Sweeteners - sugar substitutes
Sugar substitutes are substances that are used in place of sweeteners with sugar (sucrose) or sugar alcohols. They may also be called artificial sweeteners, non-nutritive sweeteners (NNS), and noncaloric sweeteners.
High-intensity sweeteners; Non-nutritive sweeteners - (NNS); Nutritive sweeteners; Noncaloric sweeteners; Sugar alternatives
Sugar substitutes may be helpful for people trying to lose weight. They provide sweetness to foods and drinks without adding a lot of extra calories. Most sugar substitutes contain almost no calories.
Using sugar substitutes in place of sugar can help prevent dental decay. They also may help with blood sugar control in people with diabetes.
Sugar substitutes can be added to food when you eat. Most can also be used during cooking and baking. Most "sugar-free" or low-calorie food products you buy at the store are made using sugar substitutes.
Commonly used sugar substitutes include:
Aspartame (Equal and NutraSweet)
Saccharin (Sweet 'N Low, Sweet Twin, NectaSweet)
Stevia (Truvia, Pure Via, Sun Crystals)
Acesulfame K (Sunett and Sweet One)
Monk Fruit (Luo Han Guo)
People often have questions about the safety and health effects of sugar substitutes. Many studies have been done on FDA-approved sugar substitutes, and they have been shown to be safe. Based on these studies, the FDA states they are safe for use for the general population.
Aspartame is not recommended for people with phenylketonuria (PKU). Their body is unable to break down one of the amino acids used to make aspartame.
There is little evidence to support the use of or avoidance of sugar substitutes during pregnancy. FDA-approved sweeteners are fine to use in moderation. However, the American Medical Association suggests avoiding saccharin during pregnancy due to possible slow fetal clearance.
The FDA regulates all sugar substitutes that are sold or used in prepared foods in the United States. The FDA has set an acceptable daily intake (ADI). This is the amount that can be safely eaten each day over a person's lifetime. Most people eat far less than the ADI.
In 2012, the American Heart Association and the American Diabetes Association published a report that concluded that sensible use of sugar substitutes could help lower caloric and carbohydrate intake. Further research is still needed. There is also not enough evidence at this time to determine if sugar substitute use leads to weight loss or lower heart disease risk.
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National Cancer Institute website. Artificial sweeteners and cancer. www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet. Updated August 10, 2016. Accessed October 16, 2017.
US Department of Health and Human Services and US Department of Agriculture website. 2015-2020 Dietary Guidelines for Americans. 8th Edition. health.gov/dietaryguidelines/2015/resources/2015-2020_Dietary_Guidelines.pdf. Updated December 2015. Accessed October 16, 2017.
US Food and Drug Administration website. High-intensity sweeteners. www.fda.gov/food/food-additives-petitions/high-intensity-sweeteners. Updated December 19, 2017. Accessed February 12, 2018.
US Food and Drug Administration website. Additional information about high-intensity sweeteners permitted for use in food in the United States. www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397725.htm. Updated February 8, 2018. Accessed February 12, 2018.
Wiebe N, Padwal R, Field C, Marks S, Jacobs R, Tonelli M. A systematic review on the effect of sweeteners on glycemic response and clinically relevant outcomes. BMC Med. 2011;9:123. PMID: 22093544 www.ncbi.nlm.nih.gov/pubmed/22093544.
Review Date: 7/10/2017
Reviewed By: Emily Wax, RD, The Brooklyn Hospital Center, Brooklyn, NY. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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