Relevance of Sweeteners to Health and Diet

Fiastuti Witjaksono

ILSI SEA Region Seminar on Uses and Safety of Sweeteners (May 2013)http://www.ilsi.org/SEA_Region/Pages/ViewEventDetails.aspx?WebId=4D540914-EEB6-40E4-89EB-0B73BA3D76C1&ListId=478BE3CB-581B-4BA2-

A280-8E00CCB26F9C&ItemID=73

Fiastuti WitjaksonoDepartment of Nutrition

Faculty of Medicine Universitas Indonesia

Sweetener

� A sugar substitute� Food additive that duplicates the effect of

sugar in tasteUsually with less food energy� 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

intakeAHA 2009:AHA 2009:� Women: 100 cal/ 6 teaspoon� Men: 150 cal/ 9 teaspoonPedoman 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)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 dietNon nutritive sweeteners, also called sugar � 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

� Honey� Corn syrup� High fructose corn syrup� Fructose

� Lactose� Maltose

� High fructose corn syrup� Brown sugar

• All are equivalent in calories: about 4 calories per gram or about 16 calories per teaspoon

Nutritive Sweeteners

� Sorbitol� Mannitol� Maltitol

� Isomalt� Hydrogenated starch

hydrolysates

Sugar alcohols or polyols

� Maltitol� Erythritol� Xylitol� Lactitol

hydrolysates (combination of polyols)

Nonnutritive Sweeteners (high-intensity)

Acesulfame potassium

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 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.manis pada produk pangan.

BPOM

� Pemanis Alami (Natural Sweetener)Adalah pemanis yang dapat ditemukan dalam bahan alami meskipun prosesnya secara sintetik ataupun fermentasiMisalnya: Sorbitol, manitol, isomalt, glikosida steviol, maltitol, laktitol, silitol, eritritolmaltitol, laktitol, silitol, eritritol

� Pemanis Buatan (Artifisial sweetener)Adalah pemanis yang diproses secara kimiawi dan senyawa tersebut tidak terdapat dialamMisalnya: Asesulfam-K, Aspartam, Na/K siklamat, Sakarin, Sukralosa, Neotam

BPOM approved for sweetener� Alitame � Acesulfame potassium� Aspartame� Isomalt –GRAS� Lactytol-GRAS� Maltitol-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 � 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 sugar in diabetes � 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 � 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 � 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� 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

O

HO

OH

OHO O

Cl

Cl

OH

OH

Cl

O

HO

OH

OHO O

OH

OH

OH

OH

Sucrose Sucralose

HO

Sugar alcohols/Polyols

� Used in many “sugar-free,” “low-carb,” and reduced calorie products� gum, candy, desserts, ice-cream, cough drops

and syrup 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 � 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

Disadvantages� May have laxative

effect (gas, bloating, diarrhea)

on blood sugar in people with diabetes

� Most have fewer calories than sugar (about 2 calories per gram compared to 4)

� 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 � 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 intakecarbohydrate 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 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