Is sugar-free safe?

It has been found that consuming too much added sugar, even natural sweeteners, can lead to health problems -- tooth decay, weight gain, poor nutrition and increased risk for developing diabetes.

Over the years many artificial sweeteners or other sugar substitutes have been developed to try and provide the satisfaction of eating something sweet without the added calories. These sweeteners are found in a variety of food and beverages marketed as "sugar-free" or "diet," including drinks and baked goods. 

There are also foods labeled as having  “no added sugar” or “unsweetened.”  The terminology can be confusing and many think that since these are free of sugar you can eat as much as you want.  Unfortunately, not all foods labeled this way are free of calories.  While artificial sweeteners and sugar substitutes can reduce consumed calories, these should be used only in moderation.

Sugar substitutes are sweeteners that you use instead of regular table sugar (sucrose). Natural sweeteners are sugar substitutes that are often promoted as healthier options than sugar or other sugar substitutes. But even these natural sweeteners often undergo processing and refining.

Some examples of natural sweeteners are fruit juices and nectars, honey, molasses and maple syrup. These are not low-calorie sweeteners and when taken in excess can lead to weight gain and elevated blood sugars.

Synthetic sugar substitutes

Artificial sweeteners (aspartame, saccharin, sucralose) are synthetic sugar substitutes, but they may be also derived from naturally occurring substances, such as herbs or sugar itself (sucralose is derived from sugar). Artificial sweeteners are attractive alternatives to sugar because they add virtually no calories to the diet. You only need to use a fraction of artificial sweetener because they are many times sweeter than sugar.

Artificial sweeteners are widely used in processed foods, including soft drinks, powdered drink mixes and other beverages.  These are also used to substitute for sugar in baked goods, candy and canned foods.

Artificial sweeteners are regulated by the Food and Drug Administration as food additives and have been scrutinized intensely for decades. Some believe that artificial sweeteners cause a variety of health problems, including cancer. This is largely due to studies dating to the 1970s that linked saccharin to bladder cancer in laboratory rats.

But according to the National Cancer Institute and other health agencies, there is no sound scientific evidence that any of the artificial sweeteners approved for use cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women.

Similarly, aspartame was found safe to use in the 1980s, except for people with phenylketonuria (PKU). This is a rare genetic disorder that presents at birth where the body cannot break down phenylalanine, an amino acid found in many foods (and in aspartame).

Novel sweetener

Stevia is called a novel sweetener because it is not made in a similar manner to other artificial sweeteners. The FDA categorizes stevia as a "generally recognized as safe" (GRAS) substance. A GRAS substance is one that has such a lengthy history of common use in food that it is considered generally safe.

Another type of sugar substitute is sugar alcohol. Despite their name, sugar alcohols (sorbitol, xylitol, isomalt) do not contain ethanol, which is found in alcoholic beverages. Sugar alcohols are usually less sweet and are lower in calories than sugar. These are used in many processed foods and other products, including chocolate, chewing gum and toothpaste. Sugar alcohols add sweetness, bulk and texture to food, as well as helping food to stay moist.

Sugar alcohols are often combined with artificial sweeteners to enhance sweetness. When eaten in large amounts however, sugar alcohols can have a laxative effect, causing bloating, intestinal gas and diarrhea.

Always keep in mind that processed foods which contain sugar substitutes generally don't offer the same health benefits as whole foods, such as fruits and vegetables. These sugar-free foods may have less calories, but the other ingredients still contain calories and eating too much will defeat the purpose of the sugar substitution. Sugar-free does not always mean calorie-free. Be mindful of the listed ingredients and nutrition facts, and consume them only in moderation.