Saturday, March 7, 2009

Sweet and Sweeter

In the old days, when people with diabetes wanted to add sweetener to their food or drink, they had a choice of saccharin, saccharin, or saccharin.

Gradually new sweeteners, including Acesulfame K, cyclamate, and aspartame were added to the pot. Cyclamate was later prohibited in the United States, although it continued to be sold in Canada, because a study suggested that it increased cancer rates in rodents.

Saccharin was also reported to increase cancer rates in rodents when used in huge quantities, but it remained on the market. Many people said they had problems when they used aspartame; others said it didn’t bother them. Aspartame does break down when it is heated and isn’t recommended for cooking.

More recently, sucralose, marketed as Splenda, was added to the repertoire. And stevia, which comes from a South American plant, has been used as a sweetener although it wasn’t approved for such use in the United States and was sold instead as a “supplement” in the vitamin sections of stores. It has been used as a sweetener in Japan for some time.

You can also add a sweet taste with sugar alcohols, which are metabolized differently from regular sugars. Most of them reach the colon undigested, and bacteria in the colon digest them and produce gas, which you (and your friends) may notice if you eat a lot of these sugars. They are also good laxatives.

The names of the sugar alcohols end with “itol,” as in maltitol, lactitol, sorbitol, xylitol. Some people find these sugar alcohols don’t make their blood glucose (BG) levels go up very much; others say they do. It depends on your personal metabolism.

Unfortunately, maltitol, the sugar alcohol that is used most commonly in “sugarfree” products like candies, consists of 50% glucose, so it will raise the BG levels in most people as much as table sugar (sucrose), which is also 50% glucose.

The sugar alcohol erythritol is a little different from the others. Instead of going through the intestine undigested, much of it is absorbed into the bloodstream and then excreted unchanged by the kidneys. For this reason, it does not cause gas like the other sugar alcohols, and it has fewer calories.

I’ve described all these sugars in more detail in my book The First Year Type 2 Diabetes, and I won’t repeat that information here. Instead I’ll focus on a few of the newer sweeteners.

I never used much Splenda, primarily because it was all “cut” with maltodextrin (which is a carbohydrate made of glucose that is digested to glucose and makes your blood glucose [BG] levels increase just like starch) or glucose (listed as “dextrose” on the individual packets), or both. I did use it for a few weeks in the summer when my raspberry bushes were bearing to beat the band, as I consider it sinful to leave fresh raspberries uneaten. Uncut sweeteners like stevia are difficult to sprinkle evenly on the berries.

But now, Splenda has come out in a new formulation emphasizing fiber. Instead of maltodextrin, they’re using soluble corn fiber as a “bulking agent.” This is good news for all of us, because not only are we no longer required to add glucose or maltodextrin with the sweetener, but soluble fiber also helps keep BG levels down. Each packet contains 1 g of corn fiber.

And in 2008, the FDA began approving stevia products as GRAS (generally recognized as safe) when used as sweeteners if the manufacturers provided research results showing their safety. And a lot of manufacturers have jumped on the stevia bandwagon.

Two big boys on the sugar shelf are products combining stevia extracts with erythritol. The major new ones are made by Cargill for Coca Cola (Truvia) and the Whole Earth Sweetener Company for Pepsi Cola (Purevia). I found both these products at a grocery store in the small town where I shop.

Truvia contains only erythritol, stevia extract (rebiana), and “natural flavors,” which they don’t indicate. Purevia contains erythritol, stevia extract (which they call Reb A), isomaltulose , a little cellulose, and “natural flavors,” which they also don’t indicate. Truvia seemed a little sweeter to me, but they’re both basically the same except that Truvia doesn’t contain the isomaltulose.

Isomaltulose is made from sucrose (table sugar) and has the same number of calories. It is digested in the intestine to produce glucose and fructose, but the digestion is slower than that of sucrose, which also produces glucose and fructose, so it should have a lower glycemic index.

Some time ago I bought a similar erythritol/stevia combination (Stevita) at a local health food store. At the time, it was marketed as a “dietary supplement.”

And another stevia product, Sweet Leaf, has been on the shelves for some time. This one isn’t cut with erythritol, but with with inulin, a fiber.

Inulin is a polymer of fructose found in Jerusalem artichokes, and, like the sugar alcohols, it isn’t digested until it reaches the colon. There bacteria can break it down to release gas. It is said to stimulate the growth of “good” bacteria in the colon and some people supplement with it for that reason. Although it is made up of fructose, it doesn’t increase triglycerides as fructose does.

For some time, I’ve used the KAL brand of uncut stevia. I like it because it comes with tiny spoons that are the equivalent of 1 tsp of regular sugar. I find it sweeter than other brands of pure stevia I tried, so I need to use less. Like many other fake sugars, it becomes bitter when you use too much, so you have to be careful, but I’ve had good success with it.

Some people say they get an oregano taste when they eat stevia. I’ve found that with the unpurified stevia leaves, but not with the purified forms. But every manufacturer may purify the stevia extract slightly differently so the resulting product contains slightly different things. To me, different brands of stevia have different levels of sweetness. One kind I got in bulk at my local Coop was cheaper than the KAL brand, but about half as sweet, so I needed to use twice as much and it ended up being more expensive.

One problem with any of the supersweet sugar substitutes becomes apparent when you make a product like ice cream, which relies on the sugar to lower the freezing point as well as to sweeten. Because you use so little stevia or sucralose or saccharin if you use those to make ice cream, you end up with something that is brick hard when you put it into the freezer.

Erythritol works like sugar in this respect. I made some ice cream with pure erythritol, and it was soft and creamy even after being frozen for several days. Success at last! The new erythritol/stevia blends may work almost as well as the pure erythritol, perhaps less because the sweet stevia means you use less of the erythritol. Time will tell.

Unfortunately, erythritol is expensive. A pound of table sugar costs about $1 at the supermarket. A pound of erythritol costs about $9, a little less on the Internet, but then you also pay high shipping costs.

Another sugar that would act like table sugar for cooking is tagatose. It would also brown when cooked, like table sugar. However, the one manufacturer of tagatose decided to stop production after a short time, saying there wasn’t sufficient market for the product.

People will argue until the cows come home about which sweetener tastes the best and is the safest. Some people seem to be allergic to aspartame, for example, and others aren’t. We really won’t know the long-term effects of any of these sweeteners until they’ve been on the market for a long time. In that respect, saccharin, which has been sold for many decades, probably has the best record.

What is nice about these new products is that they give us more choice to find a sweetener that works for us. Read labels before you buy any sweetener so you know exactly what you’re buying. If you’re on a high-carbohydrate diet, the 1 g of glucose in a packet of sweetener won’t make much difference, but if you’re on a very low carb diet it could.

I think I’ll stick to pure stevia for now, but the erythritol products may be useful when I want to make my own sugarfree ice cream. I hear rumors that summer is just around the corner, and the occasional dish of homemade ice cream is pretty appealing when the weather is hot.


  1. Gretchen,

    I enjoy your blog posts in healthcentral and when I read the concise version of this post there, I was lead to this blog. Good to know that you have a blog and hopefully you will write more often.

    Good to read about the many sugar options that T2 Diabetics have. Some 3 months back, I remember there was a study that was done on what effect if such sugars have on the body and then the study recommended that artificial sweeteners are safe. Do you by any chance know who funded that study - is it the artificial sweeteners companies? What is your take on the study?

    Thanks for your reply and time.


  2. Venkat, I think the safety issue is more important when one is consuming huge amounts of sugarfree sodas every day, as some people do. Less so when one has the occasional sweet treat.

    All our food today contains some artificial chemicals.

    There have been many studies of sweetener safety. If you provide the URL of the one you're speaking of, I'll take a look at it

  3. Thanks Gretchen. The sweetener study url is this

    Also, when you reply to this comment, I do not receive any email. Is that something you have to configure?

    Thanks for your time and advise.



  4. From the Abstract, it sounds as if they didn't really find anything new. This seems to be a review, not a research study. It sounds as if it's only if you drink a lot of sodas with no food along with them that there *might* be a problem, and most of the Abstract raises issues and then says there's no evidence for them. It concludes that resolution of the problems require more study.

    The Abstract doesn't mention safety, and they say reprints are not available.

    As for getting e-mail, I'm new at this. Maybe you need to hit "Subscribe by email."

  5. A most illuminating discourse on sweeteners. Thanks!

  6. Thanks for the reply Gretchen.


  7. Gretchen,

    Recently when I was talking to one of my friend about the virtues of Low Carb diet, he forwarded me this link which says “Good and bad things” about ketosis. Especially one of the referred link says that long term Ketosis is bad for kidneys.

    Though I was not much worried about the Ketosis before, I am not sure if I feel about it the same way now. I am sure you would have done extensive research on this one. Can you please share your thoughts on this one?

    Thanks for your time.



  8. The author of this blog doesn't seem to me to be very well informed. I know of no credible evidence that mild ketosis harms healthy kidneys, but I haven't done exhaustive research on this, as I don't think it's a problem, just as I haven't done exhaustive research on whether or not Cheerios would cause kidney damage in the long term. Someone who didn't like Cheerios could argue that we have no evidence that they don't.

    Bernstein has been on a strict LC diet for decades and doesn't have kidney failure. There are many myths about LC diets that are disseminated by people who want us to eat a lot of carbohydrate.

    The stuff about the dangers of "high protein" diets is a lot of garbage. I'm actually eating less protein on my LC diet than I ate before, because I'm simply eating a lot less food because I'm not hungry all the time.

  9. Thanks for the comments Gretchen. It helps.


  10. Not much use for the ice-cream season, but have you tried liquid Splenda? Netrition sell it as Fiberfit; I import it from Canada, it's good enough to warrant the shipping costs... I slug some alcohol into the icecream maker :D

  11. No I haven't tried liquid sucralose. I'm happy with stevia. The alcohol didn't work for me with ice cream.

  12. Do any of these sweeteners work for making cookies? I'm trying to convert a typical high sugar & fat cookie into a much healther one that actually tastes good...maybe not possible...but I'm using natural peanut butter for the oil, egg whites and so on but can't get the sugar substitute down. Any ideas? Thanks!!

  13. Vicki, because sugar acts as a bulking agent as well as a sweetener, I think the best sweetener for cookies would be one of the newer ones that contain erythritol.

    The real problem for cookies is that they usually contain flour. But I'm sure there are a lot of LC cookie recipes on one of the LC recipe sites.

    The best way to find the best sugar substitute is to experiment until you find one that works for you. I don't like cookies a lot, so I haven't experimented in that area.

  14. Gretchen, another great piece! Thanks!

    One question about inulin. Is it the same as oligofructose? or are they different somehow? Is the chicory root source the same as the Jerusalem artichoke derivative? Are all inulin's considered prebiotic? All safe for diabetics?

    And a comment about erythritol, which I also use and enjoy; as it's a corn derivative, I'd like to figure out which of the manufacturers out there use a non GMO source, since we don't have mandatory GMO labeling.

    Lastly, I'm still in shock on how Monsanto's artificial sugar neotame can be used in organic products without it ever being listed on the label at all. I think this is important to highlight to your readers as well.

  15. Barry, Thanks. Inulin is a POLYsaccharide, meaning many fructoses in the chain. OLIGOsaccharide means several in the chain. I don't think there's a firm cutoff point at which several becomes many.

    Chicory root and Jerusalem artichoke are different plants.

    The inulin you buy might differ slightly depending on the source, the manufacturer, the method of extraction, etc. But in general, it should be about the same.

    I don't know which big manufacturers use non-GMO sources. I think that information would be difficult to find, and I don't trust any of them. I don't trust anyone anymore. I got some organic chocolate flavoring at my Coop and when I got home noticed it contains agave syrup, which is mostly fructose.

    My Coop sells agave syrup without warning people it's mostly fructose. Instead, the label reads, "Contains no high-fructose corn syrup." They also sell organic bacon with "no added nitrites." Instead, they use celery juice, which results in higher nitrite levels than adding the chemical alone. I pointed this out to the manager and haven't seen any warning signs.

    There's a lot of deception in the food industry. I read about some new sweetener but the ingredients didn't list anything that would be sweet. I consulted a flavor chemist, and he said some "flavor enhancers" contain compounds that are intensely sweet but can be listed on ingredients as flavor enhancers or flavorings and not described. I've seen glucose listed as a flavoring. That's why your best bet is always to buy real food or grow it yourself.