- The Washington Times - Tuesday, November 13, 2001

Sugar is not the only way to satisfy a sweet tooth. Artificial and natural sweeteners also are available but most nutritionists agree that the products should be used in moderation.
"You can't use a sugar substitute as a license to eat anything you want," says Barbara Rolls, who holds a doctorate and is a former adviser for the National Institutes of Health in Bethesda. "We found that if artificial sweeteners are used in their intended way, as a substitute for sugar, they won't increase calories. If you eat a double burger, large fries and a diet soda at a fast-food place, you can't expect the diet soda to make that much difference."
Research shows that obesity is the biggest side effect of sugar on the body, says Ms. Rolls, a professor of nutrition at Pennsylvania State University in University Park, Pa. NIH statistics show that nearly one-quarter of adults in the United States are obese. Americans spend $33 billion annually on weight-loss products and services.
Marie Pierre of Arlington says she eats sugar despite the risk of weight gain. She has never tried artificial sweeteners.
"I really like sugar," Miss Pierre says while shopping at a Giant Food store in Falls Church. "I eat the real thing. I'm a coffee lover. I use a lot of sugar in it. I also like pecan pie, and you know that is sweet."
Denise Feeley, clinical research coordinator at MedStar Research Institute in Southeast, says people who consume large amounts of refined or white sugar usually eat it in place of nutritious foods. Refined sugar not simple sugars such as those found in milk, yogurt and fruit should be avoided, she says.
"To lessen sugar consumption, you should cut back on soda," Ms. Feeley says. "One 12-ounce can has 10 teaspoons of sugar. It's the number one source of sugar. You also should cut back on desserts."
Ms. Feeley says foods with artificial sweeteners may not be lower in calories than ones with sugar.
"Since diabetics shouldn't eat a lot of sugar," she says, "I tell them to have a regular dessert but have less of it."
Lachman Khemani of Arlington says he has used artificial sweeteners since he was diagnosed with diabetes.
"I have been on Nutrasweet for a long time, about seven years," he says while shopping in Healthway Natural Foods in Annandale. "Sometimes food I eat has some sugar or corn syrup, but very rarely."
Richard Keelor, who holds a doctorate, is president and chief executive officer of the Sugar Association Inc. in Northwest. He says "sugar" comes from sucrose, while "sugars" include products such as glucose, fructose, maltose and lactose. He says products such as molasses and syrups are "sweeteners."
"We don't want our product, sugar, to be misrepresented," Mr. Keelor says, adding that he hopes people consider the source of artificial sweeteners.
"All artificial sweeteners are not found in nature," he says. "We tend to like natural products derived from sun and soil."
Mr. Keelor also warns that some artificial tabletop sweeteners contain hidden calories because of the starch in them.
"The Food and Drug Administration says if it has three or fewer calories, you can say that it has zero calories," Mr. Keelor says. "If you eat 10 extra calories a day for a decade, you gain 10 pounds. Ten extra calories is about three packets of Equal, Sweet 'N Low or Splenda."
According to research from the International Food Information Council in Northwest, the tabletop artificial sweeteners Nutrasweet and Equal use aspartame. Made from amino acids, aspartame also is found in products such as juices, chewing gum, dairy products and carbonated beverages. It loses flavor at high temperatures. The FDA approved it in 1981.
Saccharin has sweetened products since 1900. It has had interim approval from the FDA since 1970. In the past few years, researchers have reported that, contrary to the conclusions of earlier studies, it has been determined not to be associated with cancer in humans. The National Toxicology Program of the U.S. Department of Health and Human Services no longer considers saccharin a potential carcinogen. Its warning label has been removed. The tabletop sweetener Sweet 'N Low uses saccharin.
Sucralose is a derivative of sugar, and researchers say it is good for cooking and baking. It is used in the product Splenda. The FDA approved it in 1998.
The tabletop sweetener Sweet One and the soda Pepsi One use acesulfame potassium, or acesulfame-K. The FDA approved it in 1998. It also withstands high cooking and baking temperatures.
Since the 1970s, the Japanese have used Stevia as a natural sweetener. Also used in South Korea and Brazil, it is an herb derived from a South American plant called Stevia rebaudiana. It acts as a laxative and has a licorice flavor. The FDA has not approved it.
Many health-food stores in the United States sell Stevia as a dietary supplement, says Lyn Nabors, executive vice president of the Calorie Control Council in Atlanta, a nonprofit international trade association of companies that produce low-calorie and reduced-fat products and ingredients.
"Some people think because it comes from a plant that it's safe," she says. "I'm not saying that it's not safe, but that's not necessarily true."
Ms. Nabors says many people who use artificial sweeteners like them more than sugar. "Depending where you use the products," she says, "they taste as good as sugar."
Most consumers don't realize the potency of artificial sweeteners, she says. Aspartame and acesulfame potassium are 200 times sweeter than sugar. Saccharin is 400 times sweeter, and sucralose is 600 times sweeter.
"Most of the tabletop sweetener package is filler," she says. "There is only 36 milligrams of saccharin in Sweet 'N Low."
Ms. Nabors says the body cannot digest or metabolize artificial sweeteners because it doesn't have the enzymes to break them down. The products usually pass through the body, leaving it unchanged.
"They don't make a difference calorie-wise," she says. "If you put a fistful of something in the body that it can't digest, you would get a tummy ache, but so little artificial sweetener doesn't make a difference."
Michael F. Jacobson is executive director of the Center for Science in the Public Interest in Northwest. His organization calls into question the use of artificial sweeteners, especially saccharin.
"It caused cancer in animals," he says. "The best study in humans, done by the National Cancer Institute, indicated a cancer risk. We think saccharin should be taken off the market."
According to studies from the National Cancer Institute in Bethesda, data do not provide clear evidence of an association between artificial sweeteners and human cancer but also do not rule out such a possibility.
Sucralose seems to be safe, Mr. Jacobson says, but he cautions against consuming acesulfame potassium.
His group was unable to persuade the FDA to take it off the market, but he says animal testing "indicated it caused an increased risk of cancer."
Further testing for aspartame would be beneficial, Mr. Jacobson says. "I put a caution sign up to it," Mr. Jacobson says. "It is so widely used that we should be sure it's safe. Studies should be repeated by independent scientists."
Kit Pouliot, clinical manager at Providence Hospital in Northeast, says a teaspoon of sugar contains 30 calories. She advises her clients that honey is the same thing as sugar but in a different form.
"Some of them think that honey is better than sugar because it's natural," she says. "It's not."
Despite the thought of weight gain, Mrs. Pouliot encourages healthy patients to use sugar instead of artificial sweeteners. She also encourages them to use aspartame instead of saccharin.
"Even with the knowledge of cancer, people still use saccharin more because it's cheaper than aspartame and it tastes better," Mrs. Pouliot says. "It takes less saccharin to sweeten a beverage or dessert than other products."
Hetty Vandersluijs of Arlington says she tries to eat healthfully. "I hardly use any sugar at all," she says while shopping at Fresh Fields Whole Foods Market in Arlington. "I sweeten my tea with a little bit of honey. I am vehemently against artificial sweeteners."
Ms. Feeley, clinical research coordinator at MedStar Research Institute in Southeast, says balancing the diet is key.
"Artificial sweeteners in the context of a healthy diet are not a bad thing," she says. "Sugar is not bad, either, consumed in moderation."

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