Artificial Sweeteners and Diabetes

Sugar-free Isn't Always Healthy

Artificial sweeteners have been around for years. You might recognize the brand names Sweet'N Low, Equal, and Splenda, or the chemical names saccharin, aspartame, and sucralose. People use artificial sweeteners to replace table sugar because they are calorie free and do not affect blood sugar, which is especially important for people with diabetes.

However, just because artificial sweeteners are calorie free does not mean that the foods they sweeten are healthy or low in carbohydrates. Many people make the false assumption that when “sugar-free” or “no sugar added” is on the package, the food is a "free" food. Not only is this untrue, but some sugar-free foods can actually be worse than sugar sweetened foods.

How Sugar-free Foods Can Be More Unhealthy for You
If you count carbohydrates, you know that starch, fiber, and sugar make up the total carbohydrates of a food. Get rid of the sugar, and the logical conclusion is that carbohydrates will decrease. Sometimes this is true, but not always.

Often times a sugar-free food will be formulated differently than other varieties, containing more fat and saturated fat than the “regular” version. What is lost in sugar may be made up with flavor from fat or some other carbohydrate-containing ingredients. Make sure to consider and compare all food labels carefully before buying.

Watch the Sugar Alcohols, Too
In sugar-free or no sugar added foods, you also should be mindful of sugar alcohols, which usually appear in sugar-free candy, baked goods, and desserts.

These reduced-calorie sweeteners do not contain alcohol, as the name suggests, but they do contain sugar and carbohydrates—about half as much as regular sugar.1 They show up on ingredient labels with the suffix "itol," such as maltitol, xylitol, mannitol, and sorbitol.

The general rule is, if a food contains at least 5 grams of sugar alcohols, subtract half the amount of sugar alcohol from the total carbohydrates to get the net carbohydrates.1 For instance, if a no-sugar-added ice pop contains 13 grams of carbohydrates and 6 grams of sugar alcohols, the net carbohydrates would be 10 grams (13 - 3 = 10).

A warning: sugar alcohols can have a laxitive effect in some people. The amount of sugar alcohol it takes to cause bowel problems varies from person to person, so find out what your limit is, and make sure to stay under it.

For more information on which sugar substitutes, alcohol, and additives are safe, which are questionable, and which are dangerous, check out the Center for Science in the Public Interest's cheat sheet called “Chemical Cuisine.”  This information can help you shop better and eat better with diabetes.

Updated on: December 12, 2012