub thing...

    - Jeffrey J. Pape

  • June 18, 2008 8:31 a.m.

    I also read that study and it made me wonder... I drink about 16 oz of Coke Zero per day, use sweetener on my morning oatmeal and on fresh berries. So I started to pay attention to my cravings and realized that having that sweet aftertaste DOES trigger me to want more food.

    - Diane

  • June 18, 2008 7:10 a.m.

    I believe the only way to lose weight is really by your will power to reduce the food you eat. Using Splenda, and eating sensible has resulted in my losing, slowly, in the last 3 years 20 lbs. and maintaining it by noting how much I can eat without gaining (adjusting my intact by keeping track). Now I know the things to eat and the quantity, to keep from gaining weight. I am 74 yrs. old.

    - Joyce

  • June 18, 2008 6:08 a.m.

    I have used Equal for many, many years on cereal and in my coffee. I'm now on a weight loss plan and almost at 50#. Helps me!

    - Rita

  • June 17, 2008 11:28 p.m.

    Jennifer - I have used sugar subs for many years, and I do not have a weight problem. Maybe they just make people more hungry, but I don't believe subs cause obesity. It's self-control.

    - Raymond

  • June 17, 2008 10:13 p.m.

    I have Type 2 diabetes and have to be careful of sugar intake. I am allergic to Nutrasweet (gives me violent migraine headaches) and Saccharin, Splenda and Stevia have, to me, VERY VERY nasty aftertastes. I only use sugar in coffee and tea and, occasionally, use Sugar Twin from Canada with the sweetener sodium cyclamate, which at one time was permitted here in the US. No headaches, no aftertaste.

    - Mardi

  • June 17, 2008 8:39 p.m.

    "Angst? Argument? Anger?" All three, all the time. Am severely overweight, have been most of my life, and am always hungry sometimes physicially, always emotionally. Exercise simply holds the line at best, even while dieting. Across 6 years, eating habits really have changed toward mostly vegetables & 100-150 gms protein per day, but craving for chocolate and baked goods has not abated. I hate it!!

    - lynne

  • June 17, 2008 8:13 p.m.

    I really don't know what I feel about the sugar substitutes. I have had a weight problem probably all my life and began drinking diet soft drinks around age 11. I have PCOS, and I am insulin resistant. I have managed to lose 90 pounds after gaining 120 in 2 years -all the while using splenda and nutrasweet products. I am, though, having great difficulty losing the last 30 pounds to put me into my correct weight range. I would like to see if NOT using sugar-free products would assist me to reach my goal, but it is so much a part of my life. I do worry about going back to sugar and gaining weight. I can give up many things with artificial sweatners, but I do worry about exactly what I WOULD use on things like oatmeal, in my coffee, etc. So I just don't know what to do. Maybe cut way, way down?

    - Cathy

  • June 17, 2008 7:53 p.m.

    Doesn't it come down to a balanced diet, portion size and moderation? Due to a diabetic family member, we've succesfully changed our eating habits by consuming a wide variety of foods that contain the proper amount of carbs, protein, fat, fiber, etc....incorporating, when necessary, sugar and artificial sweeteners in moderation.

    - Larry

  • June 17, 2008 6:11 p.m.

    I know the studies disagree, but nutrasweet gives me migraines. I decided long ago that losing a few extra pounds was not worth that. I use no sugar substitute and today I'd be happy to weigh 5 pounds less than I do, but I'm pretty happy as I am too.

    - Mary

  • June 17, 2008 5:45 p.m.

    I have been trying to avoid artificial sweeteners, and have discovered agave syrup, which is native to where I live (AZ), and is lower on the glycemic index than other sweeteners. I have not been able to find a stevia product which appeals to me, so I use as little as possible of the agave syrup.

    - Katy

  • June 17, 2008 4:24 p.m.

    I am not allergic to anything except Splenda! Sucralose(Splenda) makes me very ill with the symptoms of severe stomach flu. I've heard that Splenda is the safest of the sugar substitutes--but NOT for me! I have used the other substitutes in diet soft drinks for many years. I am overweight and find this study very interesting. I am an active senior citizen with a life-long weight problem. I enjoy your newsletter, and am a Mayo patient. Thanks, Sandi

    - Sandi

  • June 13, 2008 4:50 p.m.

    I have to agree with you re the rate of obesity and the use of non-sugar sweeteners. After I started using them a lot I gained weight. Once I stopped I didn't gain anymore. When I have anything with Splenda I want more food. When I use Stevia I don't. I do eat the occasional real sugar treat and I don't crave it like I did when I was using diet soda. There is now a Stevia sweetened soda out and I like that....one can is enough. I don't want to drink the whole 6 pack like I did before of the Splenda sweetened soda.

    - Karen

  • June 13, 2008 7:31 a.m.

    My use of artificial sweeteners is limited to occasionally chewing sugarless gum. I maintain my healthy weight by following the Canada Food Guide and getting moderate exercise. I also enjoy sweets (usually chocolate or ice cream) occasionally, in small amounts. My husband, exercises as well, but takes in great quantities of aspartame and acesulfame potassium, as he drinks 2 to 3 quarts of diet coke every day. He also eats a lot in general and enjoys sweets (usually chocolate bars) daily. He is about 60 pounds overweight. I am very concerned for his health, but he won't change his ways. At least, he has low blood pressure, because he takes his bike out and cycles for at least an hour, almost every day.

    - Nelle

  • June 12, 2008 5:40 a.m.

    I don't use sugar substitutes since they started increasing my appetite. I figure the small amount of real sugar I use won't hurt me and actually curbs my appetite. Please make sure if you are diabetic, you talk to your doctor about this. I would hate to see anyone get ill from the "real" stuff, but just hate the fact we even have the "fake" and the high fructose corn syrup. BTW, I stay away from the latter one.

    - Catherine

  • June 11, 2008 8:29 a.m.

    My concern is not the sugar substitutes making me fat as what the chemicals in those sugar substitutes are doing to my organs. Equal has Phenos and Splenda causes chlorides to build up in your system. I am diabetic and I would like an indepth study of what these do to you.

    - Millie

  • June 10, 2008 5:59 p.m.

    I don't think that all sugar substitutes are bad but it is important to listen to your body. Pay attention to what happens after you consume something. For example, I cannot drink very much diet soda without feeling hungry afterwards. With that in mind, I limit my intake and only have it with a meal. I also use sugar substitute in my morning protein drink. I think that by having the substitute with other foods, my body is not sent the mixed signal of incoming calories when there are none.

    - LJCH

  • June 10, 2008 8:30 a.m.

    You're talking "sugar" but most of what I see is sweetened with "high fructose corn syrup."

    - Miranda

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