What Does 'Sugarless' Really Mean?

A survey done in the mid-1990s found that the average American consumes 20 teaspoons of sugar a day — nearly half a cup! You may think you can protect your teeth by eating more "sugarless" foods, but not all "sugarless" foods are really sugarless. Currently, with more awareness about obesity and emphasis on nutrition and fitness, almost 80% of adults consume some "sugarless" products.

Are Sugarless Or Sugar-Free Foods And Beverages Always Safe For Your Teeth?
No, they're not. The label "sugarless" food sometimes means that no sugar was added during processing, but these foods may not be sugar free. They may contain natural sweeteners, such as honey, molasses, evaporated cane sugar, fructose, barley malt or rice syrup. Natural sweeteners have the same number of calories per serving as sugar does, and they all are harmful to the teeth.

How Can I Find These Hidden Sugars?
Read labels carefully. Sugars that are found naturally in foods have different names, but they all end in the letters "ose" - which means "sugar." Therefore, if you read a label and one or more of the ingredients listed ends in "ose", the product contains sugar. Sugars, including naturally occurring sugars, are listed under "sugars" or "carbohydrates" on the label. Reading labels carefully will help you figure out how much sugar is in your food.

What Are Sugar Alcohols?
Some food labels will list ingredients such as xylitol, erythritol, isomalt, sorbitol, lactilol or mannitol. These are sugar alcohols, sugar substitutes often used to sweeten sugar-free cookies, candy, chewing gum and other foods. "The term 'sugar alcohol' refers to their chemical make-up, but they do not actually contain alcohol," says David Albert, D.D.S., M.P.H., an associate professor of clinical dentistry at the Columbia University College of Dental Medicine.

The U.S. Food and Drug Administration (FDA) has said that manufacturers of products contacting sugar alcohols can claim that these products do not promote tooth decay. Research has shown that one sugar alcohol, xylitol, actually can protect teeth against cavities.

How Can Xylitol Taste Sweet, Yet Protect Against Tooth Decay?
Xylitol is a natural sweetener found in fruit such as strawberries, plums and pears. Because xylitol looks and tastes like sugar, some food and candy manufacturers use it as a sweetener in their products. Xylitol is used in chewing gum, candy, gumdrops, mints, medicated syrups and tablets, toothpaste and, mouthwashes, and in dietetic and diabetic foods. Several dental associations endorse sugar-free products that are at least 50% sweetened with xylitol. Cavities are caused by the acid that is produced when bacteria in your mouth combine with sugars. Bacteria in your mouth can't break down xylitol, so no acid is produced.

Also, the sweetness of xylitol encourages salivation, which washes out the mouth and helps prevent cavities. Eating large quantities of products that contain xylitol - for example, more than 10 to 20 pieces of candy or gum per day - may have a laxative effect. This is the only known drawback to this sweetener.

Are Saccharin And Other Super-Sweet Sugar Substitutes Safe?
These so-called high-intensity sweeteners are not digested in the same way as sugars. They contain no calories or very few calories. Saccharin, aspartame, acesulfame potassium, sucralose and neotame are accepted by the FDA and do not promote tooth decay. Beginning in 1977, the FDA required that any food containing saccharin carry a label warning people that saccharin has been shown to cause cancer in laboratory animals. In December 2000, Congress passed a law removing the label because further research showed that humans don't process saccharin in the same way as rats.

• Saccharin was discovered in the late 19th century and is 300 times sweeter than sugar, although it often is formulated to be less sweet. For example, Sweet'N Low is 10 times sweeter than sugar. It has come under fire several times because studies in rats showed that a high intake of saccharin could cause bladder cancer.
  
  
• Aspartame (Equal) is 180 times sweeter than sugar. It is used in soft drinks, cereals, desserts and candy. Unlike saccharin, aspartame is not a good choice for baked goods because it degrades at high temperatures. It contains an amino acid, phenylalanine, that about one in every 16,000 people cannot break down.
  
  
• Acesulfame potassium (also called acesulfame K, brand name Sunett) is 200 times sweeter than sugar. In 1988, it was approved for table use and for use in chewing gum, drink mixes, instant coffee and tea, gelatins, puddings and nondairy creamers.
  
  
• Sucralose (Splenda) is 600 times sweeter than sugar. It's used in cereals and soft drinks, fruit, dairy and alcoholic beverages, desserts, puddings, spreads, syrups, and baked goods. Splenda was approved by the FDA in 1998. It has a good shelf life and does not degrade in heat. It does not affect blood glucose levels, so it is a good option for people with diabetes.
  
  
• Neotame was approved in 2002 by the FDA. It is a high-intensity sweetener used in soft drinks, confections and frostings, chewing gums, jams, fruit juices and baked goods. Neotame is 7,000 to 13,000 times sweeter than sugar.

Are Sugar Substitutes Okay For Dieters And Diabetics?
The American Diabetes Association supports the FDA's conclusion that aspartame, saccharine, acesulfame K and sucralose are safe and can be used as part of a healthy diet for diabetics.
Calorie-free sugar substitutes do not contain carbohydrates. However, said Dr. Albert, "Some products that are sugar free still contain carbohydrates. It is important to read the label."

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