Look around your local supermarket or convenience store and you'll see a large number of products that claim to be "sugar free" – and the number appears to be growing.
With 63 per cent of Australians classified as and , it's no wonder many people are turning to products that promise a sweet taste with little or no sugar. And According to market research firm Mintel, in Australia low-, no- and reduced-sugar claims increased from six per cent in 2009 .
But if they don't contain sugar, what do these sugar-free products contain? "If a product says it's sugar free but tastes sweet, it will contain some type of sweetener," says Aloysa Hourigan, nutrition program manager of Nutrition Australia.
And non-sugar sweeteners are found in more products than many people realise. As well as being used in foods such as cakes and soft drinks, they're often added to multivitamins, medicines and toothpaste.
What are these alternative sweeteners?
Sweeteners come in a few different forms. One of the most common group are sugar alcohols or polyols. Despite their name, they are not actually sugar or alcohol but a different type of carbohydrate.
They occur naturally in some foods but are also synthetically produced and added to confectionary, yoghurts, ice-creams, jams and some medicines and multivitamins. Common sugar alcohols you'll find on food labels are xylitol, sorbitol, mannitol, lactitol, isomalt and maltitol.
Hourigan says sugar alcohols provide the same number of kilojoules per gram as sugar (about 17 kilojoules per gram). But they are absorbed into the bloodstream more slowly than sugar, so they have very little effect on blood glucose levels.
The second group of sweeteners are known as artificial sweeteners. Unlike sugar alcohol, these sweeteners are "non-nutritive", which means they don't contain any kilojoules. They are also much sweeter than sugar so smaller amounts are needed to sweeten food.
Common artificial sweeteners you'll find in commercial products are saccharin and aspartame (Equal). Some can be substituted for sugar in home cooking and baking.
The third type of sweetener, stevia, is marketed as a "natural" sweetener because it is derived from the stevia plant.
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Not so sweet?
Sweeteners can seem like an attractive alternative to sugar, particularly for people who have diabetes or are trying to lose weight.
Fluctuating blood glucose levels can be a problem for diabetics so sugar alcohols, which have little effect on blood glucose levels, may appear to be a better option.
However, there is a downside. "Consuming large amounts of sugar alcohols may result in irritation of the gut and sometimes cause diarrhoea and flatulence," says Hourigan. "If people have irritable bowel symptoms and are advised to follow a low FODMAP diet (a diet low in a collection of molecules that can be poorly absorbed by some people), they should minimise their intake of sugar alcohols."
When it comes to artificial sweeteners, the potential negative side effects vary. While there is evidence linking high doses with cancer in animals, the Cancer Council says there is to support such a link in humans.
A US found that even though artificial sweeteners contain no kilojoules, they may contribute to weight gain and Hourigan says there is evidence that high intakes of artificially sweetened beverages, especially diet colas, may have a negative impact on the metabolism. There are also some concerns about the use of some artificial sweeteners during pregnancy. A has found daily consumption of artificially sweetened beverages by pregnant women doubled their babies' chances of becoming overweight.
Hourigan says stevia has not been associated with any significant side effects. However, Dr Kate Marsh, an advanced accredited practising dietitian and diabetes educator, says that though stevia is plant-based, many stevia products are mixed with erythritol, a sugar alcohol, which can have a laxative effect. Stevia may also leave an aftertaste.
The verdict
"Sweeteners can be a way for people with diabetes to cut down on sugar and still get the sweet taste, but I’m not a big fan – I don’t think anyone needs them," says Dr Marsh.
Both Hourigan and Dr Marsh advocate eating mainly fresh, minimally processed food, and foods containing sweeteners – even stevia – are usually commercially manufactured and therefore highly processed.
"Foods containing sweeteners are not necessarily healthy," says Dr Marsh. "They are often highly processed with little nutritional value, can be high in saturated fat and may contain other forms of carbohydrate, so they can still impact on blood glucose levels."
Hourigan says these foods may also contain large amounts of sodium.
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She says the problem is that all sweeteners still encourage a desire for sweet-tasting food. If you are trying to decrease your sugar intake, instead of using sweeteners she suggests gradually reducing the amount of sugar you use so that your tastebuds adapt over time. For example, if you have two teaspoons of sugar in your coffee, first reduce to one, then half a teaspoon, and then try drinking a coffee without any sugar.
She says water is the best drink, but if you are craving a different flavour, "an occasional artificially sweetened drink might be an option". Dr Marsh suggests drinking sparkling mineral water with fresh lemon or lime.
Instead of sweeteners, Marsh recommends eating naturally sweet-tasting foods such as fruit, dried fruit, carrot and pumpkin, and spices such as cinnamon, ginger and vanilla, with the occasional small amount of sugar. Instead of eating sugar-free lollies, she recommends a few squares of good-quality dark chocolate.
If you do opt for sugar-free products, Hourigan says, "Read the list of ingredients and the nutrition information panel to get a better understanding of what is actually in the food. 'Sugar free' is not the whole story."
The bottom line is that fresh food is best. "It helps you avoid the challenge of interpreting food labels and is undoubtedly better for your health," says Hourigan.
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