The Doctor Game

By W. Gifford-Jones M.D.
 What Should I Mix With My Rum?        
Have I been leading readers astray? For years this column has stressed that we’re all consuming too many calories, and in particular, too much sugar. I’ve always practiced what I write, so for years I’ve made sure it is a sugar-free cola that I add to my rum before dinner. But are these alternatives to sugar safe? Scientists at Tufts University report that the research on sugar substitutes continues to advance – yet few clear answers are apparent.

For over 40 years, highly refined sugar substitutes have been on the market and common additives in drinks and foods. But for food safety, a cloud has always hung overhead.
Dr. Alice H. Lichenstein, Director of the Cardiovascular Nutrition Laboratory at the USDA’s Human Nutrition Research Centre on Aging and a Professor at Tufts University, explains that sugar substitutes have various names like high intensity sweeteners, non-sugar sweeteners, low calorie sweeteners which can lead to confusion about their sources and properties. Moreover, a wide variety of compounds are used in sugar substitutes and they may not always behave the same way in the body.
Lichenstein adds that some high-intensity sweeteners are 100 to 20,000 times sweeter than sugar! This means that individuals need consume only tiny amounts to achieve the sweetness of sugar.  In fact, most sugar substitutes are non-nutritive and not absorbed by the body.

So what are the potential dangers of sugar substitutes? Lichenstein says most research has been done on beverages. The greatest risk seems to be the tendency of some to make other unhealthy choices as a result of using sugar substitutes in drinks.
Lichenstein advises that if you seek to lose weight, “Substituting beverages sweetened with sugar substitutes in place of those sweetened with sugar may be helpful, but make sure you’re not compensating by picking up those calories somewhere else.”
The Diabetes Association agrees that decreased caloric intake is of paramount importance to decrease the risk of Type 2 diabetes. And if this can be achieved by using sugar sweeteners, they can be a valid way to halt the epidemic. And using them for foods, as well as beverages, may be a beneficial option.

What about dental health? It’s generally accepted that replacing sugar with sugar substitutes reduces the risk of dental decay. And some studies suggest that the sugar alcohol xylitol in chewing gum may help to prevent the development of cavities.

So how much should we be worrying about sugar substitutes? It appears that we are still waiting for a definitive study that shows sugar substitutes are totally safe. And there is some lingering concern that sugar substitutes make it too easy for people to choose a low-sugar sweet treat than a serving of nutrient rich vegetables, nuts or fruits.

You may wonder whether I`m going to change my pre-dinner routine. Regular readers know I prefer natural remedies to prescription drugs. So it’s a good question: why would I use a manufactured sugar substitute rather than a natural sugar?

Weight is not a problem for me.  I step on a scale each day and make sure it always reads the same. But nonetheless, I am no fan of sugar, and I want to limit my intake.  I’ll take the chance on an artificial sweetener in the cola that mixes with my daily dose of rum.  My wife reminds me that there is sugar in the rum too!  But I’m convinced the health benefits of alcohol in moderation have contributed to my for good health and longevity. So I’ll stick with my poison!

Remember, I’m not your doctor, and you must always get good medical advice. But if you are overweight and a candidate for Type 2 diabetes, sugar substitutes may be helpful. In my view, obesity is a far greater health hazard than sugar substitutes.

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