Volume 12 Number 4, 1999, Page 250
Hope S. Warshaw, MMSc, RD, CDE
This article highlights recent news regarding low-calorie sweeteners. It also provides the basics about a low-calorie sweetener that recently obtained Food and Drug Administration (FDA) approval and one that is now in the hands of FDA reviewers. Guidelines for helping clients learn how to fit foods with low-calorie sweeteners into their food plans are provided along with valuable Internet resources.
What's in a Name?
What Does the American Diabetes Association Say?
"Saccharin, aspartame, acesulfame K, and sucralose are approved for use by the Food and Drug Administration (FDA) in the U.S. The FDA also determines an acceptable daily intake [ADI] for approved food additives, including nonnutritive sweeteners. Nonnutritive sweeteners approved by the FDA are safe to consume by all people with diabetes."3
The current version1 adds more detail about ADI. It also places the responsibility of safety of nonnutritive sweeteners on the FDA approval process and adds a notation about actual intake relative to ADI. The current version reads:
"Saccharin, aspartame, acesulfame K, and sucralose are approved for use in the U.S. by the Food and Drug Administration (FDA). For all food additives, including nonnutritive sweeteners, the FDA determines an acceptable daily intake (ADI), which is defined as the amount of a food additive that can be safely consumed on a daily basis over a person's lifetime without any adverse effects and includes a 100-fold safety factor. Actual intake by individuals with diabetes for all nonnutritive sweeteners is well below the ADI."
Aspartame: A Lesson Learned
The allegations were made by Nancy Markle in a lecture she presented at a "World Environmental Conference." The e-mail raised the allegation that the two breakdown products of aspartamemethanol and formateare causing an epidemic of multiple sclerosis and systemic lupus. Monsanto, the manufacturer of the NutraSweet brand of aspartame,4 the FDA via a communication with the Calorie Control Council,5 the Multiple Sclerosis Foundation,6 and the American Diabetes Association7 disclaim any truth to these allegations and continue to support the safety of aspartame.
What should concern us more than this one allegation is that our relatively new electronic communication vehiclethe Internethas its downfalls. On the Internet, anyone can present themselves as an authority, and their messages of misinformation can speed to millions in minutes.
When we hear an allegation that seems "fishy," it is our responsibility to ask questions rather than to accept the information as truth and foster the campaign of misinformation with a click of the e-mail "forward" button. First determine the source or author of the information and that person's authority or credentials. Then verify the content with reliable sources. Using this Internet story about aspartame as an example, reliable resources would have been the American Diabetes Association, the FDA, Monsanto, the Multiple Sclerosis Foundation, the Calorie Control Council, and the International Food and Information Council. A list of valuable Internet resources appears in Table 1.
Aspartame's Safety Again Affirmed
Sucralose: A Newly Approved Low-Calorie Sweetener
The advantage of sucralose for the food industry and consumers is its stability. It retains its sweetness over a wide range of temperature and storage conditions and in solution over time. The stability of sucralose allows its use in a wide variety of foods and beverages. For this reason, food manufacturers can use sucralose to create a number of foods and beverages in categories in which there are currently few products sweetened with a low-calorie sweetener, such as canned fruit, fruit drinks, baked goods, sauces, and syrups. Sucralose can also be used in home cooking and baking.
The diabetes community is just becoming familiar with sucralose. Sucralose was granted FDA approval on April 1, 1998. The approval was for the use of sucralose in 15 food and beverage categories. This is the broadest initial approval ever granted by FDA for a food additive. In addition, FDA requires no warning or informational label on products with sucralose. On Aug. 12, 1999, just 16 months after the initial approval of sucralose, the FDA approved sucralose as a general purpose sweetener, meaning that sucralose can now be used in any food or beverage where the standards of identity do not preclude its use.9 In addition, sucralose has been approved for use in foods and beverages in more than 30 countries, including Canada, Mexico, and Australia.
Sucralose is manufactured and marketed in the United States by McNeil Specialty Products Company, a Johnson & Johnson Company. Sucralose is available to food manufacturers for use in food and beverages as Splenda brand sweetener. Currently, a range of products sweetened with Splenda are already on supermarket shelves, such as carbonated soft drinks, low-calorie beverages, and maple syrup. Additional products sweetened with Splenda will continue to be brought to market. Splenda low-calorie sweetener in packets and granular form will be available nationally by early 2001. The granular form can be used as a one-to-one replacement for sugar. At present, McNeil Specialty Products Company is providing people with diabetes the opportunity to purchase the two forms of Splenda via the Internet at www.lifescan.com.
Neotame: On the Horizon
Neotame is quickly metabolized and fully eliminated by the body via the stool and urine. A clinical trial conducted in people with diabetes demonstrated no effect on insulin or glucose levels or on glycemic control. The results of this study were submitted to the FDA as part of Monsanto's food additive petition for neotame.
Monsanto filed a food additive petition at FDA for the use of neotame in tabletop sweeteners in December 1997 and a petition at FDA for the approval of neotame as a general-use sweetener in any food and beverage category in February 1999. Historically, the FDA has taken at least 10 years to approve food additives.
Acesulfame Potassium: A New Use
Until the FDA approval of ace K in soft drinks, this blend was not possible in the United States. The ace K and aspartame blend is also now used in gelatin, ice tea, and other soft drinks.
The Blending Age is Here
Historically, a few blends of low-calorie sweeteners have been used. However, it has been most common in the United States for products to be sweetened with just one low-calorie sweetener. In the early years of use of low-calorie sweeteners, cyclamate and saccharin were blended. Cyclamate was used to decrease the bitter aftertaste of saccharin. In addition, for many years aspartame and saccharin have been blended in fountain carbonated diet soft drinks. In this blend, aspartame provides the clean sweet taste, and saccharin provides the stability to maintain the sweetness over time in an acidic solution. In soft drinks with the ace K and aspartame blend, ace K provides the sweetness stability in carbonated soft drinks, while aspartame provides the clean sweet taste.
Teaching Principles and Tools
The American Diabetes Association recently developed a helpful and inexpensive teaching booklet titled A Guide to Fitting Foods with Sugar Substitutes and Fat Replacers Into Your Meal Plan. This booklet can help teach clients about the different low-calorie sweeteners, foods in which low-calorie sweeteners are used, and guidelines for fitting foods into the meal plan. Sample exercises to practice using the guidelines are included. To order call 1-800-232-6733. Booklets are only available in lots of 25. Member price is $12.95, nonmember price is $10.95 per lot.
1American Diabetes Association: Position statement: Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care. 22 (Suppl 1): S42-45, 1999.
2American Diabetes Association: American Diabetes Association Complete Guide to Diabetes. Alexandria, Va., American Diabetes Association, 1997.
3American Diabetes Association: Position statement: Nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 17:519-22, 1994.
4Monsanto Company response to the allegations about aspartame at www.monsanto.com.
5Letter from FDA available on Calorie Control Council's Internet sitewww.caloriecontrol.org.
6Multiple Sclerosis Foundation response to the allegations about aspartame at www.msfacts.org/aspartame.htm
7American Diabetes Association statement regarding aspartame at www.diabetes.org.
8Mezitis N, Koch P, Maggio C, Quoddoos A, Pi-Sunyer FX: Glycemic response to sucralose, a novel sweetener, in subjects with diabetes mellitus. Diabetes Care 19:1004-1005, 1996.
9Federal Register, Aug. 12, 1999. 64 (155):43908-43909, 1999.
The author wishes to express her gratitude to Lyn O'Brien Nabors and Maggie Powers, MS, RD, CDE, for their review of this article.
Hope Warshaw, MMSc, RD, CDE, is a diabetes educator and freelance writer in Alexandria, Va.
Note of disclosure: Ms. Warshaw is a paid consultant to the McNeil Specialty Products Company, which manufactures sucralose.
Copyright © 1999 American Diabetes Association
Last updated: 12/99