Nonnutritive Sweeteners: Where Are We Today?

Abstract

Controversy continues to surround use of nonnutritive sweeteners among consumers, despite extensive premarket safety studies used in the rigorous approval process of the U.S. Food and Drug Administration (FDA). The American Diabetes Association and the National Cancer Institute hold positions that FDA-approved nonnutritive sweeteners may be safely used by consumers.1 However, people with diabetes also continue to question the use of nonnutritive sweeteners in a diabetes eating plan even with this assurance. Misinformation regarding nonnutritive sweeteners is shared routinely through multiple sources such as the Internet, print media, and electronic communications. As a result, diabetes educators and other health care professionals need to become more familiar with the safety and usage of these products to help people with diabetes discern fact from fiction. The potential benefits of nonnutritive sweeteners for people with diabetes are reductions in calories and carbohydrates for weight management and glycemic control, respectively, as well as reductions in the risk of tooth decay.2 This article reviews the history of nonnutritive sweeteners, explains FDA safety standards and definitions, and provides an overview of nonnutritive sweeteners available in the United States and practical teaching tips for counseling consumers about their use. Sweetening agents are broadly classified as nutritive sweeteners, which provide energy, and nonnutritive sweeteners, which provide little to no energy. Nonnutritive sweeteners are several hundred to several thousand times sweeter than sucrose. Although some actually provide calories, their intense sweetness means that they are used in such small amounts that they are generally considered noncaloric. Familiar nutritive sweeteners include sucrose, fructose, agave nectar, fruit juice, and honey. Each provides ~ 4 kcal/g. Nonnutritive sweeteners are different from sugar alcohols (also known as polyols) such as xylitol and sorbitol, which are considered nutritive sweeteners, providing an average of 2 kcal/g because of their incomplete digestion and absorption. …