Relevance of Sweeteners to Health and Diet Fiastuti Witjaksono Department of Nutrition Faculty of Medicine Universitas Indonesia
Sweetener A sugar substitute Food additive that duplicates the effect of sugar in taste Usually with less food energy Some are natural and some are synthetic
Recommended Intakes of sugar WHO 2003: Added sugar be limited to 10% of total calori intake AHA 2009: Women: 100 cal/ 6 teaspoon Men: 150 cal/ 9 teaspoon Pedoman Umum Gizi Seimbang (PUGS): sugar not more than 5% of total energy
Sugar Consumption USDA Report (2004) : sugar consumption of Indonesian people is 3,45 mil ton/year or 15,6 kg percap/year or 43 g percap/d (8,6 % energi of 2000 kkal)
The Effect Of Added Sugar: The Risk of Metabolic Syndrome Mucci L et al. Cardiovascular risk and dietary sugar intake: is the link so sweet? Intern Emerg Med 2011. doi: 10.1007/s11739-011-0606-7.
Categorized of Sweetener Nutritive and nonnutritive Nutritive sweeteners provide calories or energy to the diet Non nutritive sweeteners, also called sugar substitutes or artificial sweeteners, do not provide calories and will not influence blood sugar
Nutritive Sweeteners Glucose Sucrose Fructose Lactose Maltose Honey Corn syrup High fructose corn syrup Brown sugar All are equivalent in calories: about 4 calories per gram or about 16 calories per teaspoon
Nutritive Sweeteners Sugar alcohols or polyols Sorbitol Mannitol Maltitol Erythritol Xylitol Lactitol Isomalt Hydrogenated starch hydrolysates (combination of polyols)
Nonnutritive Sweeteners (high-intensity) Approved by Food and Drug Administration (FDA) Low / no calorie sweeteners : Acesulfame potassium Aspartame Neotame Saccharin Sucralose
ADA Position: Nutritive and Nonnutritive Sweeteners (1998) It is the position of the American Dietetic Association that consumers can safely enjoy a range of nutritive and nonnutritive sweeteners when consumed in moderation and within the context of a diet consistent with the Dietary Guidelines for Americans.
FDA approved for non nutritive sweetener
BPOM Pemanis (sweetener) adalah bahan tambahan pangan berupa pemanis alami dan pemanis buatan yang memberikan rasa manis pada produk pangan.
BPOM Pemanis Alami (Natural Sweetener) Adalah pemanis yang dapat ditemukan dalam bahan alami meskipun prosesnya secara sintetik ataupun fermentasi Misalnya: Sorbitol, manitol, isomalt, glikosida steviol, maltitol, laktitol, silitol, eritritol Pemanis Buatan (Artifisial sweetener) Adalah pemanis yang diproses secara kimiawi dan senyawa tersebut tidak terdapat dialam Misalnya: Asesulfam-K, Aspartam, Na/K siklamat, Sakarin, Sukralosa, Neotam
BPOM approved for sweetener Alitame Acesulfame potassium Aspartame Isomalt GRAS Lactytol-GRAS Maltitol-GRAS Mannitol-GRAS Xylitol-GRAS Sorbitol-GRAS Neotame Saccharin Cyclamates Sucralose
Acceptable Daily Intake (ADI) Weight of sweetener per kilogram body weight that a person can safely consume every day over a lifetime without risk (ADA 2004) The ADI is usually set at 1/100 of the maximum level at which no adverse effect was observed in animal experiments Levels of use of food ingredients are set in such a way as to ensure that actual daily intakes do not exceed the ADI.
High-Intensity Sweeteners Advantages Little or no calories No effect on blood sugar in diabetes Disadvantages Some have unpleasant aftertaste Can not replace sugar entirely in baked products
Acesulfame-K 200 times sweeter than sugar Not metabolized in the human body; thus, it provides no calories and does not influence potassium intake despite its potassium content (ADA 2004). It does not promote tooth decay. It is most often used in combination with other sweeteners. May have a bitter aftertaste when used alone to sweeten a food or beverage
Aspartame 160-200 times sweeter than sugar Aspartic acid + phenylalanine PKU alert required Metabolized as protein (asp + phe); technically some calories (4kcal/g)
Aspartame Approved by FDA as safe for general use; Can be used in all foods Approved for heating applications (cooking and baking) ADI of 50 mg/kg body weight/day
Neotame The newest sweetener Approved by FDA in 2002 About 8,000 times sweeter than sugar Approved for heating applications (cooking and baking) ADI of 18 mg/person/day (mg/p/d) About 3 times higher than estimates of what people will consume daily
Saccharin 300 500 times sweeter than sugar In use for many years Not metabolized Provides no calories
Sucralose Carbohydrate-based sweetener Made from sugar 600 times sweeter than sugar Heat-stable during cooking and baking OH Cl OH HO O O HO OH O OH O OH HO OH O Cl O OH OH OH OH Cl Sucrose Sucralose
Sugar alcohols/polyols Used in many sugar-free, low-carb, and reduced calorie products gum, candy, desserts, ice-cream, cough drops and syrup
Polyols (Sugar alcohol) Do not promote the development of dental caries (The bacteria in dental plaque produce little or no acid from these substances) Produce a lower glycemic response than most sugars and starches (ADA 2000). Thus, their use may be advantageous for people with diabetes Lower in calories than sugar
Sugar Alcohols/Polyols Advantages Do not promote tooth decay May have less effect on blood sugar in people with diabetes Most have fewer calories than sugar (about 2 calories per gram compared to 4) Disadvantages May have laxative effect (gas, bloating, diarrhea) May be in foods that are not that low in calories or fat
Sorbitol Sorbitol, is a sugar alcohol that the human body metabolizes slowly Sorbitol is approximately 60 % as sweet as sucrose (6). Sorbitol behaves much like sucrose in food systems, with respect to providing bulk and interacting with other components to produce suitable texture Sorbitol and the other polyols generally do not participate in browning reactions that provide characteristic color to baked goods (1).
Xylitol Xylitol (1,2,3,4,5-pentanol) is an organic compound with the chemical formula Xylitol is a sugar alcohol (or polyol) Xylitol is about equal in sweetness to sucrose. This sugar alcohol is used as a naturally occurring sugar substitute found in the fibers of many fruits and vegetables It is also heat-stable. It is highly soluble in water
Low-Calorie Sweeteners in obesity Are safe for persons with obesity Are appropriate for management of total calories
Low-Calorie Sweeteners in Diabetes Management Are safe for persons with diabetes Are appropriate for management of carbohydrate and sugar intake Are appropriate for management of total calories Provide persons with diabetes an expanded set of food choices
Sweeteners and Diabetes Nonnutritive sweeteners and sugar alcohols are safe when consumed within the daily intake levels established by the Food and Drug Administration (FDA) (A) Nutrition recommendations and interventions for diabetes. Diabetes Care 30; S48-65, 2007
Summary Low-Calorie Sweeteners: Are Safe Provide Consumers with Choice Can Be Part of a Healthful Diet Can Help in Weight Loss through Calorie Management Can Help with Diabetes Management