Medical News Today: What are the best sweeteners for people with diabetes?

Low-calorie sweeteners, or sugar substitutes, can allow people with diabetes to enjoy sweet foods and drinks that do not affect their blood sugar levels. A range of sweeteners is available, each of which has different pros and cons.

In this article, we look at seven of the best low-calorie sweeteners for people with diabetes.

1. Stevia

Sugar and sweeteners on wooden table and wooden spoons with leaves
Stevia is a popular alternative to sugar.

Stevia is a natural sweetener that comes from the Stevia rebaudiana plant. To make stevia, manufacturers extract chemical compounds called steviol glycosides from the leaves of the plant.

This highly-processed and purified product is around 300 times sweeter than sucrose, or table sugar, and it is available under different brand names, including Truvia, SweetLeaf, and Sun Crystals.

Stevia has several pros and cons that people with diabetes will need to weigh up. This sweetener is calorie-free and does not raise blood sugar levels. However, it is often more expensive than other sugar substitutes on the market.

Stevia also has a bitter aftertaste that many people may find unpleasant. Some people report nausea, bloating, and stomach upset after consuming stevia.

The United States Food and Drug Administration (FDA) classify sweeteners made from high-purity steviol glycosides to be “generally recognized as safe,” or GRAS. However, they do not consider stevia leaf or crude stevia extracts to be safe, and it is illegal to sell them or import them into the U.S.

According to the FDA, the acceptable daily intake (ADI) of stevia is 4 milligrams per kilogram (mg/kg) of a person’s body weight. Accordingly, a person who weighs 60 kg, or 132 pounds (lb), can safely consume 9 packets of the tabletop sweetener version of stevia.

Various stevia products are available to purchase online.


2. Tagatose

Tagatose is a form of fructose that is around 90 percent sweeter than sucrose. Although rare, tagatose does occur naturally in some fruits, such as apples, oranges, and pineapples. Manufacturers use tagatose in foods as a low-calorie sweetener, texturizer, and stabilizer.

Not only do the FDA class tagatose as GRAS, but scientists are interested in its potential to help manage type 2 diabetes. Some studies indicate that tagatose has a low glycemic index (GI) and may be beneficial in the treatment of obesity. GI is a measure of a food’s potential to affect a person’s blood sugar levels.

Tagatose may be of particular benefit to people with diabetes who are following a low-GI diet. However, this sugar substitute is more expensive than other low-calorie sweeteners and may be harder to find in stores.

Tagatose products are available to purchase online.


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3. Sucralose

Top down view of woman sprinkling sugar or coconut into bowl of flour while baking
People can use sucralose instead of sugar when baking.

Sucralose, available under the brand name Splenda, is an artificial sweetener made from sucrose. Sucralose is about 600 times sweeter than table sugar but contains very few calories.

Sucralose is one of the most popular artificial sweeteners, and it is widely available. Manufacturers add it to a range of products from chewing gum to baked goods.

Sucralose is heat-stable, whereas many other artificial sweeteners lose their flavor at high temperatures. This makes sucralose a popular choice for sugar-free baking and sweetening hot drinks.

The FDA have approved sucralose as a general-purpose sweetener and set an ADI of 5 mg/kg of body weight. A person weighing 60 kg, or 132 lb, can safely consume 23 packets of a tabletop sweetener version of sucralose.

However, recent studies have raised some health concerns. A 2016 study found that male mice that consumed sucralose were more likely to develop malignant tumors. The researchers note that more studies are necessary to confirm the safety of sucralose.

A range of sucralose products is available to purchase online.


4. Aspartame

Aspartame is a very common artificial sweetener that has been available in the U.S. since the 1980s. It is around 200 times sweeter than sugar, and manufacturers add it to a wide variety of food products, including diet soda. Aspartame is available in grocery stores under the brand names Nutrasweet and Equal.

Unlike sucralose, aspartame is not a good sugar substitute for baking. Aspartame breaks down at high temperatures, so people generally only use it as a tabletop sweetener.

Aspartame is also not safe for people with a rare genetic disorder known as phenylketonuria.

The FDA consider aspartame to be safe at an ADI of 50 mg/kg of body weight. Therefore, someone with a body weight of 60 kg, or 132 lb, could consume 75 packets of a tabletop sweetener version of aspartame.

Many different aspartame products are available to purchase online.

5. Acesulfame potassium

Acesulfame potassium, also known as acesulfame K and Ace-K, is an artificial sweetener that is around 200 times sweeter than sugar. Manufacturers often combine acesulfame potassium with other sweeteners to combat its bitter aftertaste. It is available under the brand names Sunett and Sweet One.

The FDA have approved acesulfame potassium as a low-calorie sweetener and state that the results of more than 90 studies support its safety. A 2017 study in mice has suggested a possible association between acesulfame potassium and weight gain, but further research is necessary to confirm this.

The FDA have set an ADI for acesulfame potassium of 15 mg/kg of body weight. This is equivalent to a 60 kg, or 132 lb, person consuming 23 packets of a tabletop sweetener version of acesulfame potassium.


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6. Saccharin

Sweeteners in individual packets in tray
Cafes and restaurants may provide saccharin sweeteners.

Saccharin is another widely available artificial sweetener. There are several different brands of saccharin, including Sweet Twin, Sweet’N Low, and Necta Sweet. Saccharin is a zero-calorie sweetener that is 200 to 700 times sweeter than table sugar.

According to the FDA, there were safety concerns in the 1970s after research found a link between saccharin and bladder cancer in laboratory rats. However, more than 30 human studies now support the safety of saccharin, and the National Institutes of Health no longer consider this sweetener to have the potential to cause cancer.

The FDA have determined the ADI of saccharin to be 15 mg/kg of body weight, which means that a 60 kg, or 132 lb, person can consume 45 packets of a tabletop sweetener version of it.

People can purchase a range of saccharin products online.

7. Neotame

Neotame is a low-calorie artificial sweetener that is about 7,000 to 13,000 times sweeter than table sugar. Neotame can tolerate high temperatures, which means that it is suitable for baking. It is available under the brand name Newtame.

The FDA approved neotame in 2002 as a general-purpose sweetener and flavor enhancer for all foods except for meat and poultry. They state that more than 113 animal and human studies support the safety of neotame.

The FDA have set an ADI for neotame of 0.3 mg/kg of body weight. This is equivalent to a 60 kg, or 132 lb, person consuming 23 packets of a tabletop sweetener version of neotame.


Considerations when choosing a sweetener

When choosing a low-calorie sweetener, some general considerations include:

  • Intended use. Many sugar substitutes do not withstand high temperatures so they would make poor choices for baking.
  • Cost. Some sugar substitutes are very expensive, whereas others have a cost more comparable to that of table sugar.
  • Availability. Some sugar substitutes are more widely available in stores than others.
  • Taste. Some sugar substitutes, such as stevia, have a bitter aftertaste that many people may find unpleasant.
  • Natural versus artificial. Some people prefer using natural sweeteners, such as stevia, rather than artificial sugar substitutes.

Summary

Many people with diabetes need to avoid or limit sugary foods. Low-calorie sweeteners can allow them to enjoy a sweet treat without it affecting their blood sugar levels.

There is a range of sweeteners to choose from, each with different pros and cons. Although the FDA generally consider these sugar substitutes to be safe, it is still best to consume them in moderation.

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