Five intensely sweet sugar substitutes can legally be used as food ingredients in the United States. These are: acesulfame-K, aspartame, neotame, saccharin, and sucralose. All are over 100 times as sweet as sugar, so only tiny amounts are needed to replace the sweetness of sugar (see Table 1).

Before manufacturers can add a new substance to the US food supply, they must get approval from the Food and Drug Administration (FDA). Approval rests on convincing the FDA, by means of appropriate scientific studies, that the substance will be safe when used as intended.

Such safety tests are typically two-year long studies of the substance conducted in laboratory animals—at doses much higher than people would use. They are designed to mimic the exposure of humans who would consume the products every day for a lifetime. Scientists examine the results for evidence that the tested substance is toxic, that it causes cancer, or that it causes mutations that could lead to cancer. When a product has passed the animal safety tests, and has been used in foods and beverages, further studies are often conducted to monitor its use by people.

Despite such studies, concerns have been raised about intense sweeteners; frequent repetition by the popular media and on the Internet has fanned anxiety in many people. But the charges are typically without merit, and have been dismissed by respected scientific organizations and governmental regulatory bodies—here and in other countries.

Acesulfame-K
Ace-K (the K stands for potassium) is a heat-stable compound that is about 200 times sweeter than sugar. It can be used for cooking and baking, and is most often used in combination with other sweeteners.² It was approved in 1988 for use in dry food products,³ in 1998 for use in nonalcoholic beverages,⁴ and in 2003 for use as a general purpose sweetener.⁵ Some objections filed with the FDA in the 1980s and 1990s criticized these approvals based on: 1) weaknesses of some of the safety studies, 2) some animal experiments that suggested ace-K might increase the risk of cancer, and 3) concerns about a breakdown product that might form in beverages during storage. The FDA responded that although one of the studies was flawed, it had been repeated correctly and did not suggest ace-K caused illness in the animals. FDA did not find that the objections to the cancer studies had merit. Further, the breakdown product of most concern, acetoacetamide, would be present in negligible amounts, so is not a real safety issue. These issues were addressed and dismissed by the European Union’s Scientific Committee on Food.⁶

In 1997, Indian scientists reported that ace-K caused mutations in bone marrow cells of mice,⁷ but other researchers were unable to replicate these results.⁶ When the original researchers tested a mixture of aspartame and ace-K in a second study, they also found no evidence of bone marrow mutations.⁸

Aspartame
Websites and anecdotal reports that attack the safety of aspartame abound—assertions that the sweetener causes diseases ranging from lupus to cancer to fibromyalgia and neurotoxicity are common. None of these accusations are true.

The human body does break down aspartame into the amino acids phenylalanine and aspartic acid, and methanol. The only valid safety issue related to aspartame is that people with the rare inborn metabolic disorder phenylketonuria should not use it because they can’t utilize phenylalanine, and it will build up in their blood. That is the reason all products that contain aspartame carry a label indicating that phenylalanine is present.

Since aspartame was first approved in 1981,⁹ charges have been leveled that it causes cancer of various sorts, and that the methanol it contains is toxic (which is true—but at high doses). People who are concerned about this don’t realize that methanol is found widely distributed in nature in amounts that greatly exceed those that would result from the breakdown of aspartame. It is a common component of fruits and fermented foods and beverages.^10,11

In addition to the usual safety tests on animals, there have been a number of tests of aspartame in humans, including young children,¹² elderly people,¹³ people with diabetes,^14,15 as well as healthy adults.¹⁶ None have found safety problems.

In 2005, a group of Italian researchers reported that they found an increased incidence of some types of cancer in rats fed aspartame at doses similar to those that humans might encounter.¹⁷ Interpretation of the data from this study is not simple, because it was performed with a non-standard methodology that may not support the authors’ conclusions. The FDA as well as the European Food Safety Authority are reviewing the data to see if the study’s results are valid.

In contrast, Lim and colleagues¹⁸ recently reported the results of a study of over 500,000 American adults. They found no correlation between the participants’ consumption of aspartame in beverages and the occurrence of the types of cancer reported in the recent Italian study. It is possible that even if the results of the Italian rat study are valid, the mechanism by which such cancers are caused in rats does not occur in humans. This could explain the discrepancy between the two studies.

Neotame
The newest and sweetest of the sugar substitutes is neotame. Like aspartame, it contains the amino acids phenylalanine and aspartic acid, but has a different chemical structure.¹⁹ Neotame is at least 7000 times sweeter than sugar, and 30 times sweeter than aspartame—so only extremely small amounts are needed to replace sugar’s sweetness. Neotame was approved by the FDA as a general-purpose sweetener in 2002.¹⁹ Australia, New Zealand, Russia, Mexico, China, South Africa, several South American countries and most of the countries of Eastern Europe have also approved it.

In 1977, the FDA attempted to ban saccharin, in spite of its long history of use, because of studies showing that it caused bladder cancer in rats.^22,23,24 However, because of a public outcry, Congress imposed a moratorium on the proposed ban and instead required warning labels on any foods and beverages containing saccharin. This moratorium was repeatedly extended, and the sweetener was never actually banned. More recent research determined that while at very high doses, saccharin causes bladder cancer in rats, the mechanism by which it does so doesn’t occur in humans.^25,26,27 Numerous studies have sought to find a relationship between saccharin use and bladder cancer in humans; but none has been detected.^28,29,30,31

Because saccharin causes cancer in animals by a mechanism foreign to humans, and since the human data have not demonstrated a link between cancer risk and saccharin use, saccharin is no longer considered a potential human carcinogen.³² In 2000, Congress mandated that the warning label on saccharin-containing beverages and foods be removed.³³

Sucralose
Sucralose is made from sucrose (table sugar) by the substitution of three atoms of chlorine for three hydroxyl (OH) groups. The human body does not digest sucralose, and so it provides no calories. It is about 600 times sweeter than sugar.¹⁹ Sucralose was approved by the FDA as a general purpose sweetener in 1999, which means it can be used in all categories of food and beverage, as well as a table top sweetener.³⁴

Sucralose’s safety was demonstrated by the results of over 100 scientific studies before the FDA approved it. Since approval, research has further substantiated it as safe for all segments of the population, including people with diabetes who would be expected to be heavy users of the sweetener.³⁵

Some websites have raised fears about the fact that sucralose contains chlorine—an element that is poisonous in the gaseous state. Such claims are without merit. Even though pure chlorine is poisonous, it is still essential for humans when combined with other dietary components. Table salt, for example, is about one half chlorine by weight.

Summary
The five intensely sweet sugar substitutes described above have been extensively tested and, in some cases, retested to affirm their safety. Still, many complaints have been voiced that since these products are synthetic, they are somehow more dangerous than substances that occur naturally. This argument is also without merit.³⁶ There are many naturally occurring compounds that are lethal at low doses—arsenic, cyanide and botulism toxin, for example, and many are naturally found in our foods in tiny amounts.³⁷

Because they either cannot be metabolized by the human body, or are used in such small amounts that their caloric contribution is nil, intense sweeteners can help people decrease their calorie intake. Thus, they have an important role to play in Americans’ ongoing battle against overweight and obesity.

TABLE 1. Intense Sweeteners Currently Approved in the United States

Sweetener	Calories/gram	Date Approved by FDA	Potency (times sweeter than sugar)	Brand Names
Acesulfame-K	0	1988	200	Sunett, Sweet One
Aspartame	4*	1981	180	NutraSweet, Equal, others
Neotame	4*	2002	7000	Not available
Saccharin	0	In use for more than 50 years before Food Additives Amendment of 1958	300	Sweet’N Low, Sweet Twin, Sugar Twin, others
Sucralose	0	1998	600	Splenda

*Although aspartame and neotame provide 4 calories per gram, the amount used in foods and beverages is so small that they contribute a negligible number of calories to the diet.¹⁹

To locate your biceps, stand with your arms extended down at your side with your palms facing forward; your biceps muscles are the part of your upper arm that is also facing forward. Next, bend your elbow and touch your shoulder with your hand. This movement is mediated by the biceps muscles.

To complete this exercise, you will need two plastic grocery bags and several books, cans, or bottles of water for added weight. With these items, you will be able to assemble your own “dumbbells.” You may think these homemade dumbbells are hokey, but don’t buy the media hype that you need high tech, expensive equipment to get a good workout. Your muscles can’t tell the difference. All they know is resistance.

To get started, double bag the grocery bags to ensure the cans or books won’t rip through. Next, you will need to add some weight. Cans are good because they usually have their weight written on the labels. A bonus to making your own weights is that you can easily adjust the amount to better suit your level of strength and fitness. Once you are strong enough, you can place a one-gallon jug of water into the bags; this weighs about eight pounds.

Begin by filling your bag with a weight that you feel comfortable with; it is better to start out lighter because you can always add weight. Now hold the bag at arms length. If the bag has a plastic handle and you are concerned about the handle hurting your hand, you can place a wash cloth or dish towel between your hand and the plastic bag. Keep your elbow tight to the side of your body throughout the entire up and down movement. Curl the weight up as high as you can. Be sure not to “cheat” by moving your shoulder. When you get to the top of the movement, pause for one second and lower the weight back down in a controlled manner. When you have lowered the weight to the bottom, you have completed one rep. Be sure to complete the entire movement in a controlled manner to avoid injury.

Your first goal is to complete a set of 8-10 reps. If you cannot do this without swinging the weight or using your shoulder to help get the weight up, then take some weight out of the bag and try again. After you complete one set with one arm, switch the weight to the other side and complete a set with the other arm. Over time, you will be ready to take on more weight and more reps. Your final goal is to complete three sets of 8-10 reps with each arm. Don’t be frustrated if one arm is stronger than the other; this is the case for most people. Like other resistance exercises, you should perform this exercise only twice a week.

Next month we will cover our last major muscle group -- the shoulders.

The program will cover a broad spectrum of basic and clinical research in ingestive behavior, including genetic, physiological, behavioral, subjective and social analyses of normal and disordered eating. Topics include hunger and satiation, food reward, thirst, salt appetite, obesity, eating disorders, alcohol intake, food selection, and habits and beliefs. For more information and to register: http://ssib.org/naples06.htm.

INGREDIENTS:

• 1 can (20 oz) pineapple slices
• 1 tsp. each of ground ginger, curry powder, garlic powder
• ¼ tsp. cayenne pepper
• 1 tsp. cornstarch
• 1 tsp. vegetable oil
• ¼ cup each of flaked sweet coconut, slivered green onions

DIRECTIONS:

1. Drain pineapple juice into a large measuring cup. Combine spices in a small bowl. Stir ¼ tsp. spice mixture, along with cornstarch, into pineapple juice. Set aside.
2. Sprinkle all remaining spice mixture over chicken. Drizzle oil over chicken. Place on roasting pan rack. Bake in a 400 degree oven for 15 minutes.
3. Arrange pineapple slices on rack. Bake 5 minutes longer.
4. Meanwhile, stir pineapple juice mixture. Microwave, uncovered, 2 to 4 minutes until sauce boils and thickens.
5. Arrange chicken and pineapple on 4 serving plates. Spoon pineapple sauce over, and top with coconut and onions.
   Serve with ½ cup dark green vegetables.

Nutrition Information Per Serving: 298 calories, 7 grams fat, 75 milligrams cholesterol, 3 grams fiber, 84 milligrams sodium

Source: 5 A Day recipe, http://www.cdc.gov/nccdphp/dnpa/5aday/recipes