The sweet taste of sugar is rewarding, it feels good, and we now precisely understand how it influences brain activity and calms our nerves. Can we become addicted to it? Can we adapt to certain level of sweetness and then, without noticing, increase the dose to satisfy our brain? Yes, we can.1,2 And more alarming, the sugar influences our DNA and activation of our genes!3 Are you someone who thinks that when you replace sugar with sweeteners, you are making better choice? Well, this article might help you make up your mind.
Overdosing on sugar is now much easier than ever. We are rewarding ourselves on a daily basis. Sugar is hidden in our drinks, ready cooked meals, low-fat products and in foods where we would least expect to find sugar (for instance in bread).
Is there any problem here?
Well, clearly we have a problem. The association between intake of sugar and occurrence of diseases such as cardiovascular, 4,7 diabetes, 5,6,7 obesity 7,8,9 or cancer 10-13 can no longer be overlooked. So, we kind of know that a lot of sugar is not good for us. Therefore, we came up with this ground-breaking idea to replace sugar with something that tastes sweet but does not contain sugar. How clever we are. Really? Well, it seems that our body tricked us once again rather than the other way around.
Sugar free alternatives – sweeteners
The idea of using sweeteners was to minimise calories from sugar intake but still keep that sweet taste to satisfy our cravings. Thus, sweeteners should help to reduce weight gain and obesity rates. Ironically, the evidence indicates that the opposite is happening, and instead of tackling those diseases, it contributes to their development. Just like sugar, sweeteners are associated with diabetes, obesity and other metabolic problems. 5,14-17 Therefore, sweeteners are not healthier alternatives to sugary foods and drinks. Sadly, the industry is feeding us with the information that sweeteners are ok.
Agriculture, industry and what we do not hear about
It might surprise you to find out that sweeteners were first introduced in agriculture in the 1950’s. The aim was to add sweeteners to cow’s and pig’s food, in order to make them eat more and grow bigger. 15 So how on the earth we later translated this into an idea to reverse obesity in humans?
Of course, this information isn’t readily available. For instance, 83.3% studies paid by industry showed that the evidence against sweeteners is insufficient. In contrast, the similar percentage of independent research studies found that sweeteners have a negative effect on health.15
How sweeteners change our body responses
When we consume foods and drinks with sweeteners regularly, our body stops associating the sweet taste with intake of sugar and satisfactory responses in the brain. Why? Because while sweeteners partially activate satisfactory responses when the taste is detected, they fail to activate the responses that usually occur after we eat sugar – signalling to stop eating. Thus, the result is that we overeat before the response in our brains tells us: ‘’oh I’ve had enough now’’.
Moreover, in normal situations when we eat something sweet our brain detects the sweet taste and starts to activate metabolic pathways, which say to the body ‘’get ready sugar is coming’’. When we eat something with sweetener, all of these reactions will happen, but the sugar will not arrive. The question is what will happen when we do this again and again? Our brains will detect a sweet taste, but no sugar will arrive, so after a while the body will stop responding. The body will learn that a sweet taste is no longer a reliable indicator of sugar intake.
And then when we eat real sugar, our bodies will overreact . Sugar levels will rise much higher but a feeling of satisfaction from food will be weaker. On top of that, sweeteners do not go down well with gut bacteria. This might then contribute to further problems related to poor gut health. 15,17
Type of sweeteners
The most frequently used sweeteners are saccharine, aspartame, acesulfame K, sucralose, stevia/erythritol and sugar alcohol. They are all officially approved and claimed to be safe in the level present in our foods and drinks. However, it is difficult to predict the degree of safety over long-term consumption, especially when people aren’t even aware of the presence of sweeteners in certain foods (for instance in yogurt).
You might think that naturally derived sweeteners will be a healthier alternative but even though they are natural, the way they affect body responses, as described above, are not different. They still provide that sweet taste but no sugar, which disrupts body responses. There is no way to escape.
Don’t try to replace that sugar. Reduce it!
The idea of replacing sugar is WRONG, we cannot replace it. We behave like our body isn’t intelligent enough to know the difference between sugar and sweetners. But the human body is a lot more aware than we realise.
What can we do then?
Ideally, we should reduce the amount of added sugar in our foods and try to eat foods that contain naturally occurring sugar, where it is balanced with fibre (e.g. fruit). We do not need to completely forget about cakes and sweets. They taste good. But we should find special occasions, once in a while, to consume them. Also, we should stop using sugar as a reward and associate food with feeling good (emotional eating).
Eat fruit when you feel like something sweet.
Fruit juices, particularly those from concentrate, are as unhealthy as soft drinks when regularly consumed.5 Unless we drink freshly squeezed fruit juice, we are not even getting real vitamins because these juices are pasteurised (heated to high temperature which means that most of the vitamins are destroyed). So, we are left with colourful water and added artificial vitamins.
Swap the juice for real fruit. The research shows that fructose from real fruit isn’t harmful as fructose and fructose syrup artificially added to drinks and foods.18 One reason for that is the presence of fibre and unique combinations of nutrients in fruit.19 One idea might be fresh fruit salad – check out my recipe.
No single food or nutrient can be solely blamed for disease development because our health is affected by numerous environmental factors. That’s why we find controversial studies and researchers fighting over and over about the root cause of disease. In general, it’s hard to control all the factors that influence our health. We know that people with unhealthy lifestyles have a higher intake of foods and drinks containing sugar, and so the diseases they develop are underlined by other unhealthy factors. However, we have evidence that even when we exclude those factors, the health risk of sugar/sweeteners consumption is still there. Foods and nutrients are more likely to harm, if we combine them with other negative factors in our lives, and sugar and sweeteners could be one of these. Therefore, think twice when buying soft drinks, juices, sport drinks and any products that claim they are free or low in sugar!
- Lennerz B & Lennerz JK. Food Addiction, High-Glycemic-Index Carbohydrates, and Obesity. Clinical Chemistry; 2018, 64:1 64–71.
- Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev. 2008;32(1):20–39.
- Meng Q. Systems Nutrigenomics Reveals Brain Gene Networks Linking Metabolic and Brain Disorders. EBioMedicine 7 (2016) 157–166.
- Deshpande et al. Frequent Sugar-Sweetened Beverage Consumption and the Onset of Cardiometabolic Diseases: Cause for Concern? Journal of the Endocrine Society. 2017; 1, (11): 1372–1385.
- Imamura F et al. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ 2015;351:h3 576.
- Macdonald IA. A review of recent evidence relating to sugars, insulin resistance and diabetes. Eur J Nutr (2016) 55 (Suppl 2): S17–S23.
- Khan TA. Controversies about sugars: results from systematic reviews and meta‑analyses on obesity, cardiometabolic disease and diabetes. Eur J Nutr (2016) 55 (Suppl 2): S25–S43.
- Ruanpeng D et al. Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis. QJM. 2017, 1;110(8):513-520.
- Johnson JR et al. Perspective: A Historical and Scientific Perspective of Sugar and Its Relations with Obesity and Diabetes. Advances in Nutrition. 2017; 8 (3): 412–422
- Schlesinger et al. Carbohydrates, glycemic index, glycemic load, and breast cancer risk: a systematic review and dose–response meta-analysis of prospective studies. Nutrition ReviewsVR, 2017; 75(6):420–441.
- Grothey A. at al. The role of insulin-like growth factor 1 and its receptor in cell growth, transformation, apoptosis, and chemoresistance of solid tumours. JCRCO, 125 (3-4), 1999:166-73.
- Michaud DS. et al. Dietary gycemic load, carbohydrate, sugar, and colorectal cancer risk in men and women. Cancer Epidemiology, Biomarkers and Prevention. 2005; 14 (1): 138-47.
- Augustin LSA et al. Dietary glycemic index, glycemic load and ovarian cancer risk: a case-control study in Italy. Annals of Oncology. 2003; 14 (1):78-84.
- Temps LV. The truth about artificial sweeteners – Are they good for diabetics? Indian Heart Journal 70 (2018) 197–199.
- Pearlman M et al. The Association Between Artificial Sweeteners and Obesity. Curr Gastroenterol Rep (2017) 19: 64.
- Mooradian AD et al. The role of artificial and natural sweeteners in reducing the consumption of table sugar: A narrative review. Clinical Nutrition ESPEN 18 (2017) 1e8.
- Swithers SE. Not so Sweet Revenge: Unanticipated Consequences of High-Intensity Sweeteners. BEHAVANALYST (2015) 38:1–17.
- Bellavia A, Larsson SC, Bottai M, Wolk A, Orsini N. Fruit and vegetable consumption and all-cause mortality: a dose-response analysis. Am J Clin Nutr2013;98:454e9.
- Flood-Obbagy JE et al. The effect of fruit in different forms on energy intake and satiety at a meal. Appetite. 2009; 52(2): 416-422.