ARTIFICIAL SWEETNERS

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health professional.

“Is it true that aspartame causes Multiple Sclerosis?” “Isn’t aspartame a poison?” “Isn’t it true that airline pilots aren’t allowed to take aspartame before flying?” These are still common questions in our pharmacy. Are artificial sweetners evil? No, I don’t believe so. Is it possible that some people don’t react well to them? Absolutely. Some people get headaches, flushing, upset stomach, etc. when they use artifical sweetners. So we tell them not to use them. Should people without diabetes eat pounds of artifical sweetners every day? Probably not. However, are artifical sweetners a good tool for diabetics to use when they want something sweet, but don’t want their blood sugar to go up? Absolutely!

Diabetes educators now talk about CARB choices for diabetics when looking at their food. A person needs at least 9 CARB Choices per day and that should be spread over 3 meals. A female diabetic should aim for 3-4 CARB Choices per meal and a male diabetic should aim for 4-5 CARB Choices per meal. I scavenged the pharmacy staff fridge and found a no-name can of cola. In 355 mL it contains 42 g of carbohydrate, which is worth 3 CARB Choices. So if a female diabetic decided she wanted a can of cola, that would use up all her CARB Choices for one meal. Now if that same female diabetic craves 5-6 cans of cola per day, that would put her at 16 CARB Choices and that puts her way over budget for the whole day. So if she replaces regular cola with artificially sweetened cola she will be much better off.

The four common artificial sweetners are: aspartame (Equal, Nutrasweet), saccharin (Sweet ‘N Low), acesulfame (Sunette), and sucralose (Splenda). They have been blamed for everything from cancer to seizures to Multiple Sclerosis to chronic fatigue. There is no good evidence that they cause any of these. We will talk about the top two saccharin and aspartame.

Saccharin has been around for more than a century. It is 300 times sweeter than sugar. This means if you needed 42 grams of sugar to sweeten our can of cola, you would only need 0.14 grams of saccharin to sweeten it. Since so little saccharin sweetens so much stuff it was used a lot in the two World Wars because sugar was scarce. In the 1970’s the Food and Drug Administration in the US started looking at saccharin safety. Initially it was found that huge doses of saccharin (way more per body weight than people would eat) caused bladder cancer in rats. Since then, the data has been reviewed and saccharin is now considered safe. The National Cancer Institute, the National Toxicology Program, the American Diabetes Association, American Dietetic Association, American Cancer Society, and American Medical Association all support the use of saccharin and say it is safe.

Aspartame has been available in Canada since 1981. It is about 200 times sweeter than sugar. So if you needed 42 grams of sugar to sweeten our can of cola, you would only need 0.21 grams of aspartame to sweeten it. As a side note, have you ever noticed that diet soft drinks foam or froth or bubble much more that regular sugared ones? That is because you need so much more sugar to sweeten it than aspartame, the sugared soft drinks are more viscous and thus foam less. Aspartame has been accused of causing everything from seizures to cancer to hair loss. None of these claims has ever been proven in a clinical trial. Many of the claims of damage I have heard about aspartame are because as aspartame is being broken down in the body, formaldehyde is produced. Formaldehyde is a poison, so aspartame must be a poison, right? Wrong. Many fruits and vegetables break down into small amounts of formaldehyde as well. This formaldehyde will break down into formic acid and then to water and carbon dioxide. Want further proof your body can handle small amounts of formaldehyde? That last hang over you had was due in part to formaldehyde. Ethyl alcohol changes in part into formaldehyde. Some of the pain of the hang over was due to too much formaldehyde in your body. But your body eventually metabolized it and the hang over went away. You get much more formaldehyde in your body from a hang over than from aspartame.

In general aspartame has been thoroughly tested by the Canadian and American authorities and found to be safe. There is one group that must avoid aspartame. This condition is called phenylketonuria or PKU, a disorder of amino acid metabolism. Accumulation of phenylalanine can lead to neurological, behavioral and dermatologic problems in this population. Since aspartame contains phenylalanine, patients with PKU should not use aspartame.

So I have already said I think artificial sweetners are a good option for diabetics. Should non-diabetics use them? In moderation, saccharine, aspartame, acesulfame potassium and sucralose appear to be safe. The FDA in the US and Health Canada have set acceptable daily limits of these sweetners and studies show that normal diets contain far less sweetners than these limits. So yes, in moderation, these sweetners are safe to use. Do I use them? Yes I do. One last word about moderation, though. Almost anything can be toxic if used too much. A condition called water toxicity can happen if you drink too much water. I bring this up because one of the clinic physicians was talking about a patient of theirs that drank 8-12 liters of diet soft drinks per day. This patient didn’t mention this diet related quirk to their physician for years. When the patient’s enormous diet soft drink consumption finally came out, the doctor could finally successfully cure the patient’s chronic diarrhea.

As always if you have any questions or concerns about these or other products, ask your pharmacist.