The definition of artificial sweeteners often causes confusion. Artificial sweeteners and sugar alcohols are two separate types of sugar substitutes. One difference between the two types concerns calories. Artificial sweeteners have no calories and sugar alcohols do have some calories. According to the National Institute of Diabetes and Digestive and Kidney Diseases, the sugar alcohol type can cause bloating, gas and diarrhea. This can occur with as little as 10 grams consumed but often 50 grams and more cause digestive upset. The artificial sweetener type has not been proven to cause stomach upset.
Types of Sugar Substitutes
Artificial sweeteners sometimes are derived from natural substances but some are synthetic. In the United States, the FDA has approved the artificial sweeteners acesulfame potassium known as Sweet One, aspartame known as Equal and NutraSweet, saccharin known as SugarTwin or Sweet'N Low, and sucralose or Splenda. Sugar alcohols include mannitol, sorbitol, xylitol and lactitol. The FDA has also approved the listed sugar alcohols.
Sugar substitutes derived from plants, fruits and berries are known as sugar alcohols or polyols. Sugar alcohols do not contain ethanol like alcoholic beverages do. This type of sugar substitute is the primary culprit in stomach upset. Sugar alcohols like xylitol and mannitol cause diarrhea because of their osmotic effect. They pull fluid into the digestive tract and if enough gets ingested, the result is diarrhea and gas. Those concerned with stomach upset should choose artificial sweetener type substitutes like sucralose and aspartame.
According to MedlinePlus.com, little evidence exists that any of the sugar substitutes approved by the FDA carry health risks. In the past, saccharin carried a health warning but it has since been determined that saccharin is safe and the warning was removed. Sugar alcohols also get a safe rating but should be used sparingly since large doses can cause problems. Drugs.com. reports on two cases in which the subjects had lost considerable amounts of weight because of diarrhea. Doctors then discovered that both subjects had chewed large amounts of sorbitol-containing gum every day. Once the patients discontinued the gum, the symptoms of diarrhea and weight loss cleared.
It is generally accepted that sugar alcohols cause stomach upset in large amounts. Sugar alcohol type substitutes do not have the sweetness of sugar in equal amounts. This requires using larger amounts of sugar alcohol. However, the extra volume of sugar alcohols make them better for baking. Reports of stomach upset from artificial sweetener type substitutes exist, but no scientific evidence for this has come to light. In equal amounts, artificial sweeteners taste much sweeter than sugar, so smaller amounts of artificial sweetener are needed to get the same level of sweetness as sugar.
Is This an Emergency?
- University of Maryland Medical Center: Diarrhea
- National Institute of Diabetes and Digestive and Kidney Diseases: What I Need To Know About Gas
- Drugs.com: Too Much Sugar-Free Gum Linked to Severe Weight Loss
- MedlinePlus.com: Sweeteners -- Artificial
- St. Lukes Bariatric Services: Understanding Sugar, Sugar Substitutes and Sugar Alcohol