By David Blyweiss, M.D.

Not long ago, a patient asked me about the safety of sugar substitutes. Recently diagnosed with type 2 diabetes, this woman has been successful in controlling her disease without drugs by losing weight and making smart dietary choices—but she misses those sweet treats she used to enjoy.

When you eat sugar (or any type of simple carbohydrate), your blood glucose levels rise and your pancreas releases insulin to shuttle the sugar into your cells. But if you are a diabetic, you either don’t produce enough insulin (as is the case in type 1 diabetes) or your cells are resistant and don’t respond to the insulin (or both). This means that, when you eat sugar, your blood glucose levels can remain sky high. An excessive rise in blood glucose that can cause serious health problems if left unchecked. These diabetes-related complications include increased risk for kidney failure, stroke, blindness, heart disease and nerve damage.

Because of these risks, many people turn to artificial sweeteners like aspartame (NutraSweet), acesulfame K (Sunette or Sweet One) or saccharin (Sweet’N Low). These sweeteners don’t contain any calories and don’t raise blood glucose levels. A win-win, right? Actually, no. Several studies link these artificial sweeteners to an increased risk for cancer. Aspartame also crosses the blood-brain barrier and has been shown to be a neuroexcitotoxin—a compound that overexcites neurons, leading to cell death and probably one of the triggers to eventual Alzheimer’s disease.

What about sucralose, a.k.a. Splenda? This sugar substitute is created by treating sugar with chlorine, which creates chlorinated sucrose While some say sucralose doesn’t break down in the body and few short term studies have shown negative health effects, at this point, no one knows what the health impact of sucralose might be 10, 20 or 30 years down the road. Indeed, it will take years to evaluate the effect of replacing already low levels of iodine with extra chlorine on the thyroid or female breast tissue. It is possible that we are making people more hypothyroid or placing them at greater risk of fibrocystic breast disease with each packet of this “safe” sweetener.

What’s more, artificial sweeteners do raise insulin levels—even if they don’t raise your blood-glucose levels. Scientists believe that the sweet taste fools your body into thinking you’re eating sugar, which triggers the release of insulin. This can lead to complications like hypoglycemia (when blood glucose drops too low), insulin resistance and altered hormone metabolism.

Even if they were proven safe for long-term use, one thing’s for sure: Artificial sweeteners do not provide any nutritional value. And they are primarily found in highly processed “frankenfoods” that don’t provide much in the way of nutrition either.

Managing blood sugar levels is critically important, but you can achieve that without resorting to chemical sweeteners. I advise my patients to eat fewer processed treats, which rapidly raise blood sugar. Instead, eat more naturally sweet whole foods like fresh fruit and sweet vegetables like red bell peppers, sweet potatoes, sugar snap peas, and baby carrots. These foods contain less sugar than processed foods and the fiber in them helps keep your glucose levels on an even keel. If you must add sweetness to something, natural sweeteners—small amounts of honey, agave nectar, molasses and fruit juice—are lower than sugar on the glycemic index. They also provide vitamins and minerals. You can also use spices like cinnamon for sweetness. As an added bonus, adding ½ teaspoon of cinnamon to food every day can help diabetics lower their blood glucose levels.

Two other natural sweeteners can also help if you are diabetic. The first is xylitol. Naturally found in many fruits and vegetables, this sugar alcohol contains roughly 40 percent fewer calories than sugar. And because xylitol does not trigger an insulin reaction in the body, it can be useful for diabetics and those who are hypogloycemic. You may also want to try inulin. Known by its brand name “Just Like Sugar,” inulin is a naturally occurring polysaccharide that comes from plants. Not only is inulin safe, it also acts like a prebiotic that feeds your healthy gut bacteria.

While it’s next to impossible to avoid all sugar (there is sugar hidden in all sorts of foods like ketchup and salad dressings), you can blunt its effect on your blood sugar levels by increasing the amount of soluble fiber in your diet. Soluble fiber can reduce post-meal glucose levels by up to 20 percent. Foods rich in soluble fiber include dried beans, oatmeal, winter squash, dried figs, plums, apricots and ground flaxseeds.

Alpha-lipoic acid can also benefit diabetics by increasing insulin sensitivity and improving glucose uptake and metabolism. It also helps to reverse the symptoms of peripheral neuropathy that can plague diabetics. I recommend taking 150 to 300 mg. of alpha lipoic acid three times daily for best effects. Adding 500 to 1000 mg. of acetyl-L-carnitine three times daily will also  help generate increased energy by burning intracellular fatty acids—a very good idea any way you look at it.

References:

Bandyopadhyay A. Genotoxicity testing of low-calorie sweeteners: aspartame, acesulfame-K, and saccharin. Drug and Chemical Toxicology. 2008;31:447-457.

Fernstrom JD. Aspartame effects on the brain. European Journal of Clinical Nutrition. 2009; 63: 698-699.

Kirkham S. The potential of cinnamon to reduce blood glucose levels in patients with type 2 diabetes and insulin resistance. Diabetes, Obesity & Metabolism. 2009;11:1100-1113.