The shocking Diabetes Mellitus statistics

• 425 Million /globally are currently diagnosed
• Will rise to 629 million by 2045 if rising the trend continues
• 327 Million are of working age
• 1 in 2 Adults are undiagnosed
• 7% of South African population has Diabetes ie 3.85 million aged between 21 – 79 years old

The dangers of excessive consumption of sugar is well documented and how it negatively affects the health status of individuals but even more so for diabetics have been a focus area for the last few years or even decades.

The typical South African consumes 24 teaspoons of sugar daily – more than double the World Health Organization guidelines for daily intake!

But is the alternative healthier? There is a lot of controversy regarding sugar substitutes / alternative sweeteners and which is better for people living with diabetes.

Sugars that don’t affect blood sugar levels

Non-nutritive sweeteners such as Aspartame, Sucralose, Saccharine, Stevia, Xylitol, and Neotame are so popular due to it being approximately 300 to 13000 times sweeter than sugar but has no nutritional value (meaning no or low kilojoules).

Although artificial sweeteners may help to reduce total energy intake, the effectiveness in weight loss or diabetes management has not yet been established. We think fewer calories consumed = less weight gained or more weight lost right?

However, according to a recent review, regular consumption of non-nutritive sweeteners is related to an increase in BMI. This might be explained by sweeteners being associated with an amplifying of general cravings and appetite.

Despite this, and this is imperative: sweeteners are not all the same. They have different biochemical structures, with different routes of metabolization and absorption. Certain sweeteners metabolize differently and are therefore better than others in maintaining blood glucose and weight management.

Let us look at a few different sweeteners and how they weigh up!

Sucralose

Sucralose (also sold as “Splenda”) is 600 times sweeter than normal sugar. Sucralose is mostly secreted which means it does not get absorbed in the body. Although this might sound great, don’t be so quick to jump on the bandwagon – Sucralose has been associated with inflammation, and there is still ongoing research on whether it increases blood glucose level. The data is leaning towards a no for diabetics as long-term use can cause insulin resistance. It is also worth mentioning that added table sugar, if consumed in excess, also causes inflammation and has also been associated with insulin resistance.

Conclusion: Consuming Sucralose (or normal sugar) in excess over a long period of time it has been linked to inflammation. Sucralose should rather be avoided if you are diagnosed with any inflammatory diseases such as Rheumatoid arthritis or Crohn’s disease as it can worsen the inflammatory state.

Aspartame

Aspartame is mostly used in sugar-free or low sugar drinks and Iced Tea lite.

After a lot of spotlight was on Aspartame after being accused to cause cancer, recent human studies proved aspartame had no carcinogenic effect. However, it is worthwhile to note that it is still not beneficial for your health and more specifically gut health as aspartame increases certain bacteria in your gut that are directly associated with weight gain. Furthermore, the long-term (more than 10 years) use of Aspartame has been negatively associated with cardiac health. Lastly, Aspartame also leads to an increase in carbohydrate cravings, which can lead to increased appetite.

Conclusion: Although Aspartame was set-free from being cancer causing, it still increases carbohydrate cravings and the effect it has on gut-health and cardiac health shouldn’t be neglected. Remember that moderation is key and try to replace diet drinks with infused water or homemade iced teas (rooibos is such a good option). But if you still plan consume Aspartame, be sure to include extra fibrous vegetables or even a probiotic to keep the microbiota in balance.

Stevia, Erythritol and Xylitol

Stevia, Erythritol, and Xylitol have been categorised as natural sweeteners. The benefits of these sweeteners are that they don’t need insulin to be metabolised and therefore improves glucose tolerance and reduces insulin levels.

Stevia does have an undesirable bitter aftertaste and the Erythritol and Xylitol are quite expensive (roughly R150-160p/kg).

But it seems worth it, because when consuming these natural sweeteners, the rewards system is activated leaving you feeling satisfied. And in contrast to the previous mentioned sweeteners; they do not increase cravings.

Conclusion: Stevia and Xylitol is superior; it can improve glucose levels and aid in weight management, in comparison to the other artificial sweeteners. Still, moderation remains a key factor in any healthy diet and therefore using it sparingly will benefit your health as well as your wallet!