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Friday, October 12, 2012

Sugar Substitutes for Diabetes

For people with diabetes, not all sugar substitutes are created equal. Find out which ones are safe for your diabetes diet.

By Beth Gilbert Medically reviewed by Lindsey Marcellin, MD, MPH
Splenda: Good for Diabetes
Splenda or sucralose is excellent for people with diabetes — type 2 diabetes in particular. It has no effect on blood sugar and passes through the body with minimal absorption.

Saccharin: Watch Out for Weight Gain

Saccharin, under the brand name Sweet 'N' Low, is calorie-free and though it can be a sugar substitute option for those with diabetes, "research has shown that the intake of saccharin can lead to weight gain," Glassman warns. "Usually, when one eats a sweet food, the body expects calories to accompany that food. When the body does not get those calories, it looks for them elsewhere. This can lead to greater calorie consumption throughout the day as your body craves the caloric satisfaction it has missed," she explains.

Aspartame: Possible Side Effects

Aspartame, sold as Equal and NutraSweet, is not zero calories like some other artificial sweeteners, but is still very low in calories. Even though the U.S. Food and Drug Administration has reviewed the scientific research and found aspartame to be safe for human consumption, there have also been some conflicting study results on aspartame's safety. “It has been linked to many negative side effects," Glassman says. "Some research shows linkage to leukemia, lymphoma, and breast cancer. Other research shows a linkage to migraines." In addition, people with phenylketonuria (PKU), a rare condition in which they are unable to metabolize phenylalanine (a key component of aspertame), should not consume this sugar substitute.

Stevia: An All-Natural Option

Truvia is one brand of the sweetener derived from the leaf of the stevia plant, native to Central and South America. Truvia is calorie-free and has been shown to have little to no impact on blood sugar, which is why it is an excellent sugar substitute for diabetic people. Other brands are Pure Via and Sun Crystals. There have been anecdotal reports of side effects associated with over-consumption of stevia, including headaches and gastrointestinal symptoms, but to date there is no solid scientific research to back this up.

Agave: Super Sweetener

Agave nectar is a form of sugar derived from the sap of the agave plant and it is low on the glycemic index. This means it is absorbed more slowly by the body, causing a relatively lower spike in blood sugar and less of a sugar rush than other forms of the real thing. "Its low glycemic index makes it a good sugar substitute for diabetic people," says Glassman. One caveat: agave has about 60 calories per tablespoon, making portion control essential, however it is 1.5 times sweeter than sugar, so you can use less."

Another article about agave:Dietitians: Agave not an ideal sugar substitute

Sugar Alcohols: Low-Calorie Sweeteners

Sugar alcohols, or polyols, include sorbitol, mannitol, and xylitol are derived from the natural fibers in fruits and vegetables. They do contain carbohydrates, so they are considered nutritive sweeteners. Though relatively low in calories and blood-sugar friendly they can cause indigestion, bloating, diarrhea, and headaches see how you respond to a small amount before incorporating them into your daily diet.
Mullins says that sugar alcohols contain some carbohydrates, and some types break down more completely than others. "I recommend that people who are going to use these sugar substitutes keep track of carbohydrate levels," says Mullins. "Subtract half the amount of sugar alcohols from the total number of carbohydrates to understand how many carbs are actually being consumed and the impact on blood glucose levels."


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