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Artificial Sweeteners

By Juliann Schaeffer

Used in moderation, they can reduce calories and prevent blood sugar spikes, but clients should beware of some of the products that contain them.

Sweet treats, such as ice cream and strawberry pie in the heat of summer, often equate to a happy ending to an otherwise stressful day for many people—but not so for patients with diabetes, who know that even one small indulgence quickly can send their blood glucose levels soaring.

But artificial sweeteners, sold in stores and used by food and beverage companies to create sugar-free or reduced-sugar baked goods, beverages, and other products, can help clients with diabetes get the sweetness they desire without the dire consequences of sugar. A handful of artificial sweeteners are readily available at most grocery store retailers, including aspartame (NutraSweet, Equal), acesulfame potassium (Sunett, Sweet One), saccharin (Sweet’N Low), sucralose (Splenda), neotame, and rebiana (Truvia).

Hundreds of Times Sweeter
“Most of these [artificial sweeteners] are hundreds of times sweeter than sugar, so only very small quantities need be used” to elicit the sweet taste clients are after, says Nora Saul, MS, RD, CDE, LDN, manager of nutrition services at the Joslin Diabetes Center.

“Acesulfame K and aspartame are about 200 times sweeter than sugar; saccharin is 300 times sweeter; stevia sweeteners are between 200 and 300 times sweeter; and sucralose is 600 times sweeter than sugar,” says Kim Galeaz, RD, CD, a culinary nutrition consultant to the agriculture, restaurant, supermarket, and food and beverage industry, including The Coca-Cola Company.

Less Impact on Blood Glucose
By using artificial sweeteners in moderation, patients with diabetes can enjoy that sugary taste without the calories and carbohydrates that can negatively affect blood glucose levels.

While Saul says the Joslin Diabetes Center doesn’t push the use of such sweeteners (and actively discourages their use for diabetes patients who are pregnant), she says, “We do recognize that it provides a way for people to be able to have some sweetened products that have less impact on their glucose levels.”

“Simply put, the main benefit for anyone—not just those with diabetes—is to save a few calories on your favorite sweet-tasting foods and beverages” while staying within their calorie and carbohydrate budget, Galeaz says. She adds that because there’s a range of options available, clients can find an artificial sweetener that best suits their preferred taste.

Benefits of Artificially Sweetened Beverages
Stacey Adams, MS, RD, an educator with Novo Nordisk’s Diabetes Education Program, says beverages are one area where diabetes patients can benefit from using artificial sweeteners. “Beverages are the one place where using artificial sweeteners is a common practice,” she says. “Each 12 oz of diet pop that replaces regular pop can cut 39 g of carbohydrate out of an individual’s intake.”

Adams says clients with diabetes who have an affinity for flavored coffee also can benefit from using a sugar substitute. “Five pumps of sugar-based syrup can contain about 20 g of carbohydrate in addition to the amount of other carbohydrate in the drinks,” she explains. “The sucralose options available at most coffee shops can greatly decrease the amount of carbohydrate in drinks.” Clients also can add tabletop sweeteners to their daily coffee or tea to remove some of the bitterness without adding calories.

For a simple snack, clients can sprinkle an artificial sweetener on their favorite fruit. Galeaz says she likes them sprinkled in her oatmeal, “to give a sweet taste with minimal calories, making room for extra walnuts, pecans, raisins, dates, or dried cherries.”

Store-Bought Baked Goods and Other Products
Clients can find various baked goods and other food products at supermarkets that use these sweeteners to reduce calories and carbohydrates. However, it’s important to note that these products aren’t necessarily a free pass for diabetes patients just because they include a sugar substitute.

“We always encourage patients to read the food labels on the products they consume and to take note of the portion sizes, calories, fat, and grams of total carbohydrate,” says Meredith Nguyen, RD, LD, CDE, CNSC, a dietitian with the Methodist Charlton Medical Center Diabetes Self-Management Program. “Remember that sugar free doesn’t mean calorie or carbohydrate free.”

Saul agrees that a word of caution will serve most clients well. “Although many products in the marketplace use artificial sweeteners, it doesn’t mean that the product is completely carbohydrate or calorie free. It also doesn’t mean that it’s a healthful product,” she says. “In addition, sometimes a product that uses artificial sweeteners still may be high in fat, saturated fat, or salt. It’s still essential that people read the nutrition label before they buy a particular product.”

Sugar-Free Baking
Clients may be better off baking their own sweet treats to ensure they know what carbs, calories, and other goodies are going into their cakes, pies, and cookies. To do so, they can use the granular versions of artificial sweeteners that are more suitable for baking.

“If you love to bake and you’re a diabetes patient, I’m all for learning to cook with low- and no-calorie sweeteners,” Galeaz says. “You’ll save on added sugars, total calories and, ultimately, carbohydrate grams.”

Because not all sweeteners withstand the heat to the same degree during cooking (some are better for baking than others), Galeaz suggests clients visit their favorite sweetener brand’s website for recipes and tips.

“Using artificial sweeteners in recipes is a little bit of a trial-and-error process,” Saul adds. “Although artificial sweeteners replace the sweetness of sugar, they often don’t share sugar’s browning and moisture retention properties in recipes. Usually only a part of the sugar in a recipe can be replaced with an artificial sweetener.”

Saul also suggests clients follow manufacturer recommendations on a sweetener’s packaging when trying out sugar-free baking themselves.

For clients interested in making sugar-free treats, see below for three recipes that use artificial sweeteners.

— Juliann Schaeffer is a freelance writer and editor based in Allentown, Pennsylvania, and a frequent contributor to Today’s Dietitian

Remixed Banana Muffins

Makes 18 muffins

Ingredients
3 well-ripened bananas
1 egg
1/4 cup canola oil
1/3 cup milk
1/2 cup Splenda
1 tsp salt
1 tsp baking soda
1/2 tsp baking powder
3/4 cup whole wheat flour (or other whole grain flour)
3/4 cup flour
1/2 cup ground flaxseeds
1/2 cup walnut pieces

Directions
1. Preheat oven to 350˚F. Prepare muffin tins. Stir together dry ingredients (salt, baking soda, baking powder, flour, and flaxseeds). Mash bananas; add egg, oil, milk, and Splenda, and stir until combined.

2. Add dry ingredients to wet ingredients and fold in walnut pieces. Divide evenly among muffin tins.

3. Bake for 22 minutes. Cool on wire rack.

Nutrient Analysis per serving (1 muffin)
Calories: 110; Fat: 7 g; Cholesterol: 10 mg; Sodium: 215 mg; Carbohydrate: 11 g; Dietary fiber: 2.2 g; Protein: 2.5 g

— Recipe courtesy of Stacey Adams, MS, RD

Gluten-Free Blueberry Corn Muffins

Serves 22

Ingredients
Cooking spray
One 20-oz package gluten-free cornbread mix (Bob’s Red Mill)*
1 3/4 cup low-fat buttermilk
1/4 cup canola oil
1 egg
2 egg whites
1/2 lemon, juiced
1/4 cup Splenda Sugar Blend + 1 T (divided)
1/2 tsp vanilla
1 1/2 cups blueberries

*Many regular cornbread mixes contain flour and aren’t gluten free. If you’re following a gluten-free diet, make sure that your cornbread mix is gluten free.

Directions

Preheat oven to 375˚F. Line muffin tins with 22 muffin papers and spray with cooking spray.
In a large bowl, combine cornbread mix, buttermilk, oil, egg, egg whites, lemon juice, vanilla, and 1/4 cup Splenda Sugar Blend. Mix with an electric mixer on low speed until blended. Then mix on high for 30 seconds.
Gently fold blueberries into muffin batter.
Spoon about 1/4 cup batter or less into each muffin cup. Sprinkle 1 T Splenda Sugar Blend on top of muffins (evenly divided).
Bake for 22 minutes or until lightly browned on top. Cool on a wire rack.

Nutrient Analysis per serving (1 muffin)
Calories: 140; Fat: 3.5 g; Cholesterol: 10 mg; Sodium: 230 mg; Carbohydrate: 26 g; Dietary fiber: 2 g; Protein: 3 g

— This is an original recipe from the American Diabetes Association’s free nutrition resource Recipes for Healthy Living. You can get more recipes like it, along with a meal plan, and other healthful tips each month when you sign up for Recipes for Healthy Living at www.diabetes.org/recipes.

Key Lime Pie

Serves 8

Ingredients
1 box (0.3 oz) sugar-free lime flavored gelatin
1/4 cup boiling water
2 containers (8 oz each) key lime pie-flavored light yogurt
1 container (8 oz) frozen fat-free whipped topping, thawed
1 prepared 9-inch reduced fat graham cracker pie crust

Directions

In a large heat-resistant bowl, dissolve gelatin in boiling water and, with a whisk, stir in yogurt. With a wooden spoon, fold in whipped topping.
Transfer mixture to prepared crust. Refrigerate overnight or at least two hours.

Nutrient Analysis per serving
Calories: 165; Fat: 6.5 g; Cholesterol: 0 mg; Sodium: 189 mg; Carbohydrate: 25 g; Sugars: 15 g; Dietary fiber: 0 g; Protein: 3 g

— Recipe submitted to Methodist Health System Shine Magazine by Imge Whitlock