Sugar in Food: Sugar Substitutes that are Safe

Advantame

What it is: A chemical cousin of aspartame and neotame that is 20,000 times sweeter than sucrose (table sugar). It was approved by the Food and Drug Administration in 2014.

Safety: Two key safety studies on advantame were flawed. However, because the additive is so sweet, the minuscule amounts that will be added to foods are almost certainly safe.

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Neotame

Among its brand names: Newtame.

What it is: A chemical cousin of aspartame and advantame that is 8,000 times sweeter than sugar, so only minuscule amounts are used to sweeten foods. Although neotame was approved by the FDA in 2002, it is rarely used.

Safety: Animal and human studies have raised no safety concerns.

Stevia Leaf Extract

Among its brand names: Pure Via, SweetLeaf, Truvia. When used as an ingredient, typically called stevia leaf or stevia leaf extract, but may also appear as steviol glycosides, rebiana, rebaudioside A, reb A (or D, F, M, or X), or stevioside.

What it is: Highly purified extracts from the leaves of a shrub that traditionally grew in South America and that is now grown commercially in California and Asia. Stevia leaf extract is 200 to 300 times sweeter than sugar.

Safety: In the 1990s, the FDA rejected the industry’s attempt to add whole-leaf stevia or crude stevia extracts to foods because it was concerned about stevia’s potential impact on blood sugar, sperm count, kidney function, and the cardiovascular system.

However, in the early 2000s, manufacturers began developing highly purified stevia extracts, which they declared were safe. The FDA hasn’t objected to their use.

In two studies in rats, the stevia leaf extract stevioside didn’t increase the risk of cancer. In several other rat studies, a different extract (rebiana, which is also called rebaudioside A or reb A) didn’t impair fertility or lead to offspring with developmental problems. But in several of 31 genotoxicity studies, stevia-related compounds caused changes in DNA. Because of that, the FDA should have required companies to also test stevia leaf extracts for cancer in mice. That never happened.

21 Replies to “Sugar in Food: Sugar Substitutes that are Safe”

  1. I’m a long-term Nutrition Action Subsriber. What about Monk Fruit (Nectresse)? I never see you mention that one way or the other and I started using it to avoid sucralose after you issued a caution on that. TU!

    1. From Nutrition Action Healthletter: We still rate it as “caution.” It may well be perfectly safe, but the testing on it is really sparse.

  2. For 25 years I have been telling people that Nutrition Action is the place to go for objective, evidence-based nutrition information. You have disappointed me today.

    “Two key safety studies on advantame were flawed. However, because the additive is so sweet, the minuscule amounts that will be added to foods are almost certainly safe.”

    Seriously? There are substances out there that can kill you in miniscule quantities.

    1. From the Center for Science in the Public Interest (publisher of Nutrition Action Healthletter): We sent a detailed 7-page letter strongly criticizing FDA’s failure to abide by its own published standards and for dismissing concerns raised by some of its own scientists, and urged them to set a higher safety bar to ensure safety. But at the end of the day, looking at the data that was available, we did not think it was risky for consumers. If we did, we’d certainly say so.

    1. From Nutrition Action Healthletter: We rate sucralose (Splenda) as “caution.” We’ve been waiting for the publication of a study that reportedly found it to cause cancer. Once that is published, we’ll review it carefully and our rating might change. Stay tuned!

    1. From Nutrition Action Healthletter: Aspartame actually tops our list of artificial sweeteners to avoid. It caused cancers in animals in three independent studies, for starters. Sucralose we rate as “caution.”

  3. Agree with Jennifer. Lots of wiggle room in “almost certainly safe”.
    Probably threw out the results that indicated there might be an issue.

    1. From the Center for Science in the Public Interest (publisher of Nutrition Action Healthletter): We sent a detailed 7-page letter strongly criticizing FDA’s failure to abide by its own published standards and for dismissing concerns raised by some of its own scientists, and urged them to set a higher safety bar to ensure safety. But at the end of the day, looking at the data that was available, we did not think it was risky for consumers. If we did, we’d certainly say so.

    1. From Nutrition Action Healthletter: Xylitol is safe in moderation. As with most other sugar alcohols, too much can cause GI distress. Xylitol has about three-quarters as many calories as sugar and is about as sweet.

  4. Some time ago I heard that aspartame changes chemically to formaldahide when heated in tea or coffee and even in the beverage can. Is this true?

    1. From Nutrition Action Healthletter: We’re not sure about in the can, but aspartame does metabolize to formaldehyde in the body. Formaldehyde has been classified as a human carcinogen, and, like aspartame, causes leukemia/lymphoma-type cancers and other cancers in animals. (The evidence that formaldehyde causes these cancers in humans came long after the studies in animals). Studies by several different laboratories find that other chemicals that metabolize to formaldehyde also cause cancer in animals. It is generally assumed that a chemical that causes cancer in animal testing also poses a cancer hazard to humans. We recommend avoiding aspartame.

    1. From Nutrition Action Healthletter: Maltodextrin is safe to eat. A texturizer in processed foods, it’s made from starch and consists of short chains of glucose molecules. Normal maltodextrins are easily digested and absorbed by the body. Maltodextrin is usually made from starch from corn, potato, or rice, but is sometimes made from wheat starch. If maltodextrin is made from wheat, food labels will indicate that fact to protect people who are allergic to wheat.

      For more information about the safety of specific food additives, visit the Center for Science in the Public Interest’s Chemical Cuisine.

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