Facts about Sugar-Free Sweeteners

Sugar free sweeteners

How safe are sugar free products? Some food scientists regard them as the new generation junk foods. Sugar free and artificial sweeteners can be found in many products including drinks, yoghurts, sweets and medications. We don’t recommend them except for diabetics.

1. Sugar free sweeteners: the Polyols

420 Sorbitol

421 Mannitol

953 Isomalt

965 Maltitol or hydrogenated glucose syrup

966 Lactitol

967 Xylitol

968 Erythritol

1200 Polydextrose

Food regulations require these additives to be labelled ‘Excessive consumption may have a laxative effect’, but as with other additives, consumers can be unaware of the cause of their problems because:

· consumers don’t make the connection if symptoms occur more than 30 minutes later, and these are likely to be hours later

· consumers don't think of sudden diarrhoea, excruciating stomach cramps or massive bloating and gas as ‘a laxative effect’

· consumers don't regard one stick of chewing gum or one candy bar as ‘excessive consumption’

· consumers don’t regard chewing gum as food (‘I didn’t swallow it’)

so they can't work out what is going on.

Readers’ stories: [386] Effects of ‘sugar-free” polyols (January 2006)

A few months ago I started chewing sugar free chewing gum several times a day and since then, my stomach has been almost continuously bloated. On occasions the amount of gas in my stomach is so extreme that I have to force myself to burp to relieve the pressure in my stomach - Male, 30s, Australia, sorbitol and maltitol, twice daily.

I was suffering with a sort of what I thought was "gastritis", causing extreme obnoxious embarrassing gas and bloating, and after an hour or two, constant gas every 10 minutes for hours and hours .... it was so bad I wanted to run away from myself, I know that’s funny but it was quite disgusting, the doctors told me I had a spastic colon but I noticed the "health" food candy bars I thought were healthy had sorbitol and my stomach feels perfect since I've been reading the labels and staying away from the sorbitol - female, 30s, USA, sorbitol, daily

I ate 5 caramels that I thought were safe because they were free of artificial colours and other additives. A few hours later I had excruciating stomach pains and sudden diarrhea – female, 40s, Australia, maltitol, one serve

[388] Blackouts from aspartame (March 2006)

I just wanted to tell you about the effects of aspartame on my insulin dependant father in-law. He has drunk at least a can of diet soft drink every day for the last 10 yrs since becoming diabetic, thinking he was doing the right thing. But about 12 months ago he started having regular blackouts every few months or so. He is 6ft 5in and a very big man so when he falls there is a lot of room for damage of some description. The last blackout on his veranda whilst sitting on a chair putting on his boots resulted in a badly dislocated shoulder with permanent damage. He no longer drinks diet drinks after I researched and found some absolutely shocking information linking aspartame to blackouts and has not had a blackout in over 12 months. Aspartame is definitely not recommended for diabetics and no-one should ingest this poison. The alarming thing is I have recently found it in salad dressing and things kids would eat. It’s also in most low fat products. - Simonne, by email

[389] Aspartame made me very sick (March 2006)

I have been unwell for a few years with many mysterious and varied complaints. I experienced a bout of Optic Neuritis in March 2004. I was hospitalised with a possible MS diagnosis. It's a long story but I was researching a link between my maladies and a toxin as a possible cause of my health complaints when I came across aspartame and its numerous effects on health. My problems I believe can be related to the vast quantities of Diet Coke I was drinking, 1.25 litres every second day and I was addicted to this stuff. Diet coke was my preferred drink. I also had lots of sugarfree chewing gum, pocket breath strips, diet foods etc. Coke and Wrigley say its safe because FSANZ say it is. I deleted aspartame from my diet in Sept 2004 and my symptoms have gone or abated at the least. I was put on a nasty anti-depressant as well back in March so life was a struggle. I have avoided all aspartame since Sept 2004 and got off the anti-depressant in Nov 2004 and am slowly feeling like my old self. I know aspartame did terrible things to me and I hope I have not suffered permanent damage. I fear for our kids. - Andrea, by email

FDA Petition

The Centre for Science in the Public Interest has petitioned the FDA about the potential adverse health effects of eating too much sorbitol, and the special danger posed to children, and have requested that the label be changed to: ‘this product contains [name of polyol], which may cause diarrhoea, bloating, and abdominal pain. Not suitable for consumption by children. To protect yourself, start by eating no more than one serving at a time’. You can read the full petition including medical references at Jacobson MF, Petition to the U.S. Food and Drug Administration for Regulatory Action to Revise the Labeling Requirements for Foods Containing Sorbitol, Center for Science in the Public Interest, September 27, 1999 www.cspinet.org/foodsafety/labeling_sorbitol.html

From the medical journals

1) Breitenbach RA, Simon J, Cases from the aerospace medicine resident teaching file. Case #59. A case of "unbearable" gremlinenteritis, Aviat Space Environ Med, 1994 ;65(5):432-3.

A flight surgeon presents with severe diarrhea of sudden onset. The unusual cause could be traced to sorbitol, a common sweetener that is widely available and could easily affect many aviators. The symptoms are exacerbated in the aerospace environment and close investigation of the dietary history may be the only clue to this elusive diagnosis.

2) Jain NK AND OTHERS, Sorbitol intolerance in adults, Am J Gastroenterol. 1985;80(9):678-81.

Sorbitol is a commonly used sugar substitute in "sugar-free" food products. Although sorbitol intolerance manifested by abdominal pain, bloating, and diarrhea has been observed in children, it has not been well documented in adults. Forty-two healthy adults (23 whites, 19 nonwhites) participated in this study. After ingestion of 10 g of sorbitol solution, end expiratory breath samples were collected at 15-min intervals for 4 h and analyzed for H2 concentration. Clinical sorbitol intolerance was detected in 43% of the whites and 55% of the nonwhites, the difference not being statistically significant. However, severe clinical sorbitol intolerance was significantly more prevalent in nonwhites (32%) as compared to whites (4%). There was a good correlation between the severity of symptoms and the amount of hydrogen exhaled. Dietetic foods, many of them containing sorbitol, are very popular with diabetics and "weight watchers." Based on our observations, we believe that a large number of adults could be suffering from sorbitol-induced nonspecific abdominal symptoms and diarrhea. These symptoms could lead to an extensive diagnostic work-up and lifelong diagnosis of irritable bowel syndrome.

3) Hill RE and Kamath KR, "Pink" diarrhoea: osmotic diarrhoea from a sorbitol-containing vitamin C supplement. , Med J Aust, 1982;1(9):387-9,

Sorbitol was the sole cause of protracted diarrhoea in seven children seen in two paediatric-gastroenterology outpatient departments. The sorbitol had been administered in the form of a vitamin C supplement in all seven children. Pink staining of napkins was a prominent feature in five of these seven patients, and was attributed to the cochineal dye contained in the vitamin C supplement. In children with chronic or intermittent watery diarrhoea, a careful dietary history should be obtained. If sorbitol ingestion is documented, a trial of sorbitol exclusion is recommended before embarking on extensive investigations.

2. Artificial sweeteners

The safety of artificial sweeteners has not been proven, and we do not recommend them except for diabetics; we do not recommend aspartame (951) for anyone. If you have to avoid sugar due to diabetes, polyols such as sorbitol are better than artificial sweeteners but watch for the development of irritable bowel symptoms, sometimes over some months.

950 Acesulphame-K

951 Aspartame (Nutrasweet, Equal)

952 Cyclamates

954 Saccharin

955 Sucralose

Recent concerns on the safety of aspartame (30/11/2005)

European food manufacturers will have to wait longer to find out if they can continue to use aspartame, after the EU's food safety regulator said it had still not received evidence from an Italian research centre indicating that the artificial sweetener causes cancer. Researchers at the Ramazzini Institute for Cancer Research in Italy caused a stir earlier this year by claiming that their study shows that aspartame causes lymphomas and leukaemia in female laboratory animals "at doses very close to the acceptable daily intake for humans". The authors of the study also say that while rats fed aspartame ate less food, there was no difference in body weight between treated and untreated animals.http://www.foodproductiondaily.com/news/printNewsBis.asp?id=64231

A summary of safety concerns from www.AdditiveAlert.com.au

950 Acesulphame-K: caused cancer and tumours in animal tests

951 Aspartame (Nutrasweet, Equal): linked to many health problems including headaches, seizures and brain tumours. The FDA has received more complaints about aspartame than any other food additive

952 Cyclamates: suspected carcinogen banned in the UK and USA in 1970 but still permitted in Australia

954 Saccharin: linked to bladder and reproductive cancers banned in the USA in 1977 but reinstated with strict labelling provisions

955 Sucralose: caused kidney and liver damage in tests, more research needed

From the medical journals

Olney JW, Farber NB, Spitznagel E, Robins LN, Increasing brain tumor rates: is there a link to aspartame? J Neuropathol Exp Neurol. 1996;55(11):1115-23.

In the past two decades brain tumor rates have risen in several industrialized countries, including the United States. During this time, brain tumor data have been gathered by the National Cancer Institute from catchment areas representing 10% of the United States population. In the present study, we analyzed these data from 1975 to 1992 and found that the brain tumor increases in the United States occurred in two distinct phases, an early modest increase that may primarily reflect improved diagnostic technology, and a more recent sustained increase in the incidence and shift toward greater malignancy that must be explained by some other factor(s). Compared to other environmental factors putatively linked to brain tumors, the artificial sweetener aspartame is a promising candidate to explain the recent increase in incidence and degree of malignancy of brain tumors. Evidence potentially implicating aspartame includes an early animal study revealing an exceedingly high incidence of brain tumors in aspartame-fed rats compared to no brain tumors in concurrent controls, the recent finding that the aspartame molecule has mutagenic potential, and the close temporal association (aspartame was introduced into US food and beverage markets several years prior to the sharp increase in brain tumor incidence and malignancy). We conclude that there is need for reassessing the carcinogenic potential of aspartame.