It shouldn’t come as a surprise to anyone that excessive sugar intake contributes to the development of obesity, diabetes and high blood pressure. What you might not know, is that all of these are risk factors for kidney disease.
As these associations have become apparent over the last fifty years, scientists, doctors, chefs and consumers have led the search for the perfect sugar substitute. The world is now full of them. You’ve probably heard of or tried most of them. Some have been around for a long time such as Saccharin, Aspartame, and Sucralose (otherwise known as Sweet’N Low, Equal and Splenda), others have recently made their way into your foods, like Truvia, Stevia, and even more are hidden in your food, but you probably never knew they were there, like sugar alcohols such as Sorbitol and Xylitol. From baked goods to salad dressings, sodas and juices to breakfast cereals and puddings; these substances sweeten foods with a strength that ranges from 200 times all the way up to 20,000 times sweeter than traditional sugar.
While these sugar substitutes often please our sweet tooth without added calories or increased blood sugars, questions remain. Are these substitutes safe? Will they do any damage to your kidneys? Are they better than real sugar for people with kidney disease?
While the answers to these questions aren’t fully known, let’s review what information we do have.
1) Do They Cause Cancer?
Saccharin is one of the oldest artificial sweeteners. In the 1980s, Congress designated that any food containing Saccharin needed a warning label, describing the association between it and cancer in laboratory animals. It later turned out that this concern was unsupported, and the warning label was removed. More importantly, further studies have not demonstrated any association between any of the artificial sweeteners and cancer.
2) Will They Help Me Lose Weight?
Prevention and treatment of obesity, a risk factor for high blood pressure and diabetes, should be a priority for all of us. Since we know that over consumption of sugar leads to obesity, it should be easy to conclude that we should all try the sugar substitutes instead, right? Unfortunately, the answer isn’t that simple. Over the last twenty years, studies have demonstrated a variety of results on this topic, some beneficial and some not.
In the short term, it does appear that changing to sugar substitutes can help with weight loss, but this doesn’t necessarily continue for the long term. There are several possible explanations for this. Here are some proposed, but not yet proven, mechanisms:
* Sugar substitutes, because they don’t have calories, may not signal the brain to stop eating the same way a sugar sweetened food would signal the brain once that sugar is absorbed. Without the brain telling you to back up from the table or put your fork down, you may eat more than you would have if you had been using regular sugar.
* Some people take advantage of no-calorie sweeteners to eat other foods. So instead of thinking, “I’m eating fewer calories with this sugar substitute and that will help me lose weight,” they think, “Because I’m substituting a no-sugar soda with my lunch, I can add on a brownie on at the end for dessert! Yay!” That won’t work for weight loss.
* Sugar substitutes are so extra sweet that they may actually trigger you to crave sweeter foods in the future.
If used correctly, switching from sugary foods to foods sweetened with low calorie sweeteners may provide a springboard for weight loss by lowering your overall calorie intake. More importantly, these foods can be used as a safe part of a weight loss strategy. Combine them with a lifestyle focused on eating smaller portions, exercising more, incorporating stress reduction and getting adequate sleep.
3) How Do They Affect Kidney Disease?
Lastly, let’s examine the effects of these low-calorie sweeteners on the kidney. The biggest study on these sweeteners was done by looking at 15,000 individuals over twenty-three years, evaluating their consumption of diet soda and development of kidney disease. According to this study, the more diet soda a person had to drink, the higher the risk for developing End Stage Kidney Disease. This was most obvious when the participants consumed more than seven diet drinks per week. Unfortunately, this study, while interesting, didn’t provide enough information to conclude that diet soda causes kidney disease. As with other studies, it adds to the overall data but doesn’t give us the answer. Use diet soda to help you transition from regular soda to unsweetened carbonated beverages or water. Better yet, when you’re thirsty, drink water.
As the search for sugar substitutes continues, newer products come on the market each year. The newest ones, such as stevia and monk fruit are still being examined for their health effects. The FDA has not approved stevia leaves or extracts for food additives, and because they are newer, it is important to use only a little bit at a time.
All in all, as the number of artificial sweeteners continues to grow, the jury is still out on whether they help us reach our health goals. When used correctly, they can be an effective tool to help manage calorie intake or to help individuals with diabetes better control their blood sugars. When used without care, they may lead you to eat more calories and crave sweeter food.
The best way to minimize the risk of sugar consumption is to #ChangeYourBuds (taste buds that is) so that you learn to enjoy and crave fewer sweet foods. (see our website to find out more about changing your taste buds). This is done slowly, over time, by cooking with less and less sweetener. Use whole fruits to help manage your sweet cravings, and choose smaller portions of sugary (or artificially sweetened) foods when you must have them. Keep a look out for further studies on the health risks and benefits of low-calorie sweeteners.
Before making any diet changes, be sure to speak with your physician on next steps for your personal plan of care.
