Before getting into sugar and substitutes let’s talk about nutrient vs calorie dense foods and what the differences are.
Calorie Dense vs Nutrient Dense Foods
Calorie dense food refer to foods that are small in volume but have a high calorie count. Some good examples (both good and bad) are: avocadoes, nuts, seeds, fried foods, high milk fat products, refined sugar, milk chocolate, to name a few. When we reference calorie dense foods, we don’t talk about the food quality
Nutrient dense foods are foods that offer a lot of nutrients (vitamins, minerals, elements) in a portion. Some good examples are: nuts, milk, eggs, fruit, vegetables.
So, as you can see, we can have a variety of good and bad foods in the calorie dense category foods, but just because a food does not seem to offer calories, does not mean it’s not important (you need nutrients!)!
The goal is to think about – if the food is calorically dense, is it also nutrient dense?
So let’s talk sugar…
As a dietitian we often talk about “added sugar” and support our communities in ways in trying to avoid it. The added sugar we refer to is sugar ingredients used to keep shelf stable foods from spoiling, use of sugar in baked goods, and sugar sweetened beverages. Excess consumption of these items can elevate blood sugars, create unintentional weight gain, and are not nutrient dense. However we also have natural sugars that exist in food… almost every naturally occurring food (fruit, vegetables, grains, etc) – so avoiding it is not the answer.
Sweeteners (what we refer to as non-nutritive sweeteners, meaning they don’t add calories to our diet), are usually an artificial sweetener that the food industry has introduced to eliminate or reduce the amount of sugar existing in products while still leaving a sweet taste to it. There are many types of sweeteners so let’s break it down and discuss:
Natural sweeteners - These are items like stevia (Truvia). Although stevia still contains calories, it is to a much lower extent than regular sugar. Sugar Alcohols- These include erythritol, sorbitol, mannitol, and xylitol, to name a few. Artificial sweeteners - some of these include aspartame (Splenda), saccharin (Sweet ‘n’ Low), neotame (Swerve), sucralose, and acesulfame-K (Sweet One).
Where do sweeteners exist?
Some sweeteners exist as individual packaging so that you can use them for adding to foods or for baking (some products are better heat stable and offer varying amounts of sweetness intensity).
Some prepackaged items are sweetened with these alternative sweeteners like: whey protein powders, sugar-reduced ice creams, sugar-free gum, protein bars, and diet drinks. Easily recognized artificially sweetened products are usually labeled as “diet” or “sugar-free”, even though they offer quite a sweet taste.
What are the Health Risks Associated with Sugar and Sugar Substitutes?
First, to put your mind at ease, Health Canada will only permit additives (including sugar substitutes) be present in foods if they are deemed safe and are shown with extensive testing and research. The sugar substitutes that are permitted in packaged foods in Canada are:
· sugar alcohols (polyols) such as sorbitol, isolmalt, lactitol, maltitol, mannitol and xylitol
Health Canada has also set standards as to the amount that are shown as safe to ingest and that anything higher is not recommended. For example, about 50 milligrams for each kilogram of body weight. For a 150-pound person, 3,409 milligrams a day would be safe. A packet of Equal contains 37 milligrams of aspartame (So almost 100packets… woah!). A 12-ounce can of diet soda contains around 200 milligrams of aspartame.
In the past, sugar substitutes were used to help people reduce their sugar intake and mostly create a replacement for diabetics to normalize blood sugar and insulin. There has been research with animal studies to try to show that sugar substitutes can increase the risk of obesity. However, the study used amounts of sweeteners that were so high, it would be nearly impossible to intake this much in a day and quite unrealistic. However, excessive consumption of sweet substitutes can alter our taste receptors and lead us to become accustomed to really sweet products which could inevitably lead us to craving more of those products and eventually overconsumption of high calorie foods.
Some research suggests that an overconsumption of sugar substitutes can alter gut microbiota and potentially decrease glucose sensitivity. So why is this important? Our gut microbiota can play a role in weight management and decreasing glucose sensitivity means that we may not be responding appropriately when there is glucose present (this can affect weight management as well). Sugar alcohols should also be cautioned for the reason that they can create excess gas when consumed in large quantities and potentially cause diarrhea.
Using sugar substitutes in moderation will not make or break your diet or your goals, nor will they be “unsafe”. Excessive and long term use of sugar substitutes is not supported and needs to be done with caution. Having a balanced nutrition plan and checking in with your doctor and dietitian about the safety, amounts, and use of sugar substitutes is the best approach. If you find yourself constantly craving highly sweet foods, maybe reconsider restructuring your goals in eliminating some of these items daily in order to reduce cravings, and the “need” for the sweetness.