Sugars. Sepp H. / Pixabay.com / 2010 / CC0 1.0
A sweetener is a substance which is added to a dish in order to sweeten its taste. It can either be incorporated into the mixture that makes up the dish, or used as a garnish on a food item by sprinkling or pouring on, etc.
Sweeteners may be tasted by themselves, but are rarely eaten wholly by themselves in any quantity.
The Encyclopaedia Britannica defines “sweetener” as:
“Sweetener, any of various natural and artificial substances that provide a sweet taste in food and beverages.” [1]Britannica, The Editors of Encyclopaedia. “Sweetener”. Encyclopedia Britannica, 8 Feb. 2018, https://www.britannica.com/topic/sweetener. Accessed 9 April 2021.
Comparing strength of sweeteners
Refined white sugar, often referred to as table sugar or by its scientific name of “sucrose”, is now the default sweetener in Western kitchens.
When determining the amount of sweetness and calories a sweetener adds to a beverage or dish, table sugar (sucrose) is used as the base of 1.0. The following table shows relative sweetness of some sweeteners compared to table sugar.
Sweetener name | Relative sweetness | Type |
---|---|---|
Sucrose (table sugar) | 1 | Caloric |
Lactose | 0.25 | Caloric |
Glucose | 0.6 | Caloric |
Maltose | 0.6 | Caloric |
Fructose | 2 | Caloric |
Cyclamate | 30 | Non-caloric |
Steviol glycosides | 40–300 | Non-caloric |
Aspartame | 150–200 | Non-caloric |
Acesulfame-K | 150–300 | Non-caloric |
Saccharine | 300–500 | Non-caloric |
Sucralose | 600 | Non-caloric |
Alitame | 2000 | Non-caloric |
Talin | 2500 | Non-caloric |
Neotame | 7000–13000 | Non-caloric |
Table source: Rao, L.Jagan Mohan et al. Ingredients of soft drinks. In. Recent Trends in Soft Beverages. India: Woodhead Publishing. 2011. Pages 189-209
Classifying sweeteners
There are a broad range of sweeteners to choose from which offer a variety of tastes, properties, and nutritional effects.
The sweetener industry groups these in several different ways. The Mayo Clinic notes that much of the attempted categorization is open to interpretation:
“One problem is that the terminology is often open to interpretation. Some manufacturers call their sweeteners “natural” even though they’re processed or refined. Stevia preparations are one example. And some artificial sweeteners are derived from naturally occurring substances — sucralose comes from sugar.” [2]Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
Dry versus liquid sweeteners
Some sweeteners can appear in both of the dry and liquid categories. Table sugar industrially can come as liquid sugar; bar tenders may buy bottles of it labelled “sugar syrup“. Stevia also comes in both forms, dry and liquid.
Natural versus man-made sweeteners
This is a sweetener categorization which trips over many inconsistencies. White refined sugar gets lumped in with “natural”, but it is very much a man-made and highly-refined substance, not existing in nature in that form. Even honey, the “champion” natural sweetener, gets processed in the form of pasteurization. And sucralose (Splenda®), which gets categorized as man-made, is actually made from sucrose.
Sometimes man-made is referred to as “synthetic”.
Some researchers use “natural” as a synonym for nutritive / caloric:
“Sweeteners are classified as natural and synthetic. The natural ones are the most nutritive dietary sweeteners like sucrose, fructose, lactose and maltose. The synthetic sweeteners because of their intense sweetness are called high potency sweeteners (HPS)” [3]Rao, L.Jagan Mohan et al. Ingredients of soft drinks. In. Recent Trends in Soft Beverages. India: Woodhead Publishing. 2011. Pages 189-209.
Nutritive versus non-nutritive sweeteners
Also known as caloric vs non-caloric. In practice, non-caloric can mean “an insignificant number of calories”. For instance, Splenda® has a trace amount of calories in it from the dextrose and maltodextrin added to the mixture.
The USDA gives the following distinctions between nutritive and non-nutritive (caloric and non-caloric) sweeteners:
“Nutritive and nonnutritive sweeteners enhance the flavor and/or texture of food. Nutritive sweeteners provide the body with calories, while nonnutritive sweeteners are very low in calories or contain no calories at all. They can both be added to food and beverages… Nutritive sweeteners, also known as caloric sweeteners or sugars, provide energy in the form of carbohydrates. Nonnutritive sweeteners are zero- or low-calorie alternatives to nutritive sweeteners, such as table sugar. These sweeteners can be added to both hot and cold beverages and some can be used for baking. Nonnutritive sweeteners are much sweeter than sugar so only small amounts are needed. They provide fewer calories per gram than sugar because they are not completely absorbed by your digestive system.” [4]USDA National Agricultural Library. Food and Nutrition Information Center. Nutritive and Nonnutritive Sweetener Resources. Accessed April 2021 at https://www.nal.usda.gov/fnic/nutritive-and-nonnutritive-sweetener-resources
Nutritive sweeteners
Health media attention can be so focussed at times on trying to find nutrition issues with alternative sweeteners that what gets downplayed, or overlooked, is the reason they exist in the first place, which is all the clearly documented, unquestioned health issues that can occur with nutritive sweeteners (specifically free sugars, discussed further below.)
“Recent evidence also shows that free sugars influence blood pressure and serum lipids, and suggests that a reduction in free sugars intake reduces risk factors for cardiovascular diseases.” [5]Healthy Diet. Key Facts. World Health Organization. 29 April 2020. Accessed April 2021 at https://www.who.int/news-room/fact-sheets/detail/healthy-diet
While it serves no purpose to label sugar as “toxic”, as some extremists do, there’s no doubt that “common sugar and other nutritive sweeteners such as honey and corn syrup are associated with health problems (such as obesity and tooth decay) or are even a threat to life (for diabetics)” [6]Britannica, The Editors of Encyclopaedia. “Sweetener”. Encyclopedia Britannica, 8 Feb. 2018, https://www.britannica.com/topic/sweetener. Accessed 9 April 2021.
In terms of choosing one nutritive sweetener over another, there’s no health advantage: your body processes them all the same. Other nutritive sweeteners “may seem healthier than sugar. But their vitamin and mineral content isn’t significantly different. For example, honey and sugar are nutritionally similar, and your body processes both into glucose and fructose.” [7]Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
So, the best advice when deciding amongst nutritive sweeteners is simply to choose based on what tastes or works best for what you are using it with.
Non-nutritive sweeteners
The category of “non-nutritive (non-caloric) sweeteners” covers sweeteners which, in comparison with table sugar (sucrose), contribute few if any calories to a dish or beverage.
They also tend to have a much greater sweetening ability than table sugar. Owing to this, sometimes the term “high-intensity sweeteners” is used for them:
“High-intensity sweeteners are commonly used as sugar substitutes or sugar alternatives because they are many times sweeter than sugar but contribute only a few to no calories when added to foods.” [8]US Food and Drug Administration. Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States. Accessed April 2021 at https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states
Typically the main considerations when considering non-caloric sweeteners are cost, taste, and effectiveness in cooking.
Though the price of refined white sugar varies, in general as far as consumer shelf prices go, it tends to be relatively cheap compared to alternative sweeteners. [9]In terms of bulk commodity sweetener prices for industry, the opposite can be true: alternative sweeteners are often cheaper than sugar.
Some alternative sweeteners can leave an aftertaste [10]”Some artificial sweeteners may leave an aftertaste.” Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 , and even if they actually don’t, some people will swear they taste one, anyway, if they know one is in what they are eating, and say they don’t like it.
Non-caloric sweeteners may also require slight adjustment of cooking techniques when working with them (see “Uses of sweeteners in cooking” below.)
In terms of health, non-nutritive sweeteners can help reduce tooth decay and make a positive contribution to an overall weight management scheme reducing other health issues. [11]Older observational studies postulated that non-nutritive sweeteners could lead to weight gain. However, more recent controlled studies (which are superior to observational studies) are finding the opposite: “Non-nutritive sweetener (NNS) consumption is associated with higher body weight and metabolic disease in observational studies. In contrast, randomized controlled trials demonstrate that NNS may support weight loss, particularly when used alongside behavioral weight loss support.” — Sylvetsky, Allison C, and Kristina I Rother. “Nonnutritive Sweeteners in Weight Management and Chronic Disease: A Review.” Obesity (Silver Spring, Md.) vol. 26,4 (2018): 635-640. doi:10.1002/oby.22139 Dietitians emphasize, though, that just because an ice cream might be sugar-free that doesn’t give us a free pass to eat the whole tub — there’s still going to be a great many calories in there from the fat content.
Non-nutritive sweeteners are also clearly a god-send for people with diabetes, which is a growing percentage of the population at time of writing.
Despite their clear role in promoting health, non-nutritive sweeteners have been eyed suspiciously for decades, and been the object of conspiracy theories. Some studies (many funded by the sugar industry) have looked for definite links between non-nutritive sweeteners and health problems in humans, but apart from a few studies from the 1970s which were later disproved, none have been found:
“According to the National Cancer Institute and other health agencies, there’s no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women.” [12]Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
The only known issue involves aspartame and people born with a rare genetically inherited birth defect known as “phenylketonuria” (see Aspartame for full details.)
Free vs bound sugars
While the sweetener industry and the culinary world has their attention focussed on nutritive versus non-nutritive sweeteners, dietitians increasingly see the sweetener question as being instead one of “extrinsic vs intrinsic” or in layman’s language, “free vs bound-up” sugars.
That is, is the sugar in a food being consumed all too freely available for our body to glom onto, or, is it bound up in the cellular structure of the food, making it more difficult for the body to convert it to fat?
The World Health Organization now encourages the use of “free sugars” to be used as a term instead of some older sweetener categorizations still being used, as they see a sugar’s “free” status as being the critical point: “There are other unhelpful terms when it comes to describing sugars, for example: raw sugar, unrefined sugar and natural sugar. These are all free sugars.” [13] Mann, Jim. The science behind the sweetness in our diets. Bull World Health Organ 2014;92:780–781 | doi: http://dx.doi.org/10.2471/BLT.14.031114. Pp 780-781.
There is growing consensus amongst most evidence-based dietitians that there is no reason for them to care at all about the intrinsic (bound) sugars that people consume. The Sugarwise charity in England says:
“We do not need to worry about sugars that occur naturally in fruit, vegetables, milk and yoghurt.” [14]Free Sugars FAQ. Sugarwise. Cambridge, England. Accessed April 2021 at https://sugarwise.org/about/product-faqs/
The World Health Organization says:
“No reported evidence links the consumption of intrinsic sugars to adverse health effects.” [15] Information note about intake of sugars recommended in the WHO guideline for adults and children. Geneva, Switzerland: Department of Nutrition for Health and Development, World Health Organization. 2015. Page 1.
Dietitians not only have no concern about these bound sugars, they also have no concerns about how much of this kind of sugar we consume:
“[Bound-up sugars] are contained in the cellular structure of foods and drinks and naturally present in dairy products (these are intrinsic sugars and you don’t need to limit them)…” [16]Free Sugars FAQ. Sugarwise. Cambridge, England. Accessed April 2021 at https://sugarwise.org/about/product-faqs/
Free sugars, though, should be restricted. Included in this category are honey, agave nectar, coconut sugar, and maple syrup, as well as fruit and vegetable juices, and smoothies [sic]. [17]Juice and smoothies count as sources of free sugar because the juicing and blending frees the sugars up from the cell structure they were previously bound up with. This makes the sugar in them the same as sugar in a can of pop. The British Heart Foundation says:
“Free sugar is what we call any sugar added to a food or drink. Or the sugar that is already in honey, syrup and fruit juice. These are free because they’re not inside the cells of the food we eat. The sugars found in fruit, vegetables and milk don’t seem to have a negative effect on our health, and they come with extra nutrients, such as fibre.” [18]What are free sugars? British Heart Foundation. Accessed April 2021 at https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/sugar-salt-and-fat/free-sugars
Even if a sugar is natural (e.g. the sugar in an orange), if it’s rendered into a form where it’s a free sugar, then it becomes a concern. Public Health England says:
“The definition of free sugars includes: all added sugars in any form; all sugars naturally present in fruit and vegetable juices, purées and pastes and similar products in which the structure has been broken down; all sugars in drinks (except for dairy-based drinks); and lactose and galactose added as ingredients. The sugars naturally present in milk and dairy products, fresh and most types of processed fruit and vegetables and in cereal grains, nuts and seeds are excluded from the definition [of free sugars].” [19]Swan, Gillian E et al. “A definition of free sugars for the UK.” Public health nutrition vol. 21,9 (2018): 1636-1638. doi:10.1017/S136898001800085X
The World Health Organization says its recommendations to restrict sugar consumption only apply to free sugars, and not to bound-up sugars:
“What are “free sugars”? According to WHO, the term “free sugars” refers to all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus the sugars that are naturally present in honey, syrups and fruit juices… The WHO recommendations [to restrict sugar consumption] only apply to free sugars. These [restriction recommendations] do not include the sugars present in whole fruit and vegetables, which are sometimes known as intrinsic sugars. These sugars are encapsulated by a plant cell wall. They tend to be digested more slowly and take longer to enter the blood stream than free sugars.” [20] Mann, Jim. The science behind the sweetness in our diets. Bull World Health Organ 2014;92:780–781 | doi: http://dx.doi.org/10.2471/BLT.14.031114. Pp 780-781.
The difference really is in how the nutritive, caloric sweetener is presented to the body. When the sugar is bound, it is less available to the body, plus, it is accompanied by vital micronutrients and fibre:
“Most people obtain some sugars from food such as milk, fruits, and vegetables, which contain vitamins, minerals, and / or plant fibre, which can be lacking in our diet. As a result, health experts now separate sugars in these foods from free sugars, a term which covers all the other sugars in the diet: table sugar, sugar in drinks, confectionery and bakery goods, syrups, honey, fruit purees, and dried fruit. Importantly, the term free sugars also includes the sugars in fruit juice. Although these are no different from the sugars in the whole fruit, they are consumed more quickly and without the accompanying plant fibre so they can cause more rapid surges in blood sugar. This is why health advice is now to have whole fruit when possible…” [21] McNeill, Geraldine. Rowett Institute of Nutrition and Health. University of Aberdeen, Scotland. Sugars in the diet. Module 2.5. Accessed March 2021 at https://www.futurelearn.com/courses/nutrition-wellbeing/13/steps/1000087
While dietitians are concerned about free sugars, they are not concerned about non-nutritive sweeteners. In fact, many encourage the adoption of non-nutritive sweeteners to ween people off free sugars added to foods:
“There are significant health benefits to switching from a sugary drink or a juice to a diet drink or sugar free version. Following the World Health Organization, diet drinks are far healthier than juices and other sugar sweetened drinks and do not contain free sugars.” [22]Free Sugars FAQ. Sugarwise. Cambridge, England. Accessed April 2021 at https://sugarwise.org/about/product-faqs/
Uses of sweeteners in cooking
All sweeteners, whether nutritive or non-nutritive, perform the following functions:
- flavouring;
- improving the acceptability of food to people’s palates.
Nutritive / caloric sweeteners perform the following additional functions:
- add bulk, texture and structure in baking;
- add colour in cooking when caramelization occurs;
- give mouthfeel to liquids;
- provide food for yeast in fermentation for alcohol;
- interact with pectin to form a gel;
- can help preserve colour and texture in canning and (sometimes) contribute to low-water activity; [23]Note that table sugar must also be combined with correct pH and with heat-processing of the filled, sealed jars. Sugar on its own is not enough to render a product safe. Botulism outbreaks have occurred from high-sugar jams with insufficient acidity.
- increase shelf-life (colour of canned items in jars; sugar-free jams once opened don’t have the resistance to air moulds that high-sugar jams do).
When using non-nutritive sweeteners in place of nutritive sweeteners, some recipe adjustments are often needed:
“Certain recipes may need modification because unlike sugar, artificial [non-nutritive] sweeteners provide no bulk or volume. Check the labels on artificial sweeteners for appropriate home use.” [24]Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
A cake recipe designed for use with refined white sugar won’t work if a straight swap is done for Splenda®. Splenda® doesn’t provide the same ability to hold structure, so the cake will turn out very flat. Note as well that in baking, non-nutritive sweeteners won’t provide the same kind of browning or caramelization that nutritive sweeteners would, so that colour will have to be achieved by other means to keep the resultant baked good as appealing to the eye.
Relishes or chutneys calling for large amounts of refined table sugar, but made with Splenda® instead, will have a lower yield of jars, as the dissolved Splenda® provides less bulk to the mixture than melted white sugar does. Jam pectins relying on sugar to make the pectin gel won’t work with non-nutritive sweeteners. Special no-sugar needed pectins must be used instead. (See: No Sugar Needed Pectins).
Finally, there’s the issue of taste. Rarely is a non-nutritive sweetener used in the same proportions as table sugar owing to its greater sweetness, unless a blend of it has been specifically formulated to allow that. And, how well does the sweetness of the sweetener survive cooking? Aspartame loses its sweetness when heated; acesulfame potassium (aka Ace-K, Sunette), advantame, neotame (aka Newtame®), sucralose (aka Splenda®) and stevia are examples of non-nutritive sweeteners whose sweetness is unaffected by heat.
History
Throughout most of human history, most sweetness in our diets came primarily from fruit. For added sweeteners, there was honey, or grape juice-derived ones such as sapa, defritum, or caroenum made by the Romans.
In the 1700s, the advent of large-scale processing of sugar cane to provide refined table sugar changed everything:
“In the 18th century cultivation of sugar cane in the plantations in the West Indies began on a large scale. This was made possible by the slave trade, which saw West Africans shipped to work on the plantations, mostly under terrible conditions. Raw cane sugar was shipped to the UK and refined into table sugar by removal of molasses and other impurities. Initially table sugar was a luxury commodity, but it soon became cheaper and formed a large part of the diet of working families in the newly industrialised cities. Most of the sugar was used to sweeten tea or in home-produced jams, cakes, biscuits, and puddings.” [25] McNeill, Geraldine. Rowett Institute of Nutrition and Health. University of Aberdeen, Scotland. Sugars in the diet. Module 2.5. Accessed March 2021 at https://www.futurelearn.com/courses/nutrition-wellbeing/13/steps/1000087
The way we consume sugar has changed since the start of the 2000s. We eat less free sugar as table sugar, the sugar that we see and deliberately spoon onto or into our food at home. But, we now consume more free sugars as “hidden sugar” in ultra-processed foods that we buy:
“In the last few decades, there has been… a major change in the way we eat it. Much less is bought as table sugar, while much more is consumed in soft drinks and processed foods such as biscuits, cakes, confectionery, and even savoury foods such as sauces.” [26] McNeill, Geraldine. Rowett Institute of Nutrition and Health. University of Aberdeen, Scotland. Sugars in the diet. Module 2.5. Accessed March 2021 at https://www.futurelearn.com/courses/nutrition-wellbeing/13/steps/1000087
In November 2010, Weight Watchers® announced that members of the Weight Watcher scheme could eat unlimited fresh fruit (and most vegetables) without having to count it towards their daily points allowance. Some nutritionists at the time, not yet aware of the latest dietetic research about free vs bound sugars that Weight Watchers® was basing its recommendations on, were scandalized. “No single nutritionist I know would count fruit as a ‘free’ food if someone is on a diet and trying to lose weight. You have to account for it,” said Marjorie Nolan, a New York City dietitian who speaks on behalf of the Academy of Nutrition and Dietetics.” But, Weight Watchers leaders responded that Americans “who are overweight did not become fat because they binged on fresh fruit.” [27]Rabin, Roni Caryn. The Consumer: In New Diet Math, Subtracting Is Hard. New York: New York Times. 7 February 2012. Page D6.
Further reading
EFSA NDA Panel (EFSA Panel on Nutrition, Novel Foods and Food Allergens), , , , et al. Scientific Opinion on the Tolerable upper intake level for dietary sugars. EFSA Journal 2022; 20( 2):7074, 337 pp. https://doi.org/10.2903/j.efsa.2021.7074
Related entries
- Amasake
- Aspartame
- Caramel
- Date Sugar
- Dextrose
- Erythritol
- Fructose
- Honey
- Icing and Frosting
- Jaggery
- Sorbitol
- Stevia
- Sugar
- Syrups
- Xylitol
References
↑1 | Britannica, The Editors of Encyclopaedia. “Sweetener”. Encyclopedia Britannica, 8 Feb. 2018, https://www.britannica.com/topic/sweetener. Accessed 9 April 2021. |
---|---|
↑2 | Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 |
↑3 | Rao, L.Jagan Mohan et al. Ingredients of soft drinks. In. Recent Trends in Soft Beverages. India: Woodhead Publishing. 2011. Pages 189-209. |
↑4 | USDA National Agricultural Library. Food and Nutrition Information Center. Nutritive and Nonnutritive Sweetener Resources. Accessed April 2021 at https://www.nal.usda.gov/fnic/nutritive-and-nonnutritive-sweetener-resources |
↑5 | Healthy Diet. Key Facts. World Health Organization. 29 April 2020. Accessed April 2021 at https://www.who.int/news-room/fact-sheets/detail/healthy-diet |
↑6 | Britannica, The Editors of Encyclopaedia. “Sweetener”. Encyclopedia Britannica, 8 Feb. 2018, https://www.britannica.com/topic/sweetener. Accessed 9 April 2021. |
↑7 | Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 |
↑8 | US Food and Drug Administration. Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States. Accessed April 2021 at https://www.fda.gov/food/food-additives-petitions/additional-information-about-high-intensity-sweeteners-permitted-use-food-united-states |
↑9 | In terms of bulk commodity sweetener prices for industry, the opposite can be true: alternative sweeteners are often cheaper than sugar. |
↑10 | ”Some artificial sweeteners may leave an aftertaste.” Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 |
↑11 | Older observational studies postulated that non-nutritive sweeteners could lead to weight gain. However, more recent controlled studies (which are superior to observational studies) are finding the opposite: “Non-nutritive sweetener (NNS) consumption is associated with higher body weight and metabolic disease in observational studies. In contrast, randomized controlled trials demonstrate that NNS may support weight loss, particularly when used alongside behavioral weight loss support.” — Sylvetsky, Allison C, and Kristina I Rother. “Nonnutritive Sweeteners in Weight Management and Chronic Disease: A Review.” Obesity (Silver Spring, Md.) vol. 26,4 (2018): 635-640. doi:10.1002/oby.22139 |
↑12 | Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 |
↑13 | Mann, Jim. The science behind the sweetness in our diets. Bull World Health Organ 2014;92:780–781 | doi: http://dx.doi.org/10.2471/BLT.14.031114. Pp 780-781. |
↑14 | Free Sugars FAQ. Sugarwise. Cambridge, England. Accessed April 2021 at https://sugarwise.org/about/product-faqs/ |
↑15 | Information note about intake of sugars recommended in the WHO guideline for adults and children. Geneva, Switzerland: Department of Nutrition for Health and Development, World Health Organization. 2015. Page 1. |
↑16 | Free Sugars FAQ. Sugarwise. Cambridge, England. Accessed April 2021 at https://sugarwise.org/about/product-faqs/ |
↑17 | Juice and smoothies count as sources of free sugar because the juicing and blending frees the sugars up from the cell structure they were previously bound up with. This makes the sugar in them the same as sugar in a can of pop. |
↑18 | What are free sugars? British Heart Foundation. Accessed April 2021 at https://www.bhf.org.uk/informationsupport/heart-matters-magazine/nutrition/sugar-salt-and-fat/free-sugars |
↑19 | Swan, Gillian E et al. “A definition of free sugars for the UK.” Public health nutrition vol. 21,9 (2018): 1636-1638. doi:10.1017/S136898001800085X |
↑20 | Mann, Jim. The science behind the sweetness in our diets. Bull World Health Organ 2014;92:780–781 | doi: http://dx.doi.org/10.2471/BLT.14.031114. Pp 780-781. |
↑21 | McNeill, Geraldine. Rowett Institute of Nutrition and Health. University of Aberdeen, Scotland. Sugars in the diet. Module 2.5. Accessed March 2021 at https://www.futurelearn.com/courses/nutrition-wellbeing/13/steps/1000087 |
↑22 | Free Sugars FAQ. Sugarwise. Cambridge, England. Accessed April 2021 at https://sugarwise.org/about/product-faqs/ |
↑23 | Note that table sugar must also be combined with correct pH and with heat-processing of the filled, sealed jars. Sugar on its own is not enough to render a product safe. Botulism outbreaks have occurred from high-sugar jams with insufficient acidity. |
↑24 | Mayo Clinic Staff. Artificial sweeteners and other sugar substitutes. Mayo Clinic. Accessed April 2021 at https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 |
↑25 | McNeill, Geraldine. Rowett Institute of Nutrition and Health. University of Aberdeen, Scotland. Sugars in the diet. Module 2.5. Accessed March 2021 at https://www.futurelearn.com/courses/nutrition-wellbeing/13/steps/1000087 |
↑26 | McNeill, Geraldine. Rowett Institute of Nutrition and Health. University of Aberdeen, Scotland. Sugars in the diet. Module 2.5. Accessed March 2021 at https://www.futurelearn.com/courses/nutrition-wellbeing/13/steps/1000087 |
↑27 | Rabin, Roni Caryn. The Consumer: In New Diet Math, Subtracting Is Hard. New York: New York Times. 7 February 2012. Page D6. |