Sweetness being a result of the specific interaction of these substances with the taste buds

(receptor organs on the tongue) is variable. Sucrose is taken as the standard and is given a
sweetness rating of 1. Glucose is almost as sweet with a rating of .0.7. Maltose is not very sweet
and has a rating of about 0.4 (less than half as sweet as sucrose). Lactose is less sweet still with
a rating of 0.16. Starch and cellulose don’t taste sweet (except that a small amount of starch is
broken down to glucose in our mouth by salivary enzymes).

Can I Eat as Many Sugar-Free Foods as I Want?

You might be surprised to learn that "sugar-free" does not necessarily mean carbohydrate-free or
calorie-free. Although some sugar substitutes do not add calories or carbohydrate, many do. And it
is the carbohydrate that has the greatest effect on blood glucose.

People with diabetes do not manage their condition by cutting "sugary" foods out of their diet. If
you have diabetes, you can eat sugar-containing foods as part of your overall meal plan, as long
as you account for the carbohydrate and calories in the food as part of your overall meal plan.
Similarly, if you eat lots of so-called "sugar-free" foods, they may have replaced sucrose (sugar)
with sweet tasting substances like sorbitol, mannitol, xylitol, isomalt, and hydrogenated starch
hydrolysates. These are all "sugar alcohols," which are technically not "sugar" but are high in
carbohydrate. Others may be sweetened with fructose, polydextrose, and maltodextrin, which also
contain calories and carbohydrate. These foods will affect your blood glucose just as a sugar-
containing food would, in proportion to the grams of carbohydrate in each serving of the food. In
addition, foods containing these sugar alcohols can cause stomach discomfort and diarrhea if eaten
in large quantities.

Other foods may be sweetened with aspartame or other non-caloric sweeteners like saccharin,
acesulfame potassium, or sucralose. These sweeteners contain no carbohydrate. But again, you
need to check the food label to see how many grams of carbohydrate are in each serving, because
"sugar-free" does not mean "carbohydrate-free." Some of the foods sweetened with non-caloric
sweeteners (like aspartame-sweetened sodas) may indeed have no carbohydrate, and will have no
effect on your blood glucose. Others, like an aspartame-sweetened yogurt, still contain
carbohydrate (from the fruit or milk products in the yogurt) which must be calculated in your meal
plan. These foods contain caloric sweeteners in combination with non-caloric sweeteners.

Work with your dietitian and healthcare team to learn how much of different types of foods you
can eat at each meal and snack. Very likely your healthcare team will offer you the opportunity to
use carbohydrate counting as a way to use meal planning to manage your blood glucose. In
carbohydrate counting, you learn how many grams of carbohydrate you should aim for at each
meal and snack. Then you read food labels and use carbohydrate gram counting food lists to figure
out how you can "spend" the grams of carbohydrate allocated for a particular meal. You devise
your meals based on how many grams of carbohydrate you can eat and how many grams of
carbohydrate are in the various foods that comprise a given meal.
A sugar substitute is a food additive that provides a sweet taste like that of sugar while
containing significantly less food energy. Some sugar substitutes are natural and some are
synthetic. Those that are not natural are, in general, called artificial sweeteners.

An important class of sugar substitutes is known as high-intensity sweeteners. These are

compounds with many times the sweetness ofsucrose, common table sugar. As a result, much
less sweetener is required and energy contribution is often negligible. The sensation of
sweetness caused by these compounds (the "sweetness profile") is sometimes notably different
from sucrose, so they are often used in complex mixtures that achieve the most natural sweet
sensation.

If the sucrose (or other sugar) that is replaced has contributed to the texture of the product, then
a bulking agent is often also needed. This may be seen in soft drinks or sweet tea that are
labeled as "diet" or "light" that contain artificial sweeteners and often have notably
different mouthfeel, or in table sugar replacements that mix maltodextrins with an intense
sweetener to achieve satisfactory texture sensation.

In the United States, seven intensely sweet sugar substitutes have been approved for use. They
are stevia, aspartame, sucralose, neotame, acesulfame potassium (Ace-K),saccharin,
and advantame. Cyclamates are used outside the U.S., but have been prohibited in the U.S.
since 1969. There is some ongoing controversy over whether artificial sweetener usage poses
health risks. The U.S. Food and Drug Administration regulates artificial sweeteners as food
additives.[1] Food additives must be approved by the FDA, which publishes a Generally
Recognized as Safe (GRAS) list of additives.[2] (Stevia is exempt under FDA's GRAS policy due
to its being a natural substance in wide use well before 1958, and has been approved by FDA).
The conclusions about safety are based on a detailed review of a large body of information,
including hundreds of toxicological and clinical studies. [3]

The majority of sugar substitutes approved for food use are artificially synthesized compounds.
However, some bulk natural sugar substitutes are known, including sorbitol andxylitol, which are
found in berries, fruit, vegetables, and mushrooms. It is not commercially viable to extract these
products from fruits and vegetables, so they are produced by catalytic hydrogenation of the
appropriate reducing sugar. For example, xylose is converted to xylitol, lactose to lactitol,
and glucose to sorbitol. Other natural substitutes are known but are yet to gain official approval
for food use.

Some non-sugar sweeteners are polyols, also known as "sugar alcohols". These are, in general,
less sweet than sucrose but have similar bulk properties and can be used in a wide range of food
products. Sometimes the sweetness profile is 'fine-tuned' by mixing with high-intensity
sweeteners. As with all food products, the development of a formulation to replace sucrose is a
complex proprietary process.

In comparison to sugar[edit]
Eating natural sugars like glucose instead of a sugar substitute can also have negative health
effects. The calories contained in sugar-sweetened beverages contributes to increases in body
weight and body fat, and that replacement of sugar by artificial sweeteners reduces weight.
[13]
 Obesity contributes to diabetes and cardiovascular disease. Sucrose has a high glycemic
index, glucose medium, and fructose low. The consumption of added sugars has been positively
associated with multiple measures known to increase cardiovascular disease risk amongst
adolescents as well as adults. [14] There is "convincing evidence from human intervention studies,
epidemiological studies, animal studies and experimental studies, for an association between the
amount and frequency of free sugars intake and dental caries" while other sugars (complex
carbohydrate) consumption is normally associated with a lower rate of dental caries. [1

Health issues[edit]
Weight gain and insulin response to artificial sweeteners[edit]
Animal studies have indicated that a sweet taste induces an insulin response in rats. [6] However,
the extension of animal model findings to humans is unclear, as human studies of intragastric
infusion of sucralose have shown no insulin response from analogous taste receptors. [7] The
release of insulin causes blood sugar to be stored in tissues (including fat). In the case of a
response to artificial sweeteners, even if blood sugar does not increase, there can be
increased hypoglycemia or hyperinsulinemia and increased food intake the next time there is a
meal. Rats given sweeteners have steadily increased calorie intake, increased body weight, and
increased fatness.[6] Furthermore, the natural responses to eating sugary foods (eating less at the
next meal and using some of the extra calories to warm the body after the sugary meal) are
gradually lost.[8]

A 2012 study at Universidade Federal do Rio Grande do Sul showed that addition of

either saccharin or aspartame to the diet of test rats resulted in increased weight gain compared
to addition of sucrose, when total caloric intake was similar among groups.[9]

This section relies largely or entirely upon a single

source. Relevant discussion may be found on the talk page.
Please helpimprove this article by introducing citations to
additional sources. (October 2014)

A 2014 study by a collaboration of seventeen scientists from nine Israeli research institutes
presented experimental evidence that artificial sweeteners may exacerbate, rather than
prevent, metabolic disorders such as Type 2 diabetes.[10] They reported that artificial sweeteners
increase the blood sugar levels in both mice and humans by altering thecomposition and function
of the gut flora.[11] Excessive blood sugar levels are an early indicator of Type 2 diabetes and
metabolic disease. Mice given drinking water supplemented with artificial sweetener (commercial
formulations of saccharin, sucralose or aspartame) developed greater glucose intolerance than
mice drinking pure water, or water with only sugar added. The effect occurred both in mice fed
standard food and those on a high-fat diet. Changes in the composition of the gut flora were
observed by sequencing a ribosomal RNA gene. When antibiotics were then used to kill off gut
bacteria, the degree of glucose intolerance in mice fed either diet was restored to normal levels
present before artificial sweetener was introduced. Human subjects were also studied. Gut
bacteria from 381 non-diabetics averaging age 43 were analyzed, revealing differences in the gut
bacteria between those subjects who habitually consumed artificial sweeteners and those who
did not, as well as "markers" for diabetes, such as raised blood sugar levels and glucose
intolerance. The researchers noted that the increase in human consumption of artificial
sweeteners coincides with the modern epidemic incidence of obesity and diabetes. In a journal
commentary, two researchers of the pathology department at the University of Chicago, who
were not involved in the study, opined that this combination of data indicates that artificial
sweeteners "may contribute to, rather than alleviate, obesity-related metabolic conditions, by
altering the composition and function of bacterial populations in the gut". [12]