Intense Sweeteners in Diabetes

Canadian Journal Of Diabetes. 2004;28(4):385-399.
Canadian Diabetes Association National Nutrition Committee Technical Review: Non-nutritive Intense Sweeteners in Diabetes Management
Réjeanne Gougeon1 PhD, Mark Spidel2 MSc, Kristy Lee3 BSc, Catherine J. Field3 PhD
1McGill Nutrition and Food Science Centre, Montreal, Quebec, Canada 2Health and Social Services, Montague, Prince Edward Island, Canada 3Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
Abstract
The current Canadian Diabetes Association Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada state that up to 10% of daily calories can be derived from sugars. However, individuals with diabetes may also be relying on alternative, low-calorie sweetening agents (providing little or no calories along with sweet taste) to control carbohydrate intake, blood glucose, weight and dental health. Most low-calorie sweeteners, sometimes called intense or artificial sweeteners, are classified and regulated as food additives with set acceptable daily intake (ADI) levels. The Health Canada Health Products and Food Branch approved intense sweeteners for table-top use and as additives in products such as soft drinks, chewing gum, fruit and fruit spreads, dairy products and desserts. This technical review summarizes the literature on the potential health benefits and risk associated with the consumption of non-nutritive intense sweeteners (excluding polyols) and the evidence for the safety of intense sweetener use among individuals with diabetes and their effects on glycemia, appetite, weight, blood lipids, blood pressure and renal function. Research investigating the potential metabolic effects, benefits and risk of intense sweetener use among individuals with diabetes, children and adolescents, and pregnant and lactating women was reviewed to draft evidence-based recommendations for their use by people with diabetes. Current evidence...