Sugar Vs. Artificial Sweeteners

Q I really enjoy sodas. I switched to diet to save calories. My friend told me that artificial sweeteners are worse for me than sugar. Is that true? — J.L., Winterville

A You might guess that we promote drinking water over drinking any type of soda — no health controversy there. But scientists continue to raise questions about the safety or health effects of various ingredients in sodas. I asked Joe Sang, a third-year Brody medical student, to explain the controversy to you. Here is what he wants you to know.

There’s been a lot of controversy regarding the use of sweeteners in place of sugar in everyday foods and beverages. High-fructose corn syrup has been used in the United States for many years. The name appears somewhat complex but when this compound is broken down, the body responds to it similarly to regular table sugar.

Some people now choose to avoid it because of the calories it contributes to their diet. Others avoid it because they believe, as some scientists do, that HFCS also affects feelings of hunger and levels of insulin. So many people turn to beverages that use other sweeteners — both artificial and/or sugar or sucrose.

It is my hope to provide an objective view of artificial sweeteners and their role in weight management so you can make an educated decision about what foods to put in your body.

A new scientific finding about aspartame, an artificial sweetener, has received attention. Researchers published the results of a study that found aspartame “may be associated with greater glucose intolerance, particularly for those with obesity.”

The scientists discovered that for some individuals who were already obese, consuming artificial sweeteners such as aspartame might further reduce the ability of the body to control its levels of natural sugars — a condition referred to as insulin resistance. This situation can eventually lead to diabetes, heart and kidney disease, pain and tingling in the limbs, as well as changes in vision.

However, as with many studies we hear reported in the media, there are limitations to this study’s findings and I am not ready to tell patients who are obese to avoid aspartame or other artificial sweeteners and return to sugar-sweetened foods and beverages.

While this study suggests that aspartame and other artificial sweeteners MAY actually promote weight gain and insulin resistance, other studies conclusively show an association with excess sugar intake and insulin resistance. In fact, scientists have shown that when artificial sweeteners such as aspartame were substituted for regular sugar, individuals were able to drastically lower their caloric intake and subsequently promote weight loss.

I believe, at this time, the benefits of using artificial sweeteners in the place of sugars such as high-fructose corn syrup outweigh the risks. The most significant benefit of using non-caloric sweeteners is it leads to a reduction in total calories consumed in the day. While some reports have said that people using non-caloric sweeteners actually eat more because they feel good about using diet drinks, an excellent study showed that hunger and thirst ratings of non-dieting men were unaffected when they consumed drinks with aspartame — they didn’t overeat.

Some scientists voice concern that artificial sweeteners might contribute to the development of some cancers. While this is a valid concern, not all scientists agree and more research is needed. What is clear is that excess sugar and calorie intake may lead to high blood pressure, poor blood sugar control, heart disease, kidney disease, blindness and some cancers.

Each person needs to assess the risks and benefits of using sugar or artificial sweeteners. Ask your family doctor to help you decide what’s right for you. In the meantime, don’t lose sight of the big picture: Make good dietary choices with lots of fruits and vegetables and incorporate physical activity into everyday life.