PowerBar_Fitness_Community

In most cases, athletes understand the importance of carbohydrates for energy. Still, they sometimes inquire about nonnutritive or low-calorie sweetener options, especially when they are trying to trim a few pounds. In fact,according to Energy to Burn: The Ultimate Food and Nutrition Guide to Fuel Your Active Life (Julie Upton and Jenna Bell-Wilson, Wiley, 2009), sugar substitutes made the list of Top 10 most-feared foods. Likely due to this fear and confusion, sweeteners remain a hot topic with many clients of sports dietitians, and athletes are no exception. The need for a clear understanding of sweeteners — substitutes and the real thing — is important because the shelves are filled with no-calorie or low-calorie beverages and foods marketed for sport. Although “no-calorie sports drink” appears to be an oxymoron, many athletes look to these for hydration and a low-calorie option to sip throughout the day. Here’s a review of where we are in the sweetener market, along with guidelines and discussions about their use.

What people are saying
In a world where 70% of consumers are concerned about what they are eating, and 75% are concerned about their weight, low-calorie sweeteners are definitely desired. The Calorie Control Council reports that consumers are now using low- and reduced-calorie products “to stay in better overall health,” “to eat and drink healthier foods and beverages,” and “to reduce calories.” In fact, because 69% of consumers are concerned about the amount of sugar they consume, 44% feel that low-calorie sweeteners can play a role in weight management and weight loss.1 More and more consumers are gravitating toward the use of calorie-free sweeteners, a timely move as increasing numbers struggle with the issues of excess weight and obesity. In fact, according to a 2007 survey by the Calorie Control Council, approximately 194 million Americans imbibed products containing low-calorie sweeteners, in comparison with only 78 million in 1984. The American Dietetic Association (ADA) expands this data and suggests that up to 9 in 10 consumers in the U.S. purchase or use low-calorie products, including sugar-free and reduced-fat foods and beverages.2, 3

What the American Dietetic Association says about sweeteners
In a position statement on nutritive and nonnutritive sweeteners, the ADA reports that a person’s diet quality suffers when nutritive sweeteners (think: sugar and corn syrup) contribute more than 25% of total energy intake.3 Although the estimated average intake of energy-containing sweeteners in the U.S. falls below this percentage, at least one in four children (ages 9–18 years) surpasses this level. As health professionals, not only do we realize that excessive intake of nutritive sweeteners can increase one’s risk of dental caries, we suspect that it may also contribute to the obesity and weight epidemic so commonly seen in this country.

Concerning low- or no-calorie sweeteners, the ADA suggests that they may assist in weight management, control of blood glucose, and prevention of dental caries. Furthermore, the ADA adds that scientists have evaluated these sweeteners for many attributes, including sensory qualities (e.g., clean, sweet taste; no bitterness; odorless), safety, compatibility with other food ingredients, and stability in different food environments. When added to nutrient-dense foods, nonnutritive sweeteners have the potential to increase their palatability and consequently promote diet healthfulness.2,3

In summary, the ADA states that consumers can safely enjoy a range of nutritive and nonnutritive sweeteners when consumed within a healthy, balanced diet such as one that follows the Dietary Guidelines for Americans. The ADA further recommends that dietetics professionals provide consumers with science-based information about sweeteners, and support research on the use of sweeteners to promote eating enjoyment, optimal nutrition, and health.3

What’s the limit?
Unlike with vitamins and minerals, most of which have an established Recommended Dietary Allowance (RDA) or Adequate Intake (AI), there is no set recommendation on how much nonnutritive sweetener one should consume. Instead, there is an Acceptable Daily Intake (ADI) value for each of them. The ADI is a guideline amount that represents how much of the sweetener can safely be consumed daily. It is not a maximum limit of intake. The ADI for nonnutritive sweeteners is set at 1/100 of the maximum level that produces no observed effects. This 100-fold safety factor is used to reflect any uncertainties in the data or intake estimates. The ADI is expressed as how much sweetener (in mg) can be consumed per kg body weight per day. The FDA estimates that the average consumer ingests only about 4–7% of the ADI each day (with the larger amount being consumed by heavier users of aspartame or by those with lower body weights). The ADI for commonly used sweeteners is shown in the table below.

Sweetener	ADI mg/kg body weight/day	ADI equivalent (approx.) 150-lb person every day/entire life
Aspartame	50 mg	18 12-oz cans of diet soda, or almost 100 Equal packets
Acesulfame Potassium (Ace-K)	15 mg	Typically not used as stand-alone sweetener, but in blends
Saccharin	15 mg	>15 packets of Saccharin-based sweetener, or approximately 3 12-oz cans of diet soda
Sucralose	5 mg	30 Splenda packets, OR 5 12-oz cans of soda sweetened only with Sucralose
Rebiana A (from Stevia)	approximately 12 mg	16 12-oz soda; almost 30 packets

Sweeteners in the marketplace
Sweeteners abound in the marketplace, and consumers often have their favorites. The five nonnutritive sweeteners in the table below are all FDA approved, and most are commonplace on the shelves of local grocers.

Sweetener	Brand Name	Sweetness factor	Calorie factor	Notes	Safety Information
Acesulfame Potassium (Ace-K)	Sunett®, Sweet One®	200x sweeter than sugar	Calorie free	Does not contribute to potassium intake in the diet.	Approved for use in over 90 countries; approved by the U.S. Food and Drug Administration (FDA) as a general-purpose sweetener.
Aspartame	NutraSweet®, Equal®	160–200x sweeter than sugar	Metabolized as protein; 4 calories/gram	Actually composed of two amino acids. Since only small amounts are needed to impart sweetness, provides virtually no calories.	The FDA has approved for use as a general-purpose sweetener. Considered by many to be one of the most widely tested ingredients in the food supply. Not for use by individuals with phenylketonuria (PKU).
Saccharin	Sweet ‘N Low®, Sweet Twin®, SugarTwin®	300–500x sweeter than sugar	Calorie free	Oldest low-calorie sweetener; discovered in 1878	Approved for use in over 100 countries. Saccharin use is permitted in specific amounts in specific food products, including beverages, processed foods, and as a tabletop sweetener.
Rebiana A (from Stevia)	PureVia®, Truvia®	250–300x sweeter than sugar	Calorie free	Derived from the leaves of a South American plant	The FDA has approved Stevia and considers it Generally Recognized As Safe (GRAS) as a general-purpose sweetener in foods, excluding meat and poultry products, provided that food standards of identity do not preclude such use, at levels determined by current good manufacturing practices.
Sucralose	Splenda®	600x sweeter than sugar	Calorie free (even though derived from sugar	Highly heat stable; often used for cooking and baking	Approved by the FDA as a general-purpose sweetener. Safety shown in 110 animal studies.

Sources: ADA, 2004; FDA, 2006; Kroger, 2006.

Sugar substitutes and health
Most of us have been approached by consumers or clients asking the question, “Are artificial sweeteners safe?” Based on the bulk of research and FDA support, the aforementioned sweeteners have been given a clean bill of health.

Sugar substitutes and diabetes
There has also been concern about sugar substitutes in diabetes. The American Diabetes Association considers nonnutritive sweeteners an option for sweetening foods, and the ADA states that artificial sweeteners can help consumers cut down on calories and control weight, manage chronic conditions such as diabetes, and potentially prevent cavities. In a more critical review of sweeteners, aspartame in particular, scientists concluded that aspartame is safe for use by people with diabetes and may help them adhere to a lower-carbohydrate diet program to better control blood sugars.

Sugar substitutes and weight gain
Similar to their findings on diabetes, the American Diabetes Association and the ADA are not concerned that sugar-substitutes will promote weight gain. For example, they consider aspartame to be a potential weight management tool, discounting claims that low-calorie sweeteners contribute to weight gain.4

Sugar in the long run
The bottom line is that sugar substitutes are options for your clients and athletes to skim calories and protect their teeth, but when they need energy for activity, it’s “sugar in the long run.” Simple sugars — such as cane or beet sugar (table sugar, also known as sucrose), corn syrup, maltodextrin, honey, dextrose, glucose, fructose, fruit juice concentrate, molasses, and other syrups — play an important role in an athlete’s regimen and can be found in many sport-specific products. These sugars provide athletes with the energy they need right before and during their workouts. They are rapidly absorbed and help raise blood glucose levels quickly — and they allow athletes to avoid the dreaded “bonk.” For the non-active person, simple sugars should be used as discretionary calories. For the athlete, exercise suppresses insulin release, and consuming simple sugars is essential for maintaining normal blood-sugar levels and supporting endurance and high-intensity exercise.

References:
1.   International Food Information Council (IFIC) 2008 Food & Health Survey. Accessed May 28, 2009: http://www.ific.org/research/foodandhealthsurvey.cfm.

2.   American Dietetic Association, Evidence Analysis Library, Sugar and Sweet (Sweeteners). Accessed May 28, 2009: www.adaevidencelibrary.org.

3.   American Dietetic Association (ADA). Position of the American Dietetic Association: Use of Nutritive and Nonnutritive Sweeteners. J Am Diet Assoc. 2004; 104: 255–275. Calorie Control Council (CCC). “Key Questions & Answers About Aspartame.” 2005.

4.   Magnuson. Aspartame: A Safety Evaluation Based on Current Use Levels, Regulations, and Toxicological and Epidemiological Studies. Critical Reviews in Toxicology. 2007. 37(8): 629–727.

Rights of Usage Policy