The Need for Alternative Sweeteners

    Rising Incidence of Chronic Disease

    According to the Canadian Obesity Network, North American consumption of sugar-sweetened drinks and soda has "skyrocketed"in the last thirty years.

    In 2012, 1.9 million Canadians aged 12 or older reported that they had diabetes. Excessive sugar consumption has also been correlated with overweight and obesity. A study published in the Canadian Medical Association Journal (CMAJ) reported that obesity rates in Canada tripled between 1985 and 2011, rising to 18 per cent from six per cent, projecting that by 2019 nearly 21 percent of Canadian adults will be obese. The statistics point to the fact that excessive sugar consumption acts as a high risk factor for multiple diseases.

    For example, research cited in JAMA Internal Medicine found that the risk of dying of heart disease is higher among people who consume a greater percentage of calories from "added sugars." The risk was even greater for people who consumed seven servings or more of sweetened beverages a week. As a result, the Canadian Heart and Stroke Foundation is now echoing concerns voiced by the American Heart Association regarding the adverse effects of excess sugar consumption and its relation to hypertension and heart disease. Excessive sugar and sugary drink consumption also affects school age children with research findings revealing a correlation between high sugar intake, ADHD and hyperactivity.

    One in every five calories or about 21 percent of the daily calories that Canadians consume come from sugar according to 2011 Statistics Canada in a report on the sugar consumption of Canadians of all ages. The report also noted that an average Canadian consumes 110 grams (26 teaspoons) of sugar per day, with 35 per cent of the daily intake sourced from sugary drinks and candy that are high in "added sugars." This includes sugars in soft drinks, salad dressings, condiments, relishes, barbecue sauce and pasta sauce as well as baked goods, breakfast cereals, yogurts, desserts and candy.

    Close to 400 million people worldwide are affected by type II diabetes or obesity, costing the global healthcare system billions of dollars every year. The Credit Suisse Research Institute's 2013 study found that close to 90 percent of general practitioners surveyed in the US, Europe, and Asia believe excess sugar consumption is linked to the sharp growth in these health problems. The associated costs for the global healthcare system are estimated at a staggering 470 billion US dollars every year, representing over 10 percent of all global healthcare costs. To date, approximately 30%–40% of healthcare expenditures in the U.S. alone, address issues that are closely tied to the excess consumption of sugar.

    Rising incidences of these chronic health ailments, almost to epidemic levels, requires avoidance of glycemic sweeteners and high-calorie foods. As health related campaigns to reduce sugar and sugary drink marketing and consumption continue to gain momentum world wide, both manufacturers and consumers are seeking alternatives.

    Importance of Certified Organic Non-GMO Alternate Sweeteners

    As a result, a growing number of alternate sweeteners have been introduced to both the conventional and organic food, beverage, and nutraceutical industry. However, conventional alternate sweeteners which are a product of conventional agriculture may not be in a category which ensures good health.

    With today's increased demand for clearly labeled organic and non-GMO products, health conscious consumers must be vigilant to source sweeteners carefully, choosing only certified organic non-GMO alternate sweeteners. This insures freedom from pesticides, herbicides, fungicides, irradiation, sewage sludge, GMOs and other harmful hidden ingredients.

    One of the newest naturally sourced sugar alcohols is a sweetener called erythritol. Manufacturers say that it has been introduced to replace sugar, high fructose corn syrup, and other health hazardous artificial sweeteners such as aspartame, aceslulfame-K, sucralose, and saccharin. Sugar alcohols may have certain side effects. Erythritol is said to be a zero-glycemic, zero-calorie product which has gained GRAS status. With only 70% of the sweetness of sugar, it has been promoted as having a cool clean taste and can be found in confectionery products such as chocolates, candies, baked goods, ice cream and fruit preserves, as well as beverages, toothpaste, chewing gum, dog biscuits, cosmetics and nutraceuticals

    Naturally Occurring in Nature
    Zero Glycemic Zero Calorie

    Erythritol is a non-toxic sweetener derived from corn. It is industrially produced by fermentation of glucose using a yeast (monilienna pollens). It occurs naturally in fruits such as grapes, melon, pears, and mushrooms as well as in fermented foods such as soy sauce, miso, wine and beer.

    Approved by Health Canada in 2005 as well as the U.S. Food and Drug Administration, it was first introduced as an alternate non-sugar sweetener in 1990 in Japan. It has also been approved for use in foods in more than 50 countries, including Brazil, Mexico, Australia, the European Union, as well as Canada and the U.S. Free of gluten, wheat, and soy, erythritol is said to not affect blood serum glucose or insulin levels, earning recommendations from the World Health Organization (WHO) and the American Diabetes Association. It is an antioxidant and boasts a zero glycemic index as well as a high digestive tolerance. It is rapidly absorbed and eliminated from the body within 24 hours. As a result, researchers claim that foods containing substantial amounts of erythritol are unlikely to cause gaseous and laxation side effects. Health Canada has acknowledged erythritol as tooth friendly, supporting recognition by the American Dental Association. The FDA has approved the use of the "does not promote tooth decay" health claim in labeling for sugar-free foods and dental products that contain erythritol. Clear and accurate labeling is also important and necessary for healthy food choices.

    Research supports the use of erythritol as a replacement for other "added sugars" as being prudent for those requiring zero glycemic, zero calorie, natural alternate sweeteners. Choosing certified organic non-GMO may be the best way to ensure intake of sustainably produced pure, safe food and beverage products and sweeteners. WF

    Simi Summer, Ph.D., is an organic advocate, independent researcher, educator and freelance writer. She is a strong proponent of organic consumer education and informed consumer choices.

    Posted 5/19/15


    Action on Sugar. Worldwide experts unite to reverse obesity epidemic by forming ‘Action on Sugar’. (accessed 12 January 2014).

    Babey SH, Jones M, Yu H, Goldstein H. (2009). Bubbling over: soda consumption and its link to obesity in California. Policy Brief UCLA Cent Health Policy Res: 1–8.

    Bernt, WO, Borzelleca, JF, Flamm, G, Munro, IC. (1996). Erythritol: a review of biological and toxicological studies, Regulatory Toxicology and Pharmacology 24, S191–S197.

    Bleich SN, Wang YC, Wang Y Gortmaker SL. Increasing consumption of sugar-sweetened beverages among US adults: 1988-1994 to 1999-2004. Am J Clin Nutr. 2009 Jan89 (1):372-81. doi: 10.3945/ajcn.2008.26883. Epub 2008 Dec 3.

    Bornet F.R.J et al., Plasma and urine kinetics of erythritol after oral ingestion by healthy humans. Regulatory Toxicology and Pharmacology, 1996a, 24 (2, Part 2), S280 –S285.

    Chen L, Caballero B, Mitchell DC, Loria C, Lin PH, et al. (2010) Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure: aprospective study among United States adults.121: 2398–2406.

    Dean I, Jackson F, Greenough RJ. (1996).Chronic (1-year) oral toxicity study of erythritol in dogs. Regul Toxicol Pharmacol 24(2 Pt 2):S254-60.

    den Hartog GJ, Boots AW, Adam-Perrot A, Brouns F, Verkooijen IW, Weseler AR, Haenen GR, Bast A. Nutrition. (2010). Erythritol is a sweet antioxidant. Apr 26 (4):449-58. doi: 10.1016/j.nut.2009.05.004. Epub 2009 Jul 24.

    Duffey KJ, Popkin BM (2007) Shifts in patterns and consumption of beverages between 1965 and 2002. Obesity (Silver Spring) 15: 2739–2747.

    Fagherazzi G, Vilier A, Saes Sartorelli D, Lajous M, Balkau B, et al. (2013). Consumption of artificially and sugar-sweetened beverages and incident type 2 diabetes in the Etude Epidemiologique aupres des femmes de la Mutuelle Generale de l’Education Nationale-European Prospective Investigation into Cancer and Nutrition cohort. Am J Clin Nutr 97: 517–523.

    Fung TT, Malik V, Rexrode KM, Manson JE, Willett WC, et al. (2009). Sweetened beverage consumption and risk of coronary heart disease in women. 89: 1037–1042.

    Goossens, J; Gonze, M. Nutritional properties and applications of erythritol: a unique combination? (1996). Advances in Sweeteners. pp 150 – 186. Advances in Sweeteners

    Hägi,T.T., Hofmänner, P, Salvi, G. E., Ramseier, C.A., Sculean A. (2013). Clinical outcomes following subgingival application of a novel erythritol powder by means of air polishing in supportive periodontal therapy: a randomized, controlled clinical study. Quintessence International Periodontology, 44:10.

    InterAct c (2013) Consumption of sweet beverages and type 2 diabetes incidence in European adults: results from EPIC-InterAct. Diabetologia 56: 1520–1530.

    Ishikawa M, Miyashita M, Kawashima Y, Nakamura T, Saitou N, Modderman J. (1996). Effects of oral administration of erythritol on patients with diabetes. Regul Toxicol

    Pharmacol. Oct; 24 (2 Pt 2): S303-8.

    Johnson RK, Appel LJ, Brands M, Howard BV, Lefevre M, Lustig RH, Sacks F, Steffen LM, Wylie-Rosett J. American Heart Association Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism and the Council on Epidemiology and Prevention. Circulation. Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association2009 Sep 15;120(11):1011-20. doi: 10.1161/CIRCULATIONAHA.109.192627. Epub 2009 Aug 24.

    Mäkinen KK, Saag M, Isotupa KP, Olak J,Nõmmela R, Söderling E, Mäkinen P. Similarity of the effects of erythritol and xylitol on some risk factors of dental caries. Caries Res 2005; 39:207-215.

    Malhotra A. Sugar is now enemy number one in the western diet. The Guardian. 11 January 2014. (accessed 12 January 2014).

    Malik VS, Popkin BM, Bray GA, Despres JP, Hu FB (2010). Sugar-sweetened beverages, obesity, type 2 diabetes mellitus, and cardiovascular disease risk. Circulation 121:1356–1364.

    Munro IC, Berndt WO, Borzelleca JF, Flamm G, Lynch BS, Kennepohl E, Bär EA, Modderman J. Erythritol: an interpretive summary of biochemical, metabolic,

    toxicological and clinical data. Food Chem Toxicol. Dec 1998; 36 (12):1139-74.

    Ogden CL Kit BK, Carroll MD, Park S, (2011). Consumption of sugar drinks in the United States, 2005–2008. Hyattsville: National Center for Health Statistics. Available: db71.pdf.

    Qi Q, Chu AY, Kang JH, Jensen MK, Curhan GC, et al. (2012). Sugar-sweetened beverages and genetic risk of obesity. N Engl J Med 367: 1387–1396.

    Quanhe Yang; Zefeng Zhang; Edward W. Gregg; W. Dana Flanders; Robert Merritt; Frank B. Hu. Added sugar intake and cardiovascular diseases Mortality Among US Adults. JAMA Intern Med. 2014;174 (4):516-524.

    Röper, H, Goossens, J. Erythritol, A new raw material for food and non-food applications. Article first published online: 26 OCT 2006 DOI: 10.1002/star.19930451107. Copyright1993WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

    Schmidt, LA. (2014). New unsweetened truths about sugar. JAMA Intern Med. 174 (4):525-526. doi:10.1001/jamainternmed.2013.12991.

    Schulze MB, Manson JE, Ludwig DS, Colditz GA, Stampfer MJ, et al. (2004). Sugar-sweetened beverages, weight gain, and incidence of type 2 diabetes in young and middle-aged women. JAMA 292: 927–934.

    Vartanian, LR, Schwartz, MB, and Brownell, KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. (2007). Am J Public Health. 97 (4): 667–675. Division of Nutrition and Physical Activity (2006). Does drinking beverages with added sugars increase the risk of overweight? Atlanta: Centers for Disease Control and Prevention Available: http://www.cdc.govenccdphp/dnpa/nutrition/pdf/r2p_sweetend_beverages.pdf.