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Diabetes Special Report

Comparing Non-Caloric Sweeteners

Johns Hopkins Health Alerts Diabetes Comparing Non-Caloric Sweeteners

If you have diabetes, here’s important information about the six FDA-approved or recognized sweeteners as well as stevia, which is considered a food supplement.

Non-caloric sweeteners, which are found in such foods as soft drinks, frozen desserts, yogurt, cookies, candy, and gum, can be valuable for people with diabetes. Unlike sucrose (sugar), which has 15 calories per teaspoon, these products add sweetness and flavor without calories.

The American Diabetes Association considers FDA-approved non-caloric sweeteners to be safe for people with diabetes and refers to them as free foods because they do not raise blood glucose levels. However, many artificially sweetened foods and beverages do contain other sources of calories and are not nutritious, and some people fill up on them rather than on healthful foods. People with diabetes also need to look at the other nutritional aspects of sugar-free foods, which can be loaded with calories and carbohydrates despite the use of non-caloric sweeteners.

Putting Safety Concerns to Rest

Over the years, questions have arisen regarding the safety of non-caloric sweeteners. Cyclamates, once a popular sugar substitute, was banned by the U.S. Food and Drug Administration (FDA) several decades ago owing to an associated increase in the risk of cancer. In addition, because large amounts of saccharin caused bladder cancer in rats, it was suspected of causing cancer in humans. More recent studies, however, have not borne out this concern. In fact, current evidence indicates that all the available non-caloric sweeteners are safe for human consumption. Before a non-caloric sweetener is deemed safe and made available to consumers as a food ingredient, it must undergo rigorous investigation by the FDA. The FDA regularly monitors safety information on non-caloric sweeteners and may take action to protect the public if credible scientific evidence indicates a safety problem.

Cooking and Baking

In addition to sweetening coffee or tea, most non-caloric sweeteners can be used in recipes for people with diabetes. Many sugar substitutes are suitable for use in home cooking and baking because they don’t degrade at high temperatures, although using them may affect a food’s taste and texture. Aspartame tends to lose sweetness at high temperatures, so it should be added during the last few minutes of heating or cooking. When you substitute a non-caloric sweetener for sugar in a recipe, you will need to experiment with small amounts of the sugar substitute (since most of them are so much sweeter than sugar) to get the right amount of sweetness. Make sure to read labels carefully to achieve the best results, or visit the manufacturer’s web site.

Other Sugar Substitutes for People with Diabetes

Be careful when reading nutrition labels—sugar isn’t the only sweetener that contains calories. Fructose, known as fruit sugar, is found naturally in fruits, vegetables, honey, sugar cane, and sugar beets. Fruit sugar has a smaller effect than sucrose on blood glucose levels, but it still contains calories. The sugar alcohols sorbitol, xylitol, lactitol, mannitol, and maltitol are absorbed by the body more slowly than sucrose. But they do contain calories, will raise blood glucose, and can cause diarrhea and other gastrointestinal problems when consumed in large quantities.

Popular Non-Caloric Sweeteners for People with Diabetes:

  • Acesulfame potassium -- Sunett, Sweet One: Used in baked goods; frozen desserts; candies; beverages. Comments: FDA-approved. Is 200 times sweeter than sugar and is often blended with other artificial sweeteners to resemble more closely the taste of sugar.
  • Aspartame -- Equal (when used as a tabletop sweetener), NutraSweet (when used in food and beverage products): Used in tabletop sweeteners; diet beverages; breakfast cereals; desserts; chewing gum. Comments: FDA-approved. Is 160 to 220 times sweeter than sugar. Has a very small effect on blood glucose. Should not be used by people with phenylketonuria, a rare genetic disorder.
  • Neotame -- Used in beverages, such as Atkins shakes, dairy products, frozen desserts, as well as in baked goods and gums. Not available as a tabletop sweetener. Comments: FDA-approved. The most powerful sugar substitute -- 7,000 to 13,000 times sweeter than sugar.
  • Saccharin -- Sweet ’N Low: Used in tabletop sweeteners; diet sodas; baked goods. Comments: FDA-approved. Is 200 to 700 times sweeter than sugar. A cancer-related warning label was removed in 2000 after the FDA determined that it was safe.
  • Sucralose – Splenda: Used in baked goods; sodas; chewing gum; frozen dairy desserts; fruit juices; gelatins. Comments: FDA-approved. Is 600 times sweeter than sugar. The only artificial sweetener made from sugar.
  • Stevia -- Sweet Leaf, Honey Leaf: Often combined with fiber and sold as a supplement; cannot be promoted as a sweetener. Comments: Sold as a dietary supplement; not subject to regulation by the FDA. Ask you doctor before using.
  • Tagatose – Naturlose: So far used only in 7-Eleven’s Diet Pepsi Slurpees; may soon be used in other products. Comments: Has “generally recognized as safe” status from the FDA.

  • For more Diabetes articles, please visit the Diabetes Topic Page


    Posted in Diabetes on March 22, 2007
    Reviewed March 2010

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