|
You Are Here: IC
Network : Fresh Tastes
: August 2001
How Sweet It Is!
We've all heard
the same stories over and over on the nightly news: Americans are
gaining weight at an unprecedented rate and are suffering serious
health consequences as a result. Along with dietary fat and lack
of exercise, our growing consumption of sugar has become serious
concern. But if it's difficult for ordinary Americans to cut out
the sweets, its doubly hard for the diet-sensitive IC patient.
Dining out is
scary for many of us. Low-cal offerings at restaurants are loaded
with tomatoes, lemon juice, hot spices, or raw onions. Popular weight-loss
programs such as Weight Watchers, Jenny Craig, and others offer
wonderful pre-packaged foods and meal plans for weight loss but
are not equipped to deal with the complexities of the IC diet. Stroll
down the diet food aisle of your local supermarket and you find
a wide array of vitamin-packed products designed to help you lose
weight if you don't mind the bladder burning preservatives and artificial
sweeteners. Natural food markets and vitamin stores aren't much
better. They offer a treasure trove of diet products without the
preservatives, but alas, many of these do have caffeine. (Caffeine
tends to temporarily boost the metabolism and thus help burn calories).
Some products also have large doses of ascorbic acid which may flare
sensitive IC bladders.
So what is a
health conscious hypoglycemic, diabetic or obese IC patient supposed
to do? Is there anything that can help us cut out the sugar but
still satisfy our sweet tooth? Help may have arrived in the form
of some new non-nutritive or low-calorie sweeteners now appearing
on market shelves. And more products we may potentially find helpful
are on the horizon. But first lets take a quick look at several
sweetening products that have been on the market a while, and how
they affect IC bladders. Currently there are three artificial sweeteners
approved for use as food additives by the FDA: saccharine, aspartame
and acesulfame K.
Saccharin was
discovered in 1879. It has been used as a sweetener for at least
a century and is made from a substance that occurs naturally in
grapes and other fruit. Twenty-four years ago the FDA proposed a
ban on saccharin amid debate over the possibility that it could
promote cancer. Some studies indicated that in rats at least, large
amounts were carcinogenic. No human studies ever confirmed the findings
and it was noted that it would be hard for humans to consume large
enough doses to suffer the same fate as the rats. After much debate
and political pressure, in 1991 the FDA formally withdrew its proposal
for a ban on saccharin. Today however, you will find that products
containing saccharin do carry a warning label. The safety controversy
continues.
Teaspoon-for-teaspoon
saccharin is about 300 times sweeter than sugar but it has no calories
because the body can't break it down and use it for energy. Instead,
it is eliminated in the urine. From an IC patient's point of view,
it would be nice if saccharin-containing products also carried another
warning label: saccharin may be extremely painful for an IC bladder.
That's why many of us avoid the saccharin sweeteners Sweet 10 and
Sweet n' Low.
Aspartame, discovered
almost forty years ago, is more than 180 times sweeter than sugar
and contains two substances which are found naturally in various
foods-- aspartic acid and phenylalanine. When digested, your body
treats these two substances from aspartame just as it would if they
came from any other food. However, Dr. Richard Wurtman at the Massachusetts
Institute of Technology (MIT) found in one study of the effects
of aspartame on animals, that large doses of aspartame altered levels
of neuropeptides and serotonin in the brain, leading to seizures.,
Because aspartame contains phenylalanine, people with a genetic
disorder affecting about one of every 15,000 adults (called phenylketonuria
or PKU) need to watch out for it. The half million people with IC
may also want to avoid aspartame. Notorious for exacerbating IC
bladder symptoms (and also anecdotally associated with migraines
in some people), aspartame has long been on the IC patients' foods-to-avoid
list. It is sold under the brand names NutraSweet and Equal, and
is also found in many food products. Some dietitians may not count
IC patients' inability to utilize aspartame in a weight loss plan
as problematic. In several studies done in the 1980's the use of
aspartame was not found to be beneficial for weight reduction anyway.
One study reported that it actually increased appetite.
Acesulfame K
was approved by the FDA for use in food in 1988. Another intense
sweetener, it is around 200 times sweeter than sugar. Because it
has an aftertaste, most products that contain acesulfame K combine
it with another sweetener. It is sold under the name Sunette, and
is an ingredient of packaged sweeteners such as Swiss Sweet and
Sweet One. Like saccharin, it isn't metabolized by the body so it
has no calories. It too is eliminated in the urine.
(Although potassium in food hasn't been proven to provoke IC bladders,
certain researchers have suggested that dietary potassium may play
a role in flares-- at least for some people. So it may be worthy
to note that the "K" in acesulfame K stands for potassium).
Unfortunately, for whatever reason, acesulfame K also irritates
many people's IC bladder just as much as the other artificial sweeteners.
Historically
we've struck out when it comes to being able to use artificial sweeteners,
but two newly introduced products may signal a whole new ball game.
Sucralose
The creation of
sucralose and its accidental discovery as a sweetener in the early
1970's is one of science's more humorous stories. It seems a sugar
company in Europe, Tate & Lyle, was trying to find new manufacturing
uses for table sugar, known chemically as sucrose. They had tweaked
the sucrose molecule this way and that, adding and subtracting a few
atoms here and there to create new halogenated sugars. They were testing
each new substance as they produced it to see if it was useful. One
day they tried substituting a chlorine atom at several points in the
sucrose molecule where a hydroxyl group would normally exist. One
of the researchers then asked his assistant to test the new compound.
The assistant, whose native language was not English, misunderstood
his boss. He thought he was being asked to taste it. The new sugar
compound turned out to be sweet, just like the plain old-fashioned
sugar it was made from. Thus sucralose started down the long road
to market in America as a food sweetener.
Unlike table
sugar which is completely absorbed by the body, sucralose appears
to be only partially absorbed. (There are many, many kinds of sugars
including fructose, maltose, lactose and others. Some substances
which are classified as sugars are not perceived by humans as sweet.
Not all sugars can even be digested and used by humans. Whereas
termites can fully metabolize cellulose thanks to some bacteria
in their gut, we can't. Sugars not only vary in their ability to
be absorbed and utilized, they also vary in how quickly the process
takes place and how sweet we perceive them to taste).
Sucralose has
a sweetness potency of about 600 times that of sugar. Sucralose,
sold in the U.S. today under the brand name Splenda, has been exhaustively
tested for safety since the late1980's. Over 100 scientific studies
have been done in Europe where it was first introduced. The research
not only focused on the health effects and safety of sucralose,
but also of its breakdown products. One concern that initially delayed
its introduction to consumers here was the question of its slow
rate of degradation in acidic environments such as a can of soda
for instance. (Over a period of about 6 months, sucralose slowly
degrades by about 0.3% when it is used in an acid food). European
food safety experts worried that the breakdown products of sucralose
may do something that sucralose itself was unlikely to do be utilized
by gut bacteria in some detrimental way. Finally-- twenty-five years
after its discovery--the accumulated scientific evidence answered
the concerns of critics in Europe and gained for sucralose acceptance
as a safe sweetener. The Scientific Committee on Food, a subunit
of the European Commission for Health and Consumer Protection, issued
an opinion paper last year noting, " The Committee is satisfied
that the range of studies now available is sufficient for a full
safety evaluation of sucralose." They went on to conclude that
over the years their questions and concerns had been answered by
the extensive research and that, "...sucralose is acceptable
as a sweetener for general food use..."
The World Health
Organization/ FAO Joint Expert Group on Food Additives has set an
acceptable daily intake limit for sucralose at 15 mg/kg of weight.
(This is in spite of the fact that the European Committee found
it to be safe in tests of amounts up to about 628 mg/kg of weight
per day.6 More recently the far more conservative U.S. Food and
Drug Administration established the acceptable daily intake limit
at 5 mg/kg of weight.
Sucralose for Cooking
McNeil Specialty
Products markets sucralose in the U.S. in the form of a no-calorie
sweetening product called Splenda. Splenda is not pure sucralose,
but a mixture of dextrose, maltodextrin and sucralose. Because it
takes such a tiny amount of sucralose to sweeten food, the other
sugars were added to the formulation of Splenda to add bulk. (They
don't add calories, however). Splenda is available at many nationwide
grocery chains in the same aisle as th sugar or the other artificial
sweeteners. It comes in two forms: a box of white crystalline powder
that can be measured and utilized much like sugar (though it is
considerably more expensive), and individual packets of the crystalline
powder, each of which sweeten a serving of food as would 2 teaspoons
of sugar. You will notice that the powder is lighter in weight than
sugar and it may fizz a little when you stir it into something like
hot herb tea. It dissolves very quickly and easily in water. Some
people (though not everyone) also notice a faint sour taste along
with the sweetness.
According
to the manufacturer, Splenda can be used in cooking measure for
measure the same as sugar. Heat does not affect its sweetening properties.
It may behave differently in some cooking situations though because
sugar does other things besides just add a sweet taste. In breads
made with yeast for instance, table sugar acts as a nutrient for
the yeast. In candies, it contributes to the smooth texture. In
angel food cakes, sponge cakes, or meringues, sugar helps hold the
form once the air is whipped in. In other foods such as glazes or
cookies, sugar helps the food brown as it caramelizes. Sugar attracts
and holds water molecules. In home made jellies or jams sugar helps
inhibit the growth of molds by bonding to the water that the microorganisms
need to survive. In this way sugar can preserve food.
Splenda and IC
Bladders
Last spring
several IC patients posted notes on the IC Network's electronic
bulletin boards that they had successfully tried Splenda without
it bothering their bladder. One lady wrote however, that it may
have given her a small amount of additional frequency she couldn't
be sure. Numerous people wrote me to ask if I thought Splenda was
okay to try. Since it was new on the market I told them that there
wasn't any IC experience with it it was too new but to try it cautiously
and let me know how it went. Of several who responded back, 100%
reported a good experience and no one reported a symptom flare-up
similar to that which aspartame regularly produces. I've tried Splenda
myself, about 3 teaspoons a day average, on an almost daily basis
for nearly a month now. I was pleased and surprised that I did not
have the week-long symptom flare-up that aspartame and saccharin
usually give me. Only one day did I suspect that it may have caused
some irritation. That was a day that I was running late with my
daily medication doses and that may have contributed to the problem.
In pies, Splenda
works well when substituted measure-for-measure for two-thirds to
three-quarters of the sugar called for in the recipe. ( In a pear
pie for instance, in place of the 1 cup of sugar called for I used
2/3 cup of Splenda and 1/3 cup of sugar). In hot drinks like herb
tea, decaf coffee, or coffee substitute, I find an individual packet
of Splenda sweetens a bit too much. I prefer to use about half a
packet. I've mixed Splenda with cinnamon and sprinkled it on buttered
toast and hot oatmeal about half a packet does the trick. I make
my own cereal to avoid both the bladder effects of preservatives
in the mass-produced boxed cereals, and the too- sweet taste of
the fruit-juice sweetened natural-food versions. I substituted Splenda
for about half the sugar in my usual cereal recipe and it worked
just fine. Because the product is so new we are all breaking new
ground here and it pays to just experiment.
Next month's
column will feature another sweet new product Stevia extract. Meanwhile,
if you've tried sucralose or stevia, please continue write and tell
me your experience good or bad either way I'd like to hear about
it!
|
