With diabetes, it is important to limit your intake of sugar. Therefore, those affected often resort to artificial sweeteners. Diabetes experts Sue Cotey and Andrea Harris from the Cleveland Clinic in the USA explain the benefits and health risks of using artificial sweeteners in diabetes.
“Used in moderation, artificial sweeteners are safe for diabetics and can reduce both calorie and carbohydrate intake,” Cotey said in a press release. However, foods made with artificial sweeteners are not always the best choice for people with diabetes.
Link between artificial sweeteners and disease
Various studies have shown that certain sweeteners are associated with an increased risk of diseases such as cancer, heart attacks and strokes. It is therefore important to think carefully about which sweeteners you consume.
uses of sweeteners
Artificial sweeteners are found in many foods, but can also be added as stand-alone sweeteners, for example to coffee or tea, and there are also sweeteners that are suitable for baking and cooking.
In total, six artificial sweeteners have been tested and approved by the US Food and Drug Administration (FDA) or placed on the GRAS (Generally Recognized as Safe) list in the United States, according to Cotey.
“The classification on the GRAS list means that these products are demonstrably not harmful according to the current state of science when used as intended,” adds Harris. However, safe does not mean that the food is healthy.
Potential risks of sweeteners
In addition, some potential risks have also been demonstrated with various artificial sweeteners. The two experts explain which possible adverse effects are being discussed with the most common artificial sweeteners.
While there are actually more than 200 studies proving the safety of aspartame, some recent studies have shown inconsistent results. The World Health Organization (WHO) reported this year that aspartame is a possible cause of cancer.
Accordingly, aspartame is classified as a group 2B carcinogen. This group also includes lead and car exhaust. The classification means there is evidence that aspartame can cause cancer in certain situations, but there is not enough evidence to make that statement with certainty, the experts explain.
Also, people with the congenital metabolic disease phenylketonuria should avoid aspartame as it is a source of phenylalanine. And aspartame isn’t heat stable, so it shouldn’t be used in baking or cooking, researchers add.
“Unlike most other artificial sweeteners, which are chemically produced, stevia is a sweetener that’s derived from a plant,” explains Harris.
With stevia, it should be noted that there are products made from whole stevia leaves that have not received GRAS status. These are sold as dietary supplements that have not undergone rigorous testing to prove their safety. However, there are also products, for example for sweetening food, which do have the GRAS status.
However, some products containing stevia contain the sugar alcohol erythritol. According to the experts, this is associated with an increased risk of heart attacks and strokes. However, the research on this is not yet complete.
Neotame is not found in coffee shops or grocery store shelves. Rather, it is a product that is mainly used by large food manufacturers. Similar to aspartame, Neotame contains phenylalanine, which should be avoided in phenylketonuria. However, there are significantly lower amounts of phenylalanine than in aspartame, Cotey and Harris report.
Avoid artificial sweeteners if you have diabetes?
Sugar and artificial sweeteners have no health benefits and are not needed as part of the diet, the experts said.
However, diabetes can be accompanied by major changes in eating habits and generally avoiding sugar and all artificial sweeteners represents a major challenge that many people cannot sustain in the long term.
Avoid regular and high consumption
Since most of the risks of artificial sweeteners only arise with high consumption over a longer period of time, Cotey and Harris advise caution above all. Instead of completely avoiding sweeteners, it is advisable to consume as few artificial sweeteners as possible.
It is therefore not a problem to eat a piece of sugar-free cake on special occasions if you otherwise make sure that you eat healthy and are diabetic-friendly.
If you have diabetes, make sure you eat a balanced diet
“People with diabetes should make sure they eat balanced and properly portioned meals and snacks. Make sure you’re eating plenty of lean proteins, non-starchy vegetables, healthy fats, and complex carbohydrates,” Harris concludes. (as)