Regulate Use Of Artificial Sweeteners

Sweetness is an irresistible organoleptic craving that plays a major role in food satiety. A relishing dessert is undoubtedly the most awaited signing off menu of hearty meals. Intake of sugar however, is associated with risk of obesity and some diet related noncommunicable diseases. Growing prevalence of such lifestyle related disorder is paving way for alteration in food choices. Not surprisingly, evolving consumer food habits portrays a trend of reducing or avoiding sugar. A pursuit for sugar alternates has been triggered.

Advent of research and technology in the last few decades has expedited commercialisation of sugar substitutes. Artificial sweeteners mimic the effect of sugar on taste. As it has low or no calories, it is often marketed with the claim that its aids weight loss or help maintain weight. Dietary labels like “No Sugar” or “Low Sugar” are often used in products that contain such sweeteners. This has made consumer food choices easier. However, a global consensus on safety of artificial sweetener has been a challenge. Ever since the inception of first artificial sweetener, Saccharin in 1885 in USA, the health impact of long-term use of artificial sweeteners has been much debated

Natural sugar substitutes

Natural sweeteners find its taste in the migratory hydrogen atom within the sugar compound. As per the AH-B theory of sweetness, this atom attaches to oral receptor sites and helps generate sweetness. Mostly starch based, natural sugar substitutes like glucose syrup, fructose syrup, etc. serve as ingredient in manufacturing baked goods, confectionery, chewing gums, fruit drinks, etc. Sugar alcohols like Xylitol, Sorbitol, Mannitol, Maltitol, Erythritol, etc. find application in food and pharmaceutical industries. Sugar free cough syrup often contains such sweeteners. Natural sweeteners are metabolised and absorbed by the gut to a large extent during digestion. 

Artificial sweeteners are products of chemical synthesis of carbohydrates and protein. It has similar sweetness generation mechanism like sugar but do not raise blood sugar level. Often referred to as non-nutritive sweeteners, it does not lead to plaque formation. It finds applications in manufacturing of frozen desserts, yoghurt, aerated drinks, baked goods, breakfast cereals, etc. Table top artificial sweeteners are now easily available in marts and online. United States Food and Drug Administration (U.S. FDA) approves the use of artificial sweeteners like Aspartame, Saccharin, Acesulphame K, Sucralose, Neotame and Advantame. Such sweeteners possess higher intensity of sweetness. Saccharin is 200-700 times sweeter than sugar. Aspartame is 200 times sweeter than sugar. Similarly, Neotame is 12,000 times sweeter than sugar and Advantame is 20,000 times sweeter than sugar. Most artificial sweeteners don’t get metabolised and are secreted by kidney. 

Health advisories on artificial sweeteners have been issued time and again from global food safety monitoring bodies. In the 1970s, Saccharin was known to induce bladder cancer in male rats when used in high concentration. In 2000, however, the National Toxicology Programme of the National Institute of Health of USA removed Saccharin from the list of potential carcinogens. Safety of Aspartame has been controversial since its initial approval by the U.S. FDA in 1974. Studies linked its long-term use with brain tumour. However, after a through safety review in 1981 by US FDA, over ninety countries approved its use. Aspartame is used in diet soda, soft drinks, sugar free chewing gum, yogurt sugar and cough lozenge. 

On July 14, 2023, International Agency for Research on Cancer (IARC) of the World Health Organisation (WHO) proclaimed Aspartame as a possible carcinogen to human. The Joint Expert Committee on Food Additives has however reaffirmed the Acceptable Daily Intake (ADI) of 40 mg/kg body weight. The WHO guideline on “Use of Non-Sugar Sweeteners (NSS)” released in 2023, links its long-term use to increase in type 2 diabetes, mortality and cardiovascular diseases in adults. The heightened risk of pre-term birth due to higher NSS use in pregnancy and asthma, allergies and poorer cognitive functions in neonates has been mentioned. It advises against the use of non-sugar substitutes to control body weight. 

Adverse impact 

Prolonged use of artificial sweeteners gradually changes taste buds and brain response for cravings leading to possible addiction. Sugar alcohols have been associated with diarrhoea. People who suffer from a rare autosomal disease, Phenylketonuria, have difficulty breaking down phenylalanine, a compound present in Aspartame, and its build-up in the body has adverse impacts. The General Standard for Food Additive, CODEX STAN 192-1995 guides the use of Acesulphame K, Advantame, Alitame and Aspartame. In Nepal, Food Rules 2027 B.S., guides the permissible level of permitted food additives. The Food Safety and Standards Authority of India approves the use of Saccharin Sodium, Aspartame, Acesulfame Potassium, Sucralose, Neotame, and Isomaltulose in food.  

The narrative of healthy diet is slowly transforming from low fat, high carbohydrate diet of 1990’s to the low fat, low carbohydrate diet of the recent decades. Many diet consciousness people with sweet-tooth seek solace in artificial sweeteners to get rid of their sugar guilt. On the pretext of substituting sugar, any unsupervised or indiscriminate use of artificial sweetener should be avoided. Stringent compliance in use of artificial sweeteners and its nutritive labelling is imperative. There is a dire need to converge the efforts of industry and academia to ensure safety of artificial sweeteners. Regular review of national food codes is imperative. By combining evidence-based research with effective policies, we can pave way for a healthier population.

(The author is a Food Technologist and can be contacted at monicakpg@yahoo.com).