It is normally recommended that people who have had bariatric surgery should limit their sugar intake to no more than 10 g of sugar per serving. That is about 2 1/2 tsp. of sugar per serving. Bariatric surgeons recommend that patients maintain a bariatric diet that is low in sugar and fat. Such a diet must be life-long, and meals should be protein first. It also is recommended that you avoid sugar substitutes if possible.
The premise behind artificial sweeteners is simple. They aim to reduce the amount of sugar and calories in your diet without sacrificing sweetness. The FDA has approved just five artificial sweeteners: saccharin, acesulfame, aspartame, neotame, and sucralose. It has also approved two natural low-calorie sweeteners: stevia and erythritol.
Take the time to read labels. It is important to remember that sugar-free does not always mean low in calories; in fact, some sugar substitutes have a lot of calories.
One of the biggest concerns is that many artificial sweeteners may pose health risks. Several years ago, zero-calorie natural and artificial sweeteners were considered a staple for those having undergone bariatric surgery. If you do choose to use sugar substitutes it is important to choose the one that has the fewest side effects. In part one we will be looking at:
- What do we really know about artificial sweeteners?
- What are the seven substitutes that have been approved by the FDA?
- Saccharin – artificial, found in Sweet & Low (Pink packet) and others
- Sucralose – artificial, found in Splenda (Yellow packet)
- Aspartame – artificial, found in Equal (Blue packet) and others
- Neotame – artificial
- Acesulfame – artificial
- Stevia – natural, derivative of the stevia plant
- Erythritol – sugar alcohol
In part two we will be looking at:
- What are the dangers?
- What are my options?
What We Know About Artificial Sweeteners
Some artificial sweeteners are better than others, no doubt, but with the rise in consumption are we doing ourselves any favors? The main benefit of artificial sweeteners is that they offer the sweet taste we crave without the calories. Baking with sucralose versus regular sugar can save thousands of calories, so it seems like a win-win. But after bariatric surgery, are the potential health concerns worth the sweet treat?
Studies are showing that adding artificial sweeteners into our diet can actually change our palate. We are getting to the point where we need to have sugar in everything to be able to enjoy our food and drinks. This means that foods that are low in sugar have become less appealing and therefore become less prevalent in our diets. If our tastes are changing and we’re craving more things that are sweet, this can increase our intake of processed, low-nutrition foods that manage our cravings but do nothing to promote a healthy diet.
Just like sugar, artificial sweeteners have been shown to be addictive. Over time we seem to need more and more to keep us happy. Removing sugar and artificial sweeteners from your diet is the healthiest choice that you can make after bariatric surgery. It is not easy but limiting the amount is the best thing that you can do for your long-term health.
We know that by using artificial sweeteners as part of our diet we can cut down on calories, but it can be destructive to your long-term health. Another side effect of artificial sweeteners can be the assumption that since we are saving calories in one area, we can splurge in others. That is a very destructive habit to get into after bariatric surgery.
What Are The Seven Substitutes That Have Been Approved By The FDA?
The five artificial sugar substitutes that have been approved by the FDA are Saccharin, Sucralose, Aspartame, Neotame, and Acesulfame.
Saccharin is probably the most common and is found in Sweet & Low, the pink packets. It is a no-calorie sweetener that is not broken down in our bodies. During digestion, saccharin passes through the body unchanged and provides no calories in the process. Sugar, on the other hand, is broken down during digestion, contributing calories to the body.
Sucralose is also artificial and is found in Splenda, the yellow packets. It is 400–700 times sweeter than sugar and doesn’t have a bitter aftertaste like many other popular sweeteners. Sucralose is actually made from sugar but has little or no effect on blood sugar and insulin levels.
Aspartame is another artificial sweetener that is most commonly found in Equal, the blue packets. It is one of the most popular sugar substitutes and is 200 times sweeter than sugar. A 2017 study showed that aspartame found that it did not affect blood glucose, insulin, total cholesterol, or triglycerides.
Neotame is an artificial sweetener that is not as well known as the others, which is surprising because it was developed by Nutrasweet. Depending on how it is used it is between 8000 and 13,000 times sweeter than sugar. It is a modified form of aspartame that does not breakdown under heat and has very little to no after taste. Because it does not breakdown under heat it is suitable for cooking and for use in processed foods.
Acesulfame normally goes by the names Sunett or Sweet One. It is 200 times sweeter than sugar but has zero caloric content. Normally, Acesulfame is used in conjunction with other artificial sweeteners in processed low-calorie foods.
The two natural sugar substitutes that have been approved by the FDA are Stevia and Erythritol. While they are both natural, there are a few differences to note.
Stevia is a plant native to South America. The leaves of the Stevia plant have been used for their sweetness. Stevia is natural, so it does not promote weight gain and avoids the harmful side effects of many of the artificial sweeteners. While the World Health Organization (WHO) does say that Stevia is safe, it does recommend a limit of no more than 1.8 milligrams of stevia per pound per day. This equals no more than two or three packets containing about 100 milligrams of stevia if you weigh about 150 pounds.
Erythritol is a sugar alcohol. It occurs naturally and fruits and fermented foods and has been shown to cause fewer digestive issues than other sugar alcohols like xylitol. One of the reasons that it does not cause as many digestive issues is that it is absorbed into the bloodstream and excreted through the urine instead of having to go through the colon. One other good thing is that the World Health Organization has declared it safe and has set no limits on the amount that can be consumed because of the relatively limited risks associated with use.
Next week we will be looking at what the dangers of using a sugar substitute are and what your best options are if you choose to use them.