The festival season is just around the corner. A variety of sweet delicacies from traditional mithais and pastries to chocolate bouquets and candy bars are going to be available in the market. It may mean trouble for the diabetics and the health-conscious as they get lured by the sweetness in the air. You may want to delve into the pleasures of sweet gluttony by opting for products labelled sugar free, or those made with zero-calorie artificial sweeteners. Saccharin, aspartame, acesulfame potassium, sucralose, and isomaltulose are the most common artificial sweeteners available in the market that are used in anything from a can of diet coke to jams and jellies. Some like aspartame are also available in the form of ‘sugar-free’ pellets and powder to sweeten your concoctions at home.
A growing market
India is witnessing a rising incidence of cases of diabetes and cardiovascular diseases. The demand for these artificial sweeteners is continuously growing too. According to a Mordor Intelligence report, the food sweetener market is forecasted to grow at a compound annual growth rate (CAGR) of 1.1 per cent between 2019 and 2024.
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While artificial sweeteners like saccharin and aspartame provide guilt-free treats and satisfy your sweet cravings, they do not come without controversy. Research studies in the 1970s including one on the carcinogenicity of saccharin linked saccharin with cancer in the urinary bladder of rats and mice, but later human epidemiology studies did not show consistent evidence of the same in humans. More recently, studies on mice associated aspartame, saccharin, and sucralose with glucose intolerance.
A 2021 study in the International Journal of Molecular Sciences found that all three sweeteners evaluated (saccharin, sucralose, and aspartame) increased the biofilm formation of E. coli in the intestines. "Understanding the role of sweeteners in regulating biofilm formation, as well as other pathogenic effects on the intestinal epithelium and antimicrobial resistance of bacteria, could have a dramatic impact on public health in a multitude of ways," it said.
Other studies observed their effects on the gut microbiome and metabolic derangements. These effects can cause obesity and cardiovascular diseases. Besides, just because something is sugar-free, does not make it calorie-free. If you are eating sugar-free cakes or biscuits, thinking that it is healthier for you, you may be mistaken.
What are artificial sweeteners?
Artificial or non-nutritive sweeteners (also known as high-intensity sweeteners) are popular ingredients that provide a sweetening flavour to food products. "The calorific value of these artificial sweeteners is very close to zero. They are mainly used by people who are trying to lose weight or people who are diabetic," explains Bangalore-based clinical nutritionist Anju Sood.
Saccharin, discovered in 1879 by Constantin Fahlberg, was the first mass-produced commercial sweetener, and it gained traction as it was cost-effective. However, many other artificial sweeteners have come to dominate the market in the past century. From cyclamate introduced in the 1950s to aspartame that entered the American markets in 1981 and sucralose in 1998, the global market for artificial sweeteners has made a revenue of more than USD 20 billion in 2020.
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The Food & Drug Administration (FDA) of the United States has approved different non-nutritive sweeteners, deeming them safe to use. The Food Safety and Standards Authority of India (FSSAI) has also approved these artificial sweeteners: saccharin (soft drinks, sweets, etc.), aspartame (biscuits, bread, cakes, etc.), acesulfame potassium (fruit nectars, lollies, etc.), sucralose (ice creams, chutneys, etc.), and isomaltulose (chewing gums, lozenges, etc.). The FSSAI in 2015 also gave the nod to the use of stevia, which is a plant-based sweetener extracted from the compounds called glycosides in the leaves of the Stevia rebaudiana plant.
What do experts have to say about them?
Most experts seem to believe that the use of these artificial or non-nutritive sweeteners in minimum quantities is usually alright. Jaipur-based diabetologist Dr Rakesh Parikh advocates the use of artificial sweeteners for his patients who are diabetic or obese if and when they have sugar cravings. “I am not recommending [everyone] to use artificial sweeteners,” says Dr Parikh.
Regarding studies that purportedly show various health concerns related to their use, Dr Parikh says that these studies are limited in their scope and have mostly been done on animals. However, with the amount of information and research available right now, he says it is safe to use these ingredients in your diet.
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The only caveat is regarding the use of aspartame for patients of a rare hereditary condition called phenylketonuria or PKU, says Dr Parikh. Those with this condition cannot break down the amino acid phenylalanine, which is found in aspartame.
Mumbai-based medical nutritionist and fitness consultant Geeta Shenoy has the same outlook. She says that her first suggestion for patients with diabetes is to cut down on sugars and that it is okay to use artificial sweeteners in a limited amount. "Any of these artificial sweeteners in their pure form do not cause any problem as such," says Shenoy, adding that the issue is what it is mixed with.
She explains that these artificial sweeteners are hundreds of times sweeter than table sugar, and therefore, a less amount provides the same sweetness as sugar. Also, various additives are used with the sweetener to add to the bulk."It will just be one or two grams of that; the rest will be additives like microcrystalline. So, if you take a lot of these products, they might cause gut flora disturbances, and it may in some cases cause glucose issues," she says.
Shenoy does not recommend more than 3-4 pellets or servings of these sweeteners per day. Also, she suggests that these sweeteners can trigger underlying issues of gut flora and migraines, as is the case with other flavouring ingredients. "[For] those who have a sensitive stomach, say IBS [Irritable Bowel Syndrome] or are intolerant/allergic to certain foods, we do not recommend these artificial sweeteners," she says. She adds that it is a no for lactating persons too.
Sood, who has been practising for almost 30 years, says she generally asks people to avoid it as much as possible. "The content of their use is closely dictated. I don't let them use a higher quantum and not for a very long period," she adds. She shares how some of her clients who have been using stevia-based or non-nutritive sweetener-based food items tend to face bloatedness and water retention in their system. "If they are using higher quantum and for a long duration, these kinds of things set in. So, my general take is to please bring down your artificial sweetener content," adds Sood.