The magical nanny Mary Poppins sang that a spoonful of sugar makes the medicine go down. Unfortunately, the nation is quickly learning its continuous, insatiable demand for sweetness in foods has required a much different remedy.
Statistics show that the average American is consuming 20 teaspoons of added sugars a day, beyond that which is naturally occurring in foods and beverages. That's about 65 pounds per year, and is pointed to by many as a leading contributor to the country's obesity and diabetes epidemics. It's leading many consumers to seek out alternative ways to satisfy their sweet tooth.
Seventy million Americans consumed sugar-free products in 1987, according to the Calorie Control Council. The number more than doubled, to 180 million, in 2004. Not surprisingly, trend reports from the Food Marketing Institute reveal sugar as the second most common nutritional concern among today's consumers.
Increased product availability is also driving use of sugar substitutes. Aspartame alone is used in more than 6,000 products worldwide. Sugar substitutes, often referred to as low-calorie or artificial sweeteners, are not just used in beverages and baked goods, but in less suspecting products like toothpaste, pharmaceuticals and even cosmetics.
Consumers say that saving calories and controlling blood sugar are the top reasons for choosing sugar substitutes and the products that contain them.
"Artificial sweeteners increase options, especially for people trying to lose weight or control diabetes," said Jennifer Person, nutrition program manager for the U.S. Navy.
At just 15 calories per teaspoon, sugar consumption alone may not lead to weight gain, but consuming excess calories does. In contrast, sugar substitutes contain virtually no calories and provide a way for consumers to forgo calories without giving up taste.
"Anything that can help people cut back on [excess] calories is good," said Adam Drenowski, director of nutritional science at the University of Washington. Drenowski and other scientists have conducted studies that support the effectiveness of low-calorie sweeteners in controlling caloric intake and maintaining weight loss.
Some sweeteners, including saccharin and sucralose, pass through the body undigested, and therefore remain calorie free. Others, like aspartame, are digested, but are hundreds of times sweeter than sugar. Vastly smaller amounts are required for the same sugary sweetness, and the lesser quantity provides negligible calories.
Similarly, low-calorie sweeteners do not raise blood glucose levels and are endorsed by the American Diabetes Association as a safe way for diabetics to enjoy sweet-tasting foods.
Although there are now five artificial sweeteners approved by the Food and Drug Administration, as well as sugar alcohols (which are technically not artificial), use of sugar substitutes is not a new concept. Saccharin was discovered in the late 1800s and used during both world wars to compensate for sugar shortages.
Despite their long history, sugar substitutes are not without controversy. A quick Internet search yields countless sites linking artificial sweeteners to everything from headaches and nausea to cancer, multiple sclerosis, Alzheimer's disease and even Gulf War Syndrome.
Most of the claims on such Web sites are not backed up by science, while decades of research support the safety of the FDA-approved sugar substitutes. Products only go to market after an extensive review of product specifications and safety data. According to the International Sweeteners Association, "the careful and detailed approval procedure for these products, and the extensive testing done to obtain and maintain approval, have ensured that sweeteners are among the most thoroughly tested food additives in use today."
Saccharin and aspartame are usually at the heart of the controversy. In 1977, a study linking saccharin with cancer in animals resulted in mandatory labeling on saccharin-sweetened products warning of the potential risk. Since that time "extensive research on human populations has established no association between saccharin and cancer," according to the Calorie Control Council. In 2000, saccharin, along with its warning label, was officiallyremoved from the government's list of potential carcinogens.
Aspartame has its share of opponents as well, but the FDA notes aspartame as one of the most thoroughly tested food additives ever approved. Except for individuals diagnosed with the rare disorder phenylketonuria, or PKU, aspartame has been deemed safe for use in more than 100 countries for adults, children and pregnant women.
"The overwhelming body of scientific evidence clearly demonstrates that aspartame is safe and not associated with adverse health effects, including headaches," concluded a study conducted at Duke University Medical Center.
Approved for use in 1998, Splenda is the fastest-growing artificial sweetener, already holding more than 50% of the $337 million U.S. market. Splenda's promotional materials state that it "tastes like sugar because it is made from sugar." Although some consumers perceive Splenda as safer or more natural because of this fact, Splenda is made from a chemical process like other artificial sweeteners.
Just like sugar, there can be too much of a good thing when it comes to sugar substitutes. The FDA has set Acceptable Daily Intake levels, the amount of artificial sweetener one can consume every day over a lifetime without risks. Each sweetener has its own ADI, conservatively set about a hundred times lower than amounts that cause adverse effects. In practical terms, a 150-pound person could safely consume five cans of diet soda containing sucralose, 15 cans containing aspartame or 8 packets of saccharin each day.
Like sugar itself, these artificial sweeteners face potential consumer backlash. Many are turning to more natural alternatives. Stevia, extracted from a South American shrub, is one such option. Stevia is virtually calorie-free and 300 times sweeter than sugar, "so it appeals to many people as a natural alternative to artificial sweeteners," said Mark Blumenthal, executive director of the American Botanical Council.
Although it has been used for centuries in South America and for decades in Japan with no reported adverse effects, the FDA classifies stevia as an unsafe food additive, reporting that the agency does not "have enough data to conclude that the use [in food] would be safe."
Although negative effects have been seen in some animal studies, including reproductive problems and creation of cancer-promoting compounds, other studies contradict such findings.
Stevia is usually purchased in packets for tabletop sweetening, but consumers won't find it on the shelf next to Splenda or Equal, since it can only be marketed and sold as a dietary supplement in the United States.
The bottom line on sugar substitutes, according to the American Dietetic Association, is "consumers can safely enjoy a range of nutritive and non-nutritive [artificial] sweeteners when consumed in a diet that is guided by current federal nutrition recommendations."