Coach on Call. Do you wonder what s in the little colored packets near the coffee, cream, and sugar? Do you wonder what makes diet soda sweet?

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1 Coach on Call It was great to talk with you. Thank you for your interest in learning about artificial sweeteners. I hope you find this tip sheet helpful. Please give me a call if you have more questions about this or other topics. As your health coach, I m ready to help in any way I can. Do you wonder what s in the little colored packets near the coffee, cream, and sugar? Do you wonder what makes diet soda sweet? There are many myths and concerns about artificial sweeteners. Here are some facts to guide your choices. What are artificial sweeteners? How do they work? Artificial sweeteners, also called nonnutritive sweeteners, are created in a lab or made from natural sources. Nonnutritive sweeteners are zero- or low-calorie alternatives to nutritive sweeteners, which contain calories (e.g. table sugar). They are hundreds of times sweeter than sugar, so you can use them in very small amounts and produce the same sweetness as sugar. They do not contain calories in such small amounts. They do not promote tooth decay. Most do not affect blood sugar. See below for details. Are artificial sweeteners safe? The U.S. Food and Drug Administration (FDA) has approved the sweeteners on the next page as safe. Each one has an acceptable daily intake (ADI). The ADI is the largest amount that is safe to consume on a daily basis. ADIs are set at about one-hundredth of the smallest amount that the FDA believes might cause health problems. CMN UPMC _11_621 Copyright 2018 UPMC Health Plan Inc. All rights reserved C on C Nu Artif Sweet 17CA0728 (MCG) 4/1/18 PDF

2 Page 2 of 5 Sweetener Brand Name(s) ADI Equivalent* Sweet N Low 9 to 12 packets Saccharin Sweet Twin Aspartame Acesulfame K Equal NutraSweet Sunett Sweet One 100 packets or 20 cans of diet soda 30 to 32 cans of diet soda Sucralose** Splenda 6 cans of diet soda Truvia 30 packets PureVia Stevia*** or 6 cans of diet soda Sun Crystals *Amounts vary with body weight. These amounts are based on a 150-pound person. If you weigh less than 150 pounds, you should consume less of these sweeteners than what you see here. Ask your doctor for more information. **Made by chemically changing table sugar (sucrose). ***From the stevia plant. Not truly an artificial sweetener. Many studies have shown that the sweeteners above are safe for most people. Aspartame, which contains phenylalanine, is not safe for people with phenylketonuria (PKU). PKU is a rare genetic disease. Products with aspartame must include a warning on the label about PKU. Parents often wonder if artificial sweeteners are safe for children. Opinions vary among pediatricians. Talk with your child s doctor if you have questions or if your child is overweight or has diabetes. Keep in mind that children need enough calories to grow and develop. You can help your child avoid eating too much sugar without using artificial sweeteners. For example, plain or flavored seltzer water (without sugar or sweeteners) is a refreshing drink. Fresh fruit is naturally sweet. Also, for most children, one serving of a sugar-sweetened food per day is OK if they are eating a healthy diet. Are you pregnant or breastfeeding? If so, talk with your doctor about the use of artificial sweeteners.

3 Page 3 of 5 Can artificial sweeteners be used in cooking? Yes, except for aspartame, which becomes less sweet at high temperatures. What are sugar alcohols? Sugar alcohols: Include sorbitol, xylitol, maltitol, and mannitol. Are found in sugar-free candies, breath mints, chewing gum, and other foods. Are made from plant products. Provide sweetness with very few calories because the body does not absorb sugar alcohols well. Can cause bloating and diarrhea when used in large amounts. Do raise blood sugar but not as much as sugar or other carbohydrates. Do not promote tooth decay. What is agave nectar? Agave nectar is not an artificial sweetener. It is a nutritive sweetener made from the agave plant. It is a syrup that is sweeter than honey. You may be able to use less of it than sugar to produce the same sweetness. Agave nectar contains calories and will raise blood sugar.

4 Page 4 of 5 Do artificial sweeteners help people lose weight? This question has been researched, but the answer is not clear. Some experts suggest that using artificial sweeteners may cause cravings for sweetness and make it harder, not easier, to lose weight. Do you want to use artificial sweeteners as part of a weight loss program? If so, keep these tips in mind: Sugar-free does not always mean calorie-free. Stay alert for ingredients in sugar-free items that contain calories. Do not limit your beverages to diet soda and diet drinks. Include two to three cups per day of nonfat/ low-fat milk, or eat nonfat/low-fat yogurt or cheese. Drink plenty of water as well. Do not rely on artificial sweeteners alone to lose weight. Every diet soda or glass of water you drink will save you about 150 calories compared to regular soda. But this does not mean you can eat unlimited amounts of food and still lose weight. To lose weight, you will need to follow a healthy meal plan and reduce your calories. Can artificial sweeteners help people with diabetes manage their blood sugar? Yes. Used in moderate amounts, the packets and bulk forms of artificial sweeteners do not affect blood sugar. They are free foods. So are products that contain artificial sweeteners and have fewer than 20 calories and less than 5 grams of carbohydrates per serving. Examples are diet soda or fruit drinks, diet gelatin, and sugar-free chewing gums. But beware! Some products with artificial sweeteners contain more than 20 calories or 5 grams of carbohydrates per serving. These are not free foods and will increase your blood sugar. Read the Nutrition Facts label to figure out how to fit these items into your meal plan. Examples are sugar-free varieties of yogurt, hot cocoa mix, baked goods, and canned fruit.

5 Page 5 of 5 Take Action My SMART goal for this week Check when completed Do your best to reach the SMART* goal you set with your health coach. Write it below. Check the box when you have completed it. Staying on the path to wellness From time to time, review the facts on this tip sheet about artificial sweeteners. Choose one or two small changes in your use of artificial sweeteners that you would like to put into action. Set a weekly SMART goal for each one. Write your goals below. Check the boxes when you have completed them. SMART goal 1: SMART goal 2: *SMART goals are Specific, Measurable, Appropriate, Realistic, and Timely. For example, On Sunday I will buy four bottles of seltzer in different flavors. I will talk with my daughter about setting a family goal to drink less diet soda and to try the seltzer and other options. SMART goals help you succeed! If you have any trouble setting your weekly SMART goals, ask your health coach for help. The information in this tip sheet is for educational purposes only. It is not intended or implied to be a substitute for professional medical advice. Before making changes, always talk to your doctor about what is right for you. Sources: Fitch, C., & Keim, K. S. (2012). Position of the Academy of Nutrition and Dietetics: use of nutritive and nonnutritive sweeteners. Journal of the Academy of Nutrition and Dietetics, 112(5), Mattes, R. D., & Popkin, B. M. (2008). Nonnutritive sweetener consumption in humans: effects on appetite and food intake and their putative mechanisms. The American Journal of Clinical Nutrition, 89(1), Nutritive and Nonnutritive Sweetener Resources. United States Department of Agriculture. Available at Accessed January 31, 2018.