Beyond Carcinogenicity Fears, What Else Can We Talk About When It Comes to Sugar Substitutes?

Recently, the WHO’s published assessment that aspartame may be carcinogenic has sparked heated debate, prompting renewed scrutiny of sugar substitutes in processed foods. In this episode, Food Talk invited Lulu, a doctoral student in the Department of Cardiovascular Medicine at Fuwai Hospital, Peking Union Medical College, to explore sweetness and sugar substitutes with us.

The concept of sugar substitutes may sound unfamiliar, yet they have long infiltrated our daily lives. The ingredients lists of sugar-free cola, Bingfeng – the drink Shaanxi people hold as a taste of home – and preserved plums all contain artificial sweeteners. Beyond those, sugar substitutes also encompass natural sweeteners such as erythritol and steviol glycosides. Next time you spot a product claiming “0 sugar” or “low sugar”, take a moment to check which sugar substitute it actually uses.

But when did “sugar substitute” and “healthier” become synonymous? Why does the “sugar” being replaced send such dread into people? Beyond potentially causing dental caries, obesity and breakouts, medical student Lulu also walks us through the risk of how high sugar intake triggers insulin resistance, which in turn raises the risk of diabetes. Sugar substitutes may, to a degree, circumvent the harms of sucrose, yet they introduce new problems of their own.

In fact, to come as close as possible to sucrose’s sweetness, texture and other functionalities, processed foods often combine multiple sugar substitutes and additives in a single formulation, making ingredients lists ever longer. Some research also suggests that certain sugar substitutes, unable to relay sweetness signals from the gut to the brain, may actually lead us to consume more “sweet-tasting foods”, making it even harder to give up sweets – quite the opposite of what “cutting sugar” is meant to achieve.

From the painstaking foraging for sweet berries in prehistoric times, to cultivating sugar crops such as sugarcane, to the heavy use of sweeteners and sugar substitutes in processed foods, obtaining sweet foods has become ever easier. Our desire for sweetness is both inborn and one that has swollen through our mutual adaptation to the food environment.

If you truly love sweets, why not indulge in the real sweetness of fresh fruit and vegetables rather than getting hooked on addictive processed foods? And if you want to cut sugar, don’t let the myth of “sugar substitute = health” tie you down – only a thorough overhaul of your dietary habits will bring about positive change.

This Episode’s Guest

Lulu

A second-year doctoral student in the Department of Cardiovascular Medicine at Fuwai Hospital, Peking Union Medical College. Interested in nutrition and sustainable eating; enjoys music, photography and fitness.

This Episode’s Hosts

Wan Lin

A Foodthink member. Rarely eats out, often cooks at home, and tries to avoid takeaways wherever possible. Grew up on her mother’s home cooking, and her own kitchen career is now over 15 years long. Loves sports, and in her spare time enjoys reading medical history and flicking through anatomy books.

Ze’en

A Foodthink editor and a rare soul who truly doesn’t care for sweets. Cannot resist sour foods – sour pomegranates, fermented mare’s milk and douzhi chief among them – yet has always kept a keen eye on sugar and sugar substitutes.

Xiaojing

Food Talk producer, and slightly embarrassed to confess that she is something of a sweet tooth. Worked as a business journalist and interviewed Michelin-starred chefs; now hopes to return to the source of food and see the world more holistically. One change in the past two years: she checks ingredient lists before buying food.

Timeline

03:16 The recent headline “Aspartame may be carcinogenic” – should we be panicking?

05:15 When we say “sugar substitute”, what exactly are we talking about? Sugar alcohols / natural sweeteners / artificial sweeteners

07:51 Sugar-free cola, Bingfeng – the drink Shaanxi people hold as a taste of home – and preserved plums all contain artificial sweeteners. Beyond those, there are natural sweeteners and other sugars that aren’t sucrose. There are countless substances whose names contain the character for “sugar”, placing a huge cognitive burden on consumers.

12:15 Why are we afraid of “sugar”, and what exactly are sugar’s problems? High calorie content, changes in skin condition, dental caries, and the diabetes risk brought about by insulin resistance, among others.

16:45 The history of sugar substitutes goes back further than you might imagine – the first-generation artificial sweetener, saccharin, was already manufactured in 1879. Only after that did aspartame, sucralose and other sugar substitutes appear one after another.

18:23 To what extent can sugar substitutes mitigate the negative effects of “sugar”? Perhaps they help improve the diets of people with diabetes and reduce dental caries in children.

20:21 In reality, many processed foods contain multiple sugar substitutes that complement and refine one another to replicate the sweetness, colour, structural support and other combined effects of sucrose. “There is no perfect sugar substitute – only the perfect formulation.” This is why more and more additives keep appearing on ingredient lists.

25:20 Another problem with sugar substitutes: although they contain no calories, they don’t relay sweetness signals from the gut to the brain, which may lead us to eat more “sweet-tasting foods” – first, our diet loses its balance, and second, it becomes even harder to give up sweets.

29:46 Who is developing sugar substitutes? A more pressing question might be: why are we so addicted to sweetness?

35:16 Sweetness: from prehistoric humans painstakingly foraging for rare berries, to planting the first sugar-producing crop, to factories mass-producing confections with sweeteners – humanity’s desire for sweetness has been amplified beyond measure while the path to obtaining it has been continually shortened.

40:47 By the same logic, if you want to get various trace nutrients, do you really need a balanced diet – or can you just pop a vitamin tablet?

44:31 Diabetes is striking ever younger people. Why do we say “1 in 8 people has diabetes, yet 1 in 2 are in the prediabetes stage”?

47:45 Going back to the source of sweetness – eat a dried jujube or gnaw on a sugarcane stalk, and you’ll get far more than sweetness: you’ll also pick up other trace nutrients.

49:19 Our family eating habits and childhood tastes may not be the healthiest, but we can still make positive changes through conscious, independent choices.