by Marcelle Pick, OB/GYN NP
Few of us are really aware of how many new Splenda® products there are in the supermarkets. We’ve been told that this artificial sweetener is different from all the past failures — Sweet’N Low®, NutraSweet®, etc. — and according to the claims, that this Splenda is the perfect sugar substitute: as sweet as sugar, but no calories; as sweet as sugar, but no surge in insulin; as sweet as sugar, but no side effects or long-term health damage.
The wave is coming because “low–sugar” or “sugar–free” is the latest fad — a welcome trend, given the health hazards of all the sugar in the average diet. But of the hundreds of new diet foods that will soon appear, most will use Splenda as a sugar substitute. This is important because for tens of millions of women, their diet soda or artificially-sweetened food is a keystone of what they think are healthy nutrition and food choices — both for themselves and for their families.
On the other side of the argument are responsible experts who say that Splenda is unsafe — the latest in a succession of artificial sweeteners that claim at first to be healthy, only later to be proven to be full of side effects. These authorities say that Splenda has more in common with DDT than with food.
What do we believe? We think that our regulatory system doesn’t do a good enough job ensuring our long-term safety. We’re concerned about the bigger picture, too — the dependence on sweets in the American diet to make us feel good — whether those sweets are satisfied by sugar or artificial sweeteners like Splenda. And we are especially sensitive to the women who can benefit from using artificial sweeteners as a bridge to a better life with healthier nutrition.
What should you think about artificial sweeteners? We want you to be fully informed about the dangers of Splenda (which isn’t what food marketers want!) so you can make the best choices for yourself and for your family. So let’s make sure you are.
Splenda — the public health experiment
“Low–sugar” is the successor to the “low–carb” craze, even though they are essentially the same thing. According to the New York Times, by the end of this summer 11% of the food items on supermarket shelves will be labeled “reduced sugar” — most of those targeted at kids and their health-conscious moms. Sales in granulated sugar have dropped four percent in the past six months. What’s behind this trend? Splenda.
Products featuring Splenda are perceived as “natural” because even the FDA’s press release about sucralose parrots the claim that “it is made from sugar” — an assertion disputed by the Sugar Association, which is suing Splenda’s manufacturer, McNeil Nutritionals.
The FDA has no definition for “natural,” so please bear with us for a biochemistry moment: Splenda is the trade name for sucralose, a synthetic compound stumbled upon in 1976 by scientists in Britain seeking a new pesticide formulation. It is true that the Splenda molecule is comprised of sucrose (sugar) — except that three of the hydroxyl groups in the molecule have been replaced by three chlorine atoms. (To get a better picture of what this looks like, see this image of a sucralose molecule.)
While some industry experts claim the molecule is similar to table salt or sugar, other independent researchers say it has more in common with pesticides. That’s because the bonds holding the carbon and chlorine atoms together are more characteristic of a chlorocarbon than a salt — and most pesticides are chlorocarbons. The premise offered next is that just because something contains chlorine doesn’t guarantee that it’s toxic. And that is also true, but you and your family may prefer not to serve as test subjects for the latest post-market artificial sweetener experiment — however “unique.” (See our article on endocrine disruptors for more information on toxins and persistent organic pollutants.)
Once it gets to the gut, sucralose goes largely unrecognized in the body as food — that’s why it has no calories. The majority of people don’t absorb a significant amount of Splenda in their small intestine — about 15% by some accounts. The irony is that your body tries to clear unrecognizable substances by digesting them, so it’s not unlikely that the healthier your gastrointestinal system is, the more you’ll absorb the chlorinated molecules of Splenda.
So, is Splenda safe? The truth is we just don’t know yet. There are no long-term studies of the side effects of Splenda in humans. The manufacturer’s own short-term studies showed that very high doses of sucralose (far beyond what would be expected in an ordinary diet) caused shrunken thymus glands, enlarged livers, and kidney disorders in rodents. (A more recent study also shows that Splenda significantly decreases beneficial gut flora.) But in this case, the FDA decided that because these studies weren’t based on human test animals, they were not conclusive. Of course, rats had been chosen for the testing specifically because they metabolize sucralose more like humans than any other animal used for testing. In other words, the FDA has tried to have it both ways — they accepted the manufacturer’s studies on rats because the manufacturer had shown that rats and humans metabolize the sweetener in similar ways, but shrugged off the safety concerns on the grounds that rats and humans are different. In our view, determining that something is safe (or not) in laboratory rats isn’t a definitive answer, as we’ve seen countless examples of foods and drugs that have proved dangerous to humans that were first found to be safe in laboratory rats, both in short- and long-term studies.
Here are two other reasons for our concern: first, in the eleven years after Splenda was put on the market, no independent studies of sucralose lasting more than six months have been done in humans. Second, none of the trials that were done was very large — the largest was 128 people studied for three months, making us wonder, what happens when you’ve used sucralose for a year, or two, or ten? Then there’s the fact that Splenda, as a product, consists of more than just sucralose—it’s made with dextrose, and sometimes also with maltodextrin, neither of which were included in the original studies and trials of sucralose. So the reality is that we are the guinea pigs for Splenda.
And now, are our children the next trial group? Thanks to an agreement between McNeil Nutritionals (makers of Splenda) and PTO Today, which provides marketing and fund-raising aid to parents’ associations, your elementary school’s next bake sale may be sponsored by Splenda — complete with baked goods made with the product.
Splenda side effects
Evidence that there are side effects of Splenda is accumulating little by little. Sucralose has been implicated as a possible migraine trigger, for example. Self-reported adverse reactions to Splenda or sucralose collected by the Sucralose Toxicity Information Center include skin rashes/flushing, panic-like agitation, dizziness and numbness, diarrhea, swelling, muscle aches, headaches, intestinal cramping, bladder issues, and stomach pain. These show up at one end of the spectrum — in the people who have an allergy or sensitivity to the sucralose molecule. But no one can say to what degree consuming Splenda affects the rest of us, and there are no long-term studies in humans with large numbers of subjects to say one way or the other if it’s safe for everyone.
If this sounds familiar, it should: we went down the same path with aspartame, the main ingredient in Equal and NutraSweet. Almost all of the independent research into aspartame found dangerous side effects in rodents. The FDA chose not to take these findings into account when it approved aspartame for public use. Over the course of 15 years, those same side effects increasingly appeared in humans. Not in everyone, of course — but in those who were vulnerable to the chemical structure of aspartame.
As food additives, artificial sweeteners are not subject to the same gauntlet of FDA safety trials as pharmaceuticals. Most of the testing is funded by the food industry, which has a vested interest in the outcome. This can lead to misleading claims on both sides.
But one thing is certain: some of the chemicals that comprise artificial sweeteners are known hazards — the degree to which you experience side effects just depends on your individual biochemistry. Manufacturers are banking on the fact that our bodies won’t absorb very much of these compounds at any one time. And many of us don’t. But what happens when we are ingesting a combination of artificial sweeteners like Splenda dozens of times a week through many different “low–sugar” or “sugar–free” products?
People have been using artificial sweeteners for decades. Some react poorly, some don’t — the problem is, you never know until you’re already sick. Scientists are calling Splenda a mild mutagen, based on how much is absorbed. Right now, it’s anyone’s guess what portion of the population is being exposed to the dangers of Splenda or already suffering from Splenda side effects. Until an independent, unbiased research group conducts long-term studies on humans (six months is hardly long-term!), how can we be certain? With all the new Splenda products on our shelves, it looks as if we are now in the process of another grand public experiment — without our permission. And we may not know the health implications for decades. As with all things, time will unveil truth.
So I urge you to be concerned about the potential dangers of Splenda — as with any unnatural substance you put in your body. And I am especially concerned about its use for children, which I recommend you avoid. But unlike many holistic practitioners, I do think artificial sweeteners can serve a purpose for some women. And that has to do with the old question — which is better, sugar or an artificial sweetener? Let’s start with sugar, where the problems all begin.
Sugar and insulin: the energy rush
Like Pooh Bear and the honey jar, sweet treats are the comfort food of choice for most of us. Usually we’ve had powerful emotional incentives set up in childhood — like getting a lollipop after a doctor’s visit — and most of us unconsciously associate sugar with love, pleasure, and reward. Why else would we call our dear ones “honey,” “sugar,” and “sweetie”?
There’s an equally strong biological urge here that’s hard-wired. We’re predisposed to seek out sugar when we can find it. After all, sugar (sucrose) is a carbohydrate. It’s metabolized directly into blood sugar, or glucose, which fuels our brain and muscles. The purer the source, the faster it gets into the bloodstream, bypassing much of the digestive process.
Eating sugar shoots our blood sugar levels up and triggers a spike in the hormone insulin, which is needed to prep our cells to absorb the sugar. If there are no other nutrients to sustain our blood sugar level, it crashes as quickly as it rises — and we crave another hit. This is how sugar addiction begins.
Moreover, sugar floods us with pleasure by stimulating the release of the neurotransmitter serotonin, and probably other mood-elevating substances. Scientists report that eating chocolate initiates a brain response similar to falling in love.
And so our brains have learned over time to equate the taste of “sweet” with a rapid infusion of energy and pleasure — a good thing when food was hard-won and life a battle to survive. Even now when we eat sweet foods, special taste buds trigger enzymes that prime our brain to anticipate this extra boost. With a balanced diet and a healthy metabolism, a calorie–control mechanism kicks in after a few minutes to regulate the desire for more food, including the satiety hormone leptin. But with too much sugar, we eat and eat and can’t get satisfied. (For more on this process, see our article on insulin resistance.)
Another big difference between prehistoric times and now is that sugar back then came solely from complex natural sources that had other nutritional qualities, such as fruit, honey, bark, and leaves. And because naturally sweet food is seasonal, ripening with the sun in the summer or growing almost exclusively in warm climates, it was relatively rare in past times.
The evolution of sugar
Over thousands of years our bodies used naturally sweet food safely and efficiently in this way. But then what happened? As our knowledge evolved, we grew adept at refining pure sugar from its food source. Sugar became its own food group — an empty calorie, devoid of protein, fat, or fiber — but still relatively rare.
As shipping and trade routes grew, sugar became widely available. New refining technology put granulated white sugar on every table, replacing the more nutritionally complex honey, molasses, barley and maple sugars. These had been generally added to food after preparation or to taste during baking and preserving, not pumped into the food itself.
Enter the modern era with its advanced food-processing techniques and competitive food companies, and presto! Refined sugar is everywhere and in everything.
Sugar is a food processor’s fantasy: it’s cheap, it adds bulk and texture, and it makes consumers prefer their product over a less-sweet alternative. So now consumers get sugar everywhere, from simple carbohydrates (so-called white food) to pure granulated sugar, and in other forms like dextrose, fruit juice concentrate, maltodextrin, and high–fructose corn syrup. These empty calories take the place of real nutrients — so while we eat and gain weight, we’re actually starving our cells.
The health effects of sugar
What happens to our metabolism, on all that sugar? Remember, we’re still primitive at a cellular level. What starts out initially as a survival tool quickly becomes a crutch if sugar is easy to procure. A sugar craving (which is really a craving for an energy and serotonin surge) becomes a habit.
We unwittingly reprogram our biochemistry to perpetuate these cravings. What’s more, this process is exacerbated by stress — because that’s when your body needs immediate energy and serotonin. We often put our bodies through the binge–crash cycle several times a day. Your fatigue tells you to have that extra cup of coffee or high–carb snack at mid-morning and again in the afternoon.
When you look at the huge increase in sugar in our diets this past century — particularly in processed foods — you see that it marches in step with the epidemic increase in metabolic diseases. According to the US Department of Agriculture, the average American is supplied with 140 pounds of caloric sweeteners per year. That’s 43 teaspoons for every man, woman and child every day! The USDA recommends an average of 10 teaspoons a day for a healthy adult (still too much for most women, in my book). The biggest sources are the corn sugar and corn syrup found in beverages like juice drinks and soda.
If we really listened to our bodies, we probably wouldn’t consume so much sugar. Our love affair with sugar has enjoyed a slow and subtle evolution — with daily nudges from the food industry. But our bodies simply aren’t equipped to handle such large amounts of sugar on a daily basis. Even in the short term, too much sugar can trigger headaches, tooth decay, and indigestion.
Over time, your body loses the ability to make enough sugar-digesting enzymes to meet the demand, and sugar sensitivity develops. Women tend to notice this more during perimenopause, when excess sugar and other simple carbohydrates trigger symptoms of hormonal imbalance.
Excess sugar consumption also upsets the balance of intestinal flora in your digestive tract and can cause symptoms of intestinal distress such as bloating, cramping, and gas. Other symptoms of sugar sensitivity are headaches, insomnia, aggression, panic attacks, irritability, mood swings, and depression. Too much sugar can deplete levels of serotonin, the neurotransmitter whose deficiency is linked to depression. What’s worse, low levels of serotonin actually trigger more sugar cravings.
New studies in accelerated aging link elevated sugar intake with a process called glycosylation: proteins in our bodies morph into AGE’s, or advanced glycosylation end-products, a kind of metabolic debris that collects in our organ, joint, and skin tissues.
Long-term sugar intolerance leads to type 2 diabetes and other complications like obesity and inflammation. Drinking more than one soda a day raises your risk of serious weight gain by 80%.
If it’s a natural food, why is sugar so hard to digest? Again, it’s the sheer quantity not the substance itself that causes concern. Studies show that our bodies actually work harder in sugar’s afterburn to restore metabolic homeostasis.
So is it any surprise that we’ve turned to artificial sweeteners for answers? For women trying to stay healthy, artificial sweeteners can seem like the best of both worlds — sugar without calories. But there simply is no free lunch. Artificial sweeteners can be just as troublesome, with one exception: sugar addiction — those of us who simply cannot stop eating sugar once we start. In this case, artificial sweeteners may help short-circuit the dependency.
Aspartame and saccharin: are they safer than Splenda?
Aside from Splenda, the most popular artificial sweeteners are aspartame (and its cousin, neotame) and saccharin. Foods with these additives are marketed to women as low-fat, low-sugar, and low-calorie.
Diet programs like Weight Watchers sell low-calorie foods that trade real nutrients for artificial ingredients, including sugar substitutes. I think it’s great to try and lose unwanted weight, but I question whether these packaged items should be marketed as healthy choices. Good nutrition needs to take more into account than calories and fat content — especially when it comes to how many artificial sweeteners we’re eating and what we’re mixing them with.
Dangers in aspartame
Aspartame, the main ingredient in Equal and NutraSweet, is responsible for the most serious cases of poisoning, because the body actually digests it. Aspartame should be avoided by most women, but particularly in those with neuropsychiatric concerns. Recent studies in Europe show that aspartame use can result in an accumulation of formaldehyde in the brain, which can damage your central nervous system and immune system and cause genetic trauma. The FDA admits this is true, but claims the amount is low enough in most that it shouldn’t raise concern. I think any amount of formaldehyde in your brain is too much.
Aspartame has had the most complaints of any food additive available to the public. It’s been linked with MS, lupus, fibromyalgia and other central nervous disorders. Possible side effects of aspartame include headaches, migraines, panic attacks, dizziness, irritability, nausea, intestinal discomfort, skin rash, and nervousness. Some researchers have linked aspartame with depression and manic episodes. It may also contribute to male infertility.
Saccharin, the first widely available chemical sweetener, is hardly mentioned any more. Better-tasting NutraSweet took its place in almost every diet soda, but saccharin is still an ingredient in some prepared foods, gum, and over-the-counter medicines. Remember those carcinogen warnings on the side of products that contained saccharin? They no longer appear because industry testing showed that saccharin only caused bladder cancer in rats. Most researchers agree that in sufficient doses, saccharin is carcinogenic in humans. The question is, how do you know how much artificial sweeteners your individual body can tolerate?
That being said, some practitioners think saccharin in moderation is the best choice if you must have an artificially sweetened beverage or food product. It’s been around a relatively long time and seems to cause fewer problems than aspartame. I don’t argue with this recommendation, but I encourage you to find out as much as you can about any chemical before you ingest it.
Artificial sweeteners are body toxins. They are never a good idea for pregnant women, children or teenagers — despite the reduced sugar content — because of possible irreversible cell damage. If you decide it’s worth the risks, then go ahead, but pay attention to your body and your cravings. Once you start tracking your response to artificial sweeteners, it may surprise you.
Short-circuiting the insulin spike
Basically, artificial sweeteners confuse your brain. The enzymes in your mouth begin a cascade that primes your cell receptors for an insulin surge, and when it doesn’t arrive your brain feels cheated. That’s why most diet sodas are loaded with caffeine — so you’ll still feel a jolt.
But even if your brain is distracted momentarily, soon enough it wants the energy boost you promised it — and you find yourself craving carbohydrates. In one study, people who used artificial sweeteners ate up to three times the amount of calories as the control group. But again, this is individual. It all comes down to the brain’s perception of calories, which can get thrown off whenever artificial ingredients are substituted for whole food.
In my practice I’ve seen that many patients are better able to break their addiction to sugar and maintain weight loss with the help of sugar substitutes. This is probably because insulin is not involved. Also, the substitutes are hundreds of times sweeter than sugar, so you may use less of them. In certain cases, I think moderate use of artificial sweeteners is okay — as long as you feel well.
But you should know that sugar substitutes don’t have to be artificial. There is another way!
Stevia and sorbitol — natural alternatives to artificial sweeteners
Other countries and diabetics have both taught us a lot about controlling insulin naturally. For many years, diabetics have used products sweetened with polyalcohol sugars like sorbitol, xylitol, malitol, and mannitol. These are natural sweeteners that do not trigger an insulin reaction. (Xylitol can be derived from birch tree pulp.) They have half the calories of sugar and are not digested by the small intestine.
While most polyalcohol sugars have no side effects, sorbitol is a natural laxative and can cause diarrhea, irritable bowel syndrome, bloating and flatulence.
For this reason, we recommend the herb stevia (Stevia rebaudiana) over sorbitol as a natural sweetener to our patients. Known in South America as the “sweet herb,” stevia has been used for over 400 years without ill effect. Stevia has been enormously popular in Japan, where it has been in use for more than 20 years, now rivaling Equal and Sweet’N Low. It’s 200–300 times sweeter than sugar, so just a small portion of stevia will sweeten even a strong cup of tea.
We’ve known about stevia in the US since 1918, but pressure from the sugar import trade blocked its use as a commodity. Today stevia is slowly gaining steam as a sugar substitute, despite similar hurdles. The FDA has approved its use as a food supplement, but not as a food additive due to a lack of studies. Stevia can be used for anything you might use sugar in, including baking. It is naturally low in carbohydrates. You can buy stevia at most health food stores and over the web. There will always be those who have a sensitivity to a substance, but based on reports from other countries it appears to have little to no side effects. For women who want to move through their cravings for sugar without artificial chemicals, stevia is a great option.
More importantly, you can do a lot to support your body in other ways to reduce your dependency on sugar and sugar substitutes — something I encourage every woman to do. Once your body returns to its natural state of balance, you may find that you can toss out those artificial sweeteners and put sugar in its proper place: where you have control over it and not vice versa.
Artificial sweeteners are chemicals, not food! They have no calories because they don’t nourish your body in anyway — they’re toxins your body has to clear, or, depending on how well you detoxify, store. But if you can’t live without your diet drink, don’t beat yourself up about it. Accept it and give your body extra support elsewhere.
Living the sweet life with better nutrition
At our practice, we encourage our patients to build their snacks and meals from whole food, which means food that has not been processed and manipulated. Your food should resemble its source as closely as possible (e.g., fresh fish, not fish sticks). And this includes sugar. Even if you don’t have a reaction or sensitivity to sugar, continue to use refined sugar rarely, if ever. Instead, sweeten sparingly with the more nutritionally complex natural sugars such as honey, rice syrup, molasses, and maple syrup.
If you already suffer from weight gain, diabetes, inflammation, chronic pain, migraines, headaches, or depression, you may have sugar intolerance. Check with your healthcare practitioner and try the elimination diet, eliminating sugar entirely from your diet for a couple of weeks, then reintroducing it for a day to see how you feel. Many of our patients are amazed at how much better they feel after breaking the sugar habit.
Remember these healthy habits:
- Take a daily multivitamin to support your body’s nutritional needs.
- Eat protein, healthy fats and complex carbohydrates for breakfast. Simple carbs and sugar fire up your insulin receptors and spark those sugar cravings. Starting your day with a sugary or high-carb breakfast dooms you to a day of up-and-down blood sugar levels — which will drive you to eat too much of the wrong things all day long.
- Shop the perimeter of your grocery store — avoid the processed foods in the center aisles. Read all labels and be wary of food that contains aspartame, neotame, saccharin, acesulfame K, or sucralose. No studies have been done on the safety of mixing artificial sweeteners, and who wants to become a living, breathing test subject. So if you consume them, do so prudently.
- Minimize or avoid products that have sugar, high-fructose corn syrup or corn syrup near the top of their ingredient list. Sugar can also be disguised as evaporated cane juice, cane sugar, beet sugar, glucose, sucrose, maltose, maltodextrin, dextrose, sorbitol, fructose, corn sugar, fruit juice concentrate, barley malt, caramel, and carob syrup.
- Keep a bowl of fresh ripe fruit nearby to snack on, to relieve your sugar cravings. Think primitive and eat fruit that is in season. The fresher the fruit, the more succulent and satisfying it will be. You may find you don’t need anything sweeter!
- If you are craving something sweet, don’t feel guilty. We’re often made to feel that avoiding sugar is only matter of willpower, but it’s more complicated than that. Most of the time, uncontrollable or patterned cravings stem from a malfunctioning metabolism or low serotonin. Work on healthy nutrition and you’ll find your cravings will disappear.
- Indulge yourself sometimes. Remember, we have sweet taste buds for a reason. Try a piece of fruit first — you may find your craving diminishes. If you still want a piece of chocolate or pie, go ahead! But savor it slowly like a rare treat you may not have again for a while. Once your brain is allowed to fully register the experience, you may find you’re sated after a few bites. And, to help balance out the accompanying insulin surge, eat a piece of protein with it. Just make it a treat, not a habit.
- Remember that wine and alcohol are sugar. When it comes to sugar, having a glass or two of wine every day is just like a daily dessert.
- Take a short walk after eating and breathe in deeply. It’s likely you won’t want dessert after all! And if you do, you’ll appreciate it more.
- Focus more on what you’d like to cook and eat than what you shouldn’t. If you listen to your body, it may surprise you with a craving for eggs, not a diet soda.
Finding comfort in the right places
After taking a closer look at what you eat, it may also be useful for you to examine the role sweet food plays in your life. This often ties in to deep associations and emotions buried in childhood. Perhaps you always crave sugar in the mornings because you associate family, home, and security with the pancake breakfasts your mother used to make.
But just as a pancake breakfast won’t satisfy your emotional longings, fake sugar won’t feed your body’s needs — nor real sugar, for that matter. There simply are no shortcuts in that department. Facing what is really going on in our emotions, our bodies, and our lives can be challenging, and it’s tempting to take the easy out, buffeted by sugary treats and comfort food. In my experience, that path only leads back to the same place — more pain, and eventually, sickness.
So I encourage you to nourish yourself from the inside out, with healthy food, self-care, and healthy relationships. In life there is bound to be some bitterness — the secret is to restore enough balance to delight in the sweet.