Sweeteners and diabetes is a confusing topic. Can I eat Sweeteners? Will sweeteners increase my blood sugar levels? Aren’t sweeteners bad for you? I’d rather have real sugar than sweeteners as sweeteners are artificial. .
These are some of the common questions and statements I come across when running diabetes education sessions for patients. In fairness the topic is confusing with so many nutritionists and media articles frequently writing conflicting statements.
Therefore, I thought I’d take some time to clarify my position as a diabetes specialist dietitian on sweeteners and their effect on health and particularly diabetes.
What are sweeteners
Sweeteners are added to food and drink to help enhance the flavour of sweetness often being substituted in place of sugar.
Sweeteners fall into two distinct categories:
These all contain calories and carbohydrates and therefore will have an effect on your blood glucose levels. These actually include sugars such as glucose, fructose, sucrose, honey, syrup and maltose because these help to sweeten products and therefore by definition are sweeteners.
Also in this category are sugar alcohols known as polyols. These include sweeteners such as erythritol, isomalt, maltitol, mannitol, sorbitol and xylitol. These also contain carbohydrates but less than full sugar alternatives. Classic uses for these sweeteners are in chewing gums and diabetic foods.
Diabetes specialists and Diabetes UK currently do not recommend using diabetic foods to help manage diabetes. This is because they still have an effect on blood glucose levels and also can have a laxative effect causing flatulence, diarrhoea and bloating. Furthermore, diabetes products can have a higher calorie content than their non diabetic product counterparts.
It is still not clear how those counting carbohydrate should adjust their insulin for polyols because not all of the carbohydrate is absorbed.
Non – Nutritive Sweeteners
When thinking about sweeteners these are the ones more commonly referred to. This category of sweeteners contain no calories or carbohydrates and therefore do not effect your blood glucose levels. Often called artificial sweeteners, this category of sweeteners can be a useful way of reducing your overall calorie and carbohydrate intake.
There are various artificial sweeteners licensed for use in the UK. Examples include aspartame (used in Canderel), saccharin (used in Sweetex), sucralose (used in Splenda), ascesfulfame potassium otherwise known as acesulfame -K, (used in Hermesetas Gold sweetener) and cyclamate (used in Hermesetas liquid). Some products may also use a combination of the different types of non-nutritive sweeteners.
Are sweeteners safe?
According to the European Food Safety Authority, the European Commission, Parliament and Council regulate the use of food additives. Each sweetener undergoes stringent testing prior to approval for the use in food products. Therefore, currently approved non-nutritive sweeteners have shown no ill effects on human health.
Should I just eat sugar instead
One common point I come across is patients who opt for sugar in place of sweeteners because they view sweeteners as artificial. Before subscribing to this idea consider how sugarcane, which is a plant, ends up as a crystallised sugar granule in your cupboard. Sugarcane is exposed to many treatments of, crushing, heating, centrifuging and dying before reaching the shops shelfs and therefore may not be as natural as you may think.
Does sweeteners increase my taste for sweetness
There is no conclusive literature supporting this to my knowledge. If you abstain from sweeteners and sugar all together, your cravings for sweetness will likely subside over time. So yes, it may be argued by integrating such foods into your diet you are more likely to crave sweet foods.
However, if you are worried sweeteners will increase your cravings for sweet things but you are unwilling to give up sweet foods all together, the alternative is to use nutritive sweeteners or actual sugar, which will likely increase your cravings for sweet foods anyway. These alternatives will also increase your blood glucose levels and calorie intake.
Therefore, non nutritive sweeteners are a good way of satisfying a sweet craving without increasing your calorie intake or blood glucose levels.
Do sweeteners increase blood glucose levels
I’ve already mentioned non-nutritive sweeteners have no effect on blood glucose levels but I wanted to just pick back up on this point. One regular comment I come across is whether ingesting sweeteners prepares your body for sweetness much in the same way eating sugar would?
As my previous point mentioned, if the alternative is to eat sugar, you are much better off having a non-nutritive sweetener from a blood glucose and weight perspective.
There is no concrete evidence for this anyway and therefore I wouldn’t too much about this.
In summary, we often recommend the use of non-nutritive sweeteners for diabetes care because these are often replacing the sugar in patients diets.
There are no health benefits of adding non-nutritive sweeteners into your diet if sugar containing foods aren’t already a regular feature in your diet. However, if you are prone to sugar containing foods or drinks, a sweetened alternative such as full sugar drink replaced with a dietary option, can help improve your weight and blood glucose control.