Exploring Sweeteners: Are They Truly Safe? (Part 2)

    Following last week's discussion on the World Health Organization's findings, which highlighted the potential health risks of long-term sweetener consumption, we will delve deeper into the topic. What factors should we consider when opting for sweeteners over sugar?

    Sweeteners, commonly used in the food and beverage industry, provide minimal to no calories. Examples include acesulfame potassium, advantame, aspartame, cyclamate, neotame, saccharin, steviol glycosides, and sucralose. Among these, aspartame and saccharin are the most familiar names, with saccharin having been in use for a considerable period. However, what about newer sweeteners like acesulfame potassium and the increasingly popular stevia extract? Each sweetener is utilized differently in the food industry, with some suitable for heating and cooking and others retaining their taste without changes.

    In the case of individuals who do not add artificial sugars to their diets but consume sugar-free beverages or packaged foods labeled as "sugar-free," "zero," "lite," or "less sugar," caution is required. At times, manufacturers may fail to provide sufficient information on the label, leading consumers to unknowingly consume sweeteners.

    Moving forward, it is essential to read and scrutinize product labels, paying attention to what we are consuming. Many of us have developed a certain degree of dependence on sweet tastes. Let's examine the differences between sweeteners and sugar replacements. For instance, when we add one teaspoon (approximately 4 grams) of sugar to our coffee, it amounts to 16 calories. However, by using stevia extract as an alternative, we can achieve a sweet taste without consuming any energy. Additionally, stevia is approximately 300 times sweeter than regular sugar. Similarly, for those addicted to soft drinks, a 325 ml can containing 34 grams of sugar (equivalent to 140 kilocalories) can be replaced with a zero or lite formula, which indicates 0 kilocalories or less energy compared to the sugar-based formula. Opting for these drinks can result in lower sugar and calorie intake, benefiting individuals with diabetes by helping control blood sugar levels, as well as aiding in calorie management for the general population. Therefore, if someone were to switch from consuming a can of regular soft drink daily to the sugar-free version, without altering their diet or activity level, weight loss could be expected—a straightforward outcome.

    However, it appears that relying on sweeteners instead of sugar in our long-term diet does not necessarily help with weight control. In fact, data suggests that substituting sugar with sweeteners is associated with a 1.76-fold increased risk of obesity and a 1.23-1.34-fold increased risk of diabetes (although these risks are still considered low).

    This information contradicts our initial assumptions. While we choose to consume foods and beverages that employ sweeteners as sugar substitutes, it does not seem to yield the desired outcomes.

    Another crucial aspect to consider is that even if we reduce sugar consumption by using sweeteners, it does not guarantee energy reduction or weight loss if we neglect other factors, such as monitoring overall calorie intake from sources like carbohydrates, protein, and fat, as well as incorporating physical activity. Managing diabetes requires addressing all relevant risk factors, not just sugar intake alone.

    To summarize, the use of sweeteners as sugar substitutes may not fully meet the requirements for promoting diabetes reduction and combating obesity. Nonetheless, sweeteners can still be utilized with caution. However, it is vital not to overlook other contributing factors that can lead to various health conditions. If possible, it is best to avoid or reduce

Assoc. Prof. Dr. Nattada Areepiam and Asst. Prof. Dr. Bodin Tiwasuwan

Faculty of Pharmacy Chulalongkorn University