Diabetes Self-Management Blog

Last week I started to take another look at the various nonnutritive sweeteners that are available on the market.

Sweeteners, in general, tend to be shrouded with a cloud of controversy: on the one hand, people are concerned about “artificial” chemicals use in foods and beverages. On the other hand, sugar and other nutritive sweeteners are also perceived as being “bad,” containing empty calories and wreaking havoc with our weight, our teeth, and our blood glucose.

Yet a desire for sugar is somehow ingrained in humans. Sugar, despite all of its shortcomings, can make us feel happy due to its effects on brain chemistry (how many people do you know who reach for a celery stick when they’re upset?). So is there a sweetener out there that tastes good and makes us happy, but that isn’t fattening and doesn’t cause cavities and other possible health problems? Let’s keep looking.

  • Acesulfame-K (Sweet One, Sunnett). Also called acesulfame potassium, this sweetener was discovered in 1967 and approved by the FDA for use in 1988. It’s 200 times sweeter than sugar and chemically is similar to saccharin. Acesulfame-K holds up to heat very well, making it suitable for use in baked goods and beverages, as well as candy, soft drinks, desserts, and pudding. Also, this sweetener tends to have a “clean” taste, unlike some other sweeteners that can leave an aftertaste. It’s often used along with other nonnutritive sweeteners in products. It has no effect on blood glucose or blood lipid levels. More than 90 studies have demonstrated its safety and there have been no known documented health effects. The ADI (acceptable daily intake) for acesulfame-K is 15 milligrams (mg) per kilogram (kg) of body weight.

    One of the controversies surrounding acesulfame-K has to do with methylene chloride. This chemical is a carcinogen and is used as a solvent when making the sweetener (methylene chloride is also used to decaffeinate coffee, strip paint, and act as a propellant!). Long-term exposure to methylene chloride can cause kidney and liver damage, headaches, central nervous system depression, confusion, and cancer. The FDA has noted that based on submitted data, no detectable levels of this chemical could be found in acesulfame-K, and the agency thereby deemed it safe for consumption. The Center for Science in the Public Interest (CSPI; the organization that publishes Nutrition Action Healthletter) points out studies done in animals linking acesulfame-K to lymphomas, leukemia, and breast tumors in rats, and they have petitioned the FDA to review the data and reconsider its recommendations.

  • Sucralose (Splenda, Nevella) Sucralose made its debut in 1998 as a tabletop sweetener and was approved as a “general purpose sweetener” in 1999. This is the only nonnutritive sweetener that’s actually made from sugar (three chlorine atoms are substituted for three hydroxyl groups on the sugar molecule). Sucralose is 600 times sweeter than sugar, has no unpleasant aftertaste, and is extremely stable under heat, making it ideal for baking and cooking. It’s also been extensively studied — more than 100 studies over a 20-year period have documented its safety. More than 4500 foods and beverages contain sucralose. The ADI for sucralose is 5 mg/kg body weight.

    As with most nonnutritive sweeteners, some health concerns have arisen around this product. The Splenda Web site explains that even though sucralose is made from sugar, it’s not a natural substance. And claims (albeit unfounded) abound that sucralose, along with other nonnutritive sweeteners, may be to blame for weight gain, multiple sclerosis, lupus, diabetes, and more. Yet, there are no studies that support these claims. The concern surrounding sucralose’s safety has to do with the fact that it contains chlorine. However, chlorine is an electrolyte that is needed in the body to help maintain fluid balance. And it’s found in many foods that we eat (including salt — hence the term sodium chloride). Sucralose isn’t absorbed or metabolized by the body, and it doesn’t accumulate in fatty tissue. CSPI deems sucralose to be safe (and they’re very particular about food additives!).

  • Neotame. Although approved by the FDA in 2002, this sweetener is relatively unknown because it hasn’t been used extensively yet in foods and beverages. It’s actually made from the same two amino acids that make up aspartame (aspartic acid and phenylalanine), but it’s not broken down in the body the same way as aspartame. Neotame is extremely sweet (about 8,000 times sweeter than sugar) so obviously only a little bit is needed to sweeten things up. More than 130 studies have confirmed its safety. The ADI for neotame is 2 mg/kg body weight. So far, there doesn’t seem to be any adverse effects from neotame. Perhaps we’ll learn more if and when it’s used more widely.
  • More on sweeteners next week, including a look at stevia!

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Nonnutritive Sweeteners: Help or Hindrance? (Part 1)
Nonnutritive Sweeteners: Help or Hindrance? (Part 2)
Nonnutritive Sweeteners: Help or Hindrance? (Part 3)
Nonnutritive Sweeteners: Help or Hindrance? (Part 4)
Nonnutritive Sweeteners: Help or Hindrance? (Part 5)
Nonnutritive Sweeteners: Help or Hindrance? (Part 6)

  1. I am assuming you really meant to say Chloride, the electrolyte, and not Chlorine the chemical used in pools and as a gas.

    Posted by Denise |
  2. Yes, thanks Denise. Chlorine is primarily found in nature as the chloride ion, or electrolyte.

    Posted by acampbell |
  3. Very informative! I look forward to additional discussion. The use of Agave Nectare has recently made headlines as not being diabetic friendly, although there are many people who substitute it in for other forms of sugar. I hope this ingredient will be covered, as well.

    Posted by Liz Anderson |
  4. As you next talk about stevia, I am also particularly interested in Truvia and it’s additives. The volume per packet was surprisingly large. (I think there is sugar-alcohol? too) Truvia is sold as a sweetener, and not a dietary supplement. Thank you.

    Posted by Brett |
  5. Amy, Denise - technically you are both correct. Chlorine (chemical symbol Cl) is the chemical name of the element, and at the “standard temperature and pressure” (STP) of 0° C and 1 atmosphere, it is gaseous.

    Cl is found in both table salt (NaCl) and sodium or calcium hypochlorite (NaClO or KClO) are, respectively, used to disinfect city water supplies and swimming pools.

    In its gaseous form it is highly toxic, but the sodium or potassium salt form is not toxic to humans in moderate quantities.

    Sorry, my chemistry teacher alter-ego just shows up sometimes. :-)

    Posted by Sam |
  6. I am also curious about mixed statements re: Agave. And would like your thoughts on Stevia vs artificial sweetners.

    Posted by Fay Lambie |
  7. There is an all natural sweetener named Susta that claims benefits over artificial sweeteners. Can you report on it also?

    Posted by Terry Linduski |
  8. What is the truth about Truvia?? Stevia??

    Posted by Susan Burns |
  9. Thanks, Sam. I appreciate it, as I’m afraid my chemistry expertise isn’t quite what it used to be!

    Posted by acampbell |
  10. Thank you. I agree to a great extent what you have stated above on artificial sweeteners. I am using one artificial sweetner by name ” Sweetex” ( without knowing its chemistry or the name of manufcturer) purchased in Tesco in London during the past two years. I am able to maintain my blood glucose level fairly under control without any side effects so far. I personally feel more studies are required to have conclusive opinion on artificial sweetners and their useful or harmful effects on human body.
    G V Rao

    Posted by Dr. G V Rao |
  11. Do you know about luo han.It’s a great sweetner and has been around for hundreds of years. It’s a Chinese herb and doesn’t raise blood sugar.

    Posted by angela |
  12. When I was first diagnosed with diabetes, I kept a journal of what I ate and what made my sugar jump. Saccarin had the same effect on my blook sugar count as sugar. Splenda had no effect on my blood sugar counts either bringing it up or down. I have been experimenting with growning stevia, but didn’t know how to use it from the plant. I have tried the kind that comes in a packet and like it but have not experimented on how it effects my sugar.

    Posted by Judy Knight |
  13. How about NutraTaste zero calorie sweetener. Thats what I use. Don’t tell me they are not all alike. Are you just selling the brand names?

    Posted by Carolyn Rountree |
  14. Hi Carolyn,

    I don’t sell anything, and I don’t endorse one particular sweetener over another. And no, not all sweeteners are alike, which is why I’ve been writing about them! However, NutraTaste is aspartame, so pretty much it’s the same as NutraSweet or Equal. Many grocery stores even have aspartame marketed under their store brand, so it’s difficult to list every possible sweetener. My purpose was to list the most commonly known brand names of sweeteners.

    Posted by acampbell |
  15. Does Sacharin in the pink packets cause a rise in blood sugar? If sacharin is really non-nutrient then it would not cause such a rise. Most of us get the pink packet in diners and restaurants when we order coffee or tea. Is using it a mistake? Please advise as the pink packets are probably the most used ‘non-nutrient’ product in the USA. Need to know to save my life!! (You know you can try to eat right but the dishonesty in advertising and even government sponsored media makes it all but impossible to really know what is scientific. I just read that a prominent Ph.D professor at one of our major colleges was caught falsifying data on a science project! The public needs an Ombudsman. The FDA is crooked and a joke.)

    Posted by tootie schirmer |
  16. Several of my friends and I now avoid Splenda due to significant flatulence it causes. I’ve discovered Xylitol, in addition to Stevia, and have read about Erythritol (I believe that’s the spelling). I hope you’ll include info about these in the future. Thanks for this series. It’s most helpful!

    Posted by Nana |
  17. Thank you for your articles.
    They are succinct, supported by evidence, and informative.
    Judi Bjork, DNP, FNP/CDE

    Posted by judi bjork |
  18. My wife is so sensitive to artificial sweetners that she became ill when the mfg of her toothpaste started useing aspartame. It took us 3 days to finally figure out where she was getting it from.
    5 years ago my wife was diagnosed with Lupis. I went online to see what I could do to help her. By accident I found a site explaining artificial (poison)sweetners and it’s effects. My wife stopped her intake of artificial sweetners, and within three weeks was fine. Three weeks from going on disability to perfectly healthy. I am the diabetic, but sugar, with moderation, works just fine.
    Just because the big money behind artificial sweetners supress studies, don’t be fooled, this stuff is poison.

    Posted by John Lee |
  19. Isee you have not talked about Stevia and Turvia. What do they say about these as a sugar substitue?

    Posted by Dean |
  20. Hi Dean,

    Look for my new posting this week where I discuss stevia-based sweeteners (this is a two-part series).

    Posted by acampbell |
  21. Thank you, Judi, for your feedback. I’m glad you’ve found my postings to be helpful!

    Posted by acampbell |
  22. I found your articles on sweetners to be very informative. Am I correct in thinking based on your review of Splenda that although it is derived from sugar that it does not act like sugar in the body, i.e. causing weight gain because it is not metabolized by the body?

    Can you also discuss Agave Nectar which some of the cooking show hosts are using/suggesting stating that it does not affect blood sugar?


    Posted by Sjones |
  23. Hi

    I read a while ago that aspartame was very similar in chemical structure to regular sugar, which is how it is able to fool the tongue. The author suggested that aspartame consumption actually increases insulin production, as it ability to fool the tongue somehow neuropathically transmits this information to the pancreas, which then produces more insulin in anticipation of sugar. This overproduction of insulin, according to the writer, would then lead to the gradual stressing out of the pancreas and its evenual diminished ability to produce insulin at all.

    Consequently, I’m wondering what studies have been done on artifical sweeteners and subsequent insulin production. Although they do not contain sugar, it seems that all of them these somehow “trick” the tongue into thinking that sugar is being consumed.

    Thank you,

    Posted by Regina |
  24. Splenda doesn’t cause gas - you have to look at all the sweeteners on the label. Usually you will see more than one - sorbitol, xylitol, mannitol, maltitol - sugar alcohols - they raise blood sugar in diabetics and cause terrible gas and diarrhea. I really don’t understand why they have to use those - it’s not necessary. Even read the labels of splenda and aspartame and it’s mixed with something that raises blood sugar - maltodextrine - it’s a glucose. Stevia is by far the best - but make sure that’s all you are getting - not mixed. I’ve witnessed MANY bad effects with aspartame and won’t put it in MY body. Not good for the nerves and as diabetics you have to do everything you can to keep your nerves healthy. Japan has used stevia for 40 years and Indians have used it for centuries, but the the powers that be didn’t want it in this counrty - it would interfere with their profits - how sad.

    Posted by Marge Niren |
  25. There seems to be a large number of people that claim Neotame is incredibly bad for your health due to its intense sweetness and the way the body breaks it down. Is there any validity to claims like the ones made here:


    Posted by Kyle L. |

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