How Sweet It Is! – Fresh Tastes by Bev

By Bev Laumann, Author of A Taste of The Good Life: A Cookbook for IC & OAB

We’ve all heard the same stories over and over on the nightly news: Americans are gaining weight at an unprecedented rate and are suffering serious health consequences as a result. Along with dietary fat and lack of exercise, our growing consumption of sugar has become serious concern. But if it’s difficult for ordinary Americans to cut out the sweets, it’s doubly hard for the diet-sensitive IC patient.

Dining out is scary for many of us. Low-cal offerings at restaurants are loaded with tomatoes, lemon juice, hot spices, or raw onions. Popular weight-loss programs such as Weight Watchers, Jenny Craig, and others offer wonderful pre-packaged foods and meal plans for weight loss but are not equipped to deal with the complexities of the IC diet. Stroll down the diet food aisle of your local supermarket and you find a wide array of vitamin-packed products designed to help you lose weight if you don’t mind the bladder burning preservatives and artificial sweeteners. Natural food markets and vitamin stores aren’t much better. They offer a treasure trove of diet products without the preservatives, but alas, many of these do have caffeine. (Caffeine tends to temporarily boost the metabolism and thus help burn calories). Some products also have large doses of ascorbic acid which may flare sensitive IC bladders.

So what is a health conscious hypoglycemic, diabetic or obese IC patient supposed to do? Is there anything that can help us cut out the sugar but still satisfy our sweet tooth? Help may have arrived in the form of some new non-nutritive or low-calorie sweeteners now appearing on market shelves. And more products we may potentially find helpful are on the horizon. But first lets take a quick look at several sweetening products that have been on the market a while, and how they affect IC bladders. Currently there are three artificial sweeteners approved for use as food additives by the FDA: saccharine, aspartame and acesulfame K.

Saccharin was discovered in 1879. It has been used as a sweetener for at least a century and is made from a substance that occurs naturally in grapes and other fruit. Twenty-four years ago the FDA proposed a ban on saccharin amid debate over the possibility that it could promote cancer. Some studies indicated that in rats at least, large amounts were carcinogenic. No human studies ever confirmed the findings and it was noted that it would be hard for humans to consume large enough doses to suffer the same fate as the rats. After much debate and political pressure, in 1991 the FDA formally withdrew its proposal for a ban on saccharin. Today however, you will find that products containing saccharin do carry a warning label. The safety controversy continues.

Teaspoon-for-teaspoon saccharin is about 300 times sweeter than sugar but it has no calories because the body can’t break it down and use it for energy. Instead, it is eliminated in the urine. From an IC patient’s point of view, it would be nice if saccharin-containing products also carried another warning label: saccharin may be extremely painful for an IC bladder. That’s why many of us avoid the saccharin sweeteners Sweet 10 and Sweet n’ Low.

Aspartame, discovered almost forty years ago, is more than 180 times sweeter than sugar and contains two substances which are found naturally in various foods– aspartic acid and phenylalanine. When digested, your body treats these two substances from aspartame just as it would if they came from any other food. However, Dr. Richard Wurtman at the Massachusetts Institute of Technology (MIT) found in one study of the effects of aspartame on animals, that large doses of aspartame altered levels of neuropeptides and serotonin in the brain, leading to seizures., Because aspartame contains phenylalanine, people with a genetic disorder affecting about one of every 15,000 adults (called phenylketonuria or PKU) need to watch out for it. The half million people with IC may also want to avoid aspartame. Notorious for exacerbating IC bladder symptoms (and also anecdotally associated with migraines in some people), aspartame has long been on the IC patients’ foods-to-avoid list. It is sold under the brand names NutraSweet and Equal, and is also found in many food products. Some dietitians may not count IC patients’ inability to utilize aspartame in a weight loss plan as problematic. In several studies done in the 1980’s the use of aspartame was not found to be beneficial for weight reduction anyway. One study reported that it actually increased appetite.

Acesulfame K was approved by the FDA for use in food in 1988. Another intense sweetener, it is around 200 times sweeter than sugar. Because it has an aftertaste, most products that contain acesulfame K combine it with another sweetener. It is sold under the name Sunette, and is an ingredient of packaged sweeteners such as Swiss Sweet and Sweet One. Like saccharin, it isn’t metabolized by the body so it has no calories. It too is eliminated in the urine.
(Although potassium in food hasn’t been proven to provoke IC bladders, certain researchers have suggested that dietary potassium may play a role in flares– at least for some people. So it may be worthy to note that the “K” in acesulfame K stands for potassium). Unfortunately, for whatever reason, acesulfame K also irritates many people’s IC bladder just as much as the other artificial sweeteners.

Historically we’ve struck out when it comes to being able to use artificial sweeteners, but two newly introduced products may signal a whole new ball game.

Sucralose

The creation of sucralose and its accidental discovery as a sweetener in the early 1970’s is one of science’s more humorous stories. It seems a sugar company in Europe, Tate & Lyle, was trying to find new manufacturing uses for table sugar, known chemically as sucrose. They had tweaked the sucrose molecule this way and that, adding and subtracting a few atoms here and there to create new halogenated sugars. They were testing each new substance as they produced it to see if it was useful. One day they tried substituting a chlorine atom at several points in the sucrose molecule where a hydroxyl group would normally exist. One of the researchers then asked his assistant to test the new compound. The assistant, whose native language was not English, misunderstood his boss. He thought he was being asked to taste it. The new sugar compound turned out to be sweet, just like the plain old-fashioned sugar it was made from. Thus sucralose started down the long road to market in America as a food sweetener.
Unlike table sugar which is completely absorbed by the body, sucralose appears to be only partially absorbed. (There are many, many kinds of sugars including fructose, maltose, lactose and others. Some substances which are classified as sugars are not perceived by humans as sweet. Not all sugars can even be digested and used by humans. Whereas termites can fully metabolize cellulose thanks to some bacteria in their gut, we can’t. Sugars not only vary in their ability to be absorbed and utilized, they also vary in how quickly the process takes place and how sweet we perceive them to taste).

Sucralose has a sweetness potency of about 600 times that of sugar. Sucralose, sold in the U.S. today under the brand name Splenda, has been exhaustively tested for safety since the late1980’s. Over 100 scientific studies have been done in Europe where it was first introduced. The research not only focused on the health effects and safety of sucralose, but also of its breakdown products. One concern that initially delayed its introduction to consumers here was the question of its slow rate of degradation in acidic environments such as a can of soda for instance. (Over a period of about 6 months, sucralose slowly degrades by about 0.3% when it is used in an acid food). European food safety experts worried that the breakdown products of sucralose may do something that sucralose itself was unlikely to do be utilized by gut bacteria in some detrimental way. Finally– twenty-five years after its discovery–the accumulated scientific evidence answered the concerns of critics in Europe and gained for sucralose acceptance as a safe sweetener. The Scientific Committee on Food, a subunit of the European Commission for Health and Consumer Protection, issued an opinion paper last year noting, ” The Committee is satisfied that the range of studies now available is sufficient for a full safety evaluation of sucralose.” They went on to conclude that over the years their questions and concerns had been answered by the extensive research and that, “…sucralose is acceptable as a sweetener for general food use…”

The World Health Organization/ FAO Joint Expert Group on Food Additives has set an acceptable daily intake limit for sucralose at 15 mg/kg of weight. (This is in spite of the fact that the European Committee found it to be safe in tests of amounts up to about 628 mg/kg of weight per day.6 More recently the far more conservative U.S. Food and Drug Administration established the acceptable daily intake limit at 5 mg/kg of weight.

Sucralose for Cooking

McNeil Specialty Products markets sucralose in the U.S. in the form of a no-calorie sweetening product called Splenda. Splenda is not pure sucralose, but a mixture of dextrose, maltodextrin and sucralose. Because it takes such a tiny amount of sucralose to sweeten food, the other sugars were added to the formulation of Splenda to add bulk. (They don’t add calories, however). Splenda is available at many nationwide grocery chains in the same aisle as th sugar or the other artificial sweeteners. It comes in two forms: a box of white crystalline powder that can be measured and utilized much like sugar (though it is considerably more expensive), and individual packets of the crystalline powder, each of which sweeten a serving of food as would 2 teaspoons of sugar. You will notice that the powder is lighter in weight than sugar and it may fizz a little when you stir it into something like hot herb tea. It dissolves very quickly and easily in water. Some people (though not everyone) also notice a faint sour taste along with the sweetness.

According to the manufacturer, Splenda can be used in cooking measure for measure the same as sugar. Heat does not affect its sweetening properties. It may behave differently in some cooking situations though because sugar does other things besides just add a sweet taste. In breads made with yeast for instance, table sugar acts as a nutrient for the yeast. In candies, it contributes to the smooth texture. In angel food cakes, sponge cakes, or meringues, sugar helps hold the form once the air is whipped in. In other foods such as glazes or cookies, sugar helps the food brown as it caramelizes. Sugar attracts and holds water molecules. In home made jellies or jams sugar helps inhibit the growth of molds by bonding to the water that the microorganisms need to survive. In this way sugar can preserve food.

Splenda and IC Bladders

Last spring several IC patients posted notes on the IC Network’s electronic bulletin boards that they had successfully tried Splenda without it bothering their bladder. One lady wrote however, that it may have given her a small amount of additional frequency she couldn’t be sure. Numerous people wrote me to ask if I thought Splenda was okay to try. Since it was new on the market I told them that there wasn’t any IC experience with it it was too new but to try it cautiously and let me know how it went. Of several who responded back, 100% reported a good experience and no one reported a symptom flare-up similar to that which aspartame regularly produces. I’ve tried Splenda myself, about 3 teaspoons a day average, on an almost daily basis for nearly a month now. I was pleased and surprised that I did not have the week-long symptom flare-up that aspartame and saccharin usually give me. Only one day did I suspect that it may have caused some irritation. That was a day that I was running late with my daily medication doses and that may have contributed to the problem.

In pies, Splenda works well when substituted measure-for-measure for two-thirds to three-quarters of the sugar called for in the recipe. ( In a pear pie for instance, in place of the 1 cup of sugar called for I used 2/3 cup of Splenda and 1/3 cup of sugar). In hot drinks like herb tea, decaf coffee, or coffee substitute, I find an individual packet of Splenda sweetens a bit too much. I prefer to use about half a packet. I’ve mixed Splenda with cinnamon and sprinkled it on buttered toast and hot oatmeal about half a packet does the trick. I make my own cereal to avoid both the bladder effects of preservatives in the mass-produced boxed cereals, and the too- sweet taste of the fruit-juice sweetened natural-food versions. I substituted Splenda for about half the sugar in my usual cereal recipe and it worked just fine. Because the product is so new we are all breaking new ground here and it pays to just experiment.

Next month’s column will feature another sweet new product Stevia extract. Meanwhile, if you’ve tried sucralose or stevia, please continue write and tell me your experience good or bad either way I’d like to hear about it!