Sweeteners: worse or less bad than sugar?

Free sugar gets a bad rap… but so does “fake sugar”. Are sugar-free sweeteners less bad, worse, as bad as sugar for your health? Cross discussion between two scientists whose points of view differ, Liliane Malczewski and Geneviève Pilon.

In the current context of overconsumption of sugar, is it still a better choice to turn to sugar-free sweeteners?

Geneviève Pilon: This is probably not the miracle solution as one might think at first glance. The picture is not so clear, but epidemiological studies show that we do not necessarily see an improvement in diabetes and obesity among people who consume more artificial sweeteners. According to intervention studies, certain artificial sweeteners increase glucose intolerance, therefore prediabetes. It can be seen in animals and it can be seen in some people, but not in everyone.

How is this explained?

GP: A lot of it is because of gut bacteria. In some people, this will unbalance the intestinal microbiota and make them more sensitive to the sugar they subsequently consume. Other people, however, will be less affected. Some sweeteners should also be monitored more than others. Stevia [un substitut extrait des feuilles de stévia utilisé dans les desserts et les boissons] rather shows neutral or even beneficial effects.

Liliane Malczewski: There are sugar substitutes called sugar alcohols, such as xylitol, mannitol and sorbitol. Xylitol is extracted from birch bark. Where it becomes interesting for the oral aspect is that studies show that xylitol – which contains around 50% of the calories of sugar – can have an anticariogenic effect. [il limite la prolifération des bactéries, et donc des caries]. Dentists now will recommend xylitol gum to people with dry mouths; This will stimulate salivary flow and have a positive impact on cavities. If you consume too much, on the other hand, you can have digestive effects, such as bloating: there are therefore maximum thresholds to respect.

Is it better to opt for sugar-free gum or mint or sweetened gum?

LM: It is certain that, for my part, I will answer without sugar. Especially since if you keep the candy in your mouth for a long time, it increases the cariogenic effect even more.

GP: From a metabolic standpoint, if it’s just a few mints a day, I don’t believe that’s what would cause an obesity problem. And I wouldn’t put sugar alcohols in the same category as non-caloric sweeteners like saccharin, sucralose and aspartame. That could be a good compromise.

Sweeteners are also commonly used in soft drinks. Which is better? With or without sugar ?

GP: Occasionally it’s okay, but from my point of view, with or without sugar, it’s a bit dangerous. Sugary drinks are one of the causes of the rise in obesity. As for the option of replacing sugar, it depends on which artificial sweetener. According to studies, the artificial sugars that are the most damaging to glucose metabolism are saccharin and sucralose. For aspartame, it’s not so clear because the effects seem to vary depending on the individual.

So stevia is preferable?

GP: Studies so far seem to indicate that stevia and molecules isolated from this plant would be a safer choice for health. That said, regardless of their nature, non-caloric sweeteners – very stimulators of sweet taste – encourage our consumption of sugar. In an ideal world, I think we should consume less sugar and opt more for natural complex sugars like maple syrup. Its effects on metabolic health are less significant than those of refined sugar.

On your side, M^me Malczewski, what do you think of soft drinks? With or without sugar ?

LM: It is certain that the sugar substitute will have less cariogenic effects, but the fact remains that the strong carbonization of these drinks can in itself cause a loss of enamel, therefore erosion of the teeth. It’s very acidic. The watchword would be to avoid both, especially for young children, whose tooth enamel is very thin.

Who are they ?

Liliane Malczewski

Dentist and president of the Order of Dentists of Quebec. She is “rather for” sweeteners, especially alcohol sugars.

Geneviève Pilon

Co-author of the book The truth about sugar and research professional at the Institute of Nutrition and Functional Foods, at Laval University. She is “rather against” non-caloric sweeteners.