The Nutrition Company, a juice bar and natural grocery store owned by Dr. Catherine Wilbert, is located next to an ice cream chain. The two shops serve as telling visual reminders of Americans' nutritive crossroads.
Inside The Nutrition Company, Wilbert moves from one customer to the next, dispensing advice and leading them to appropriate supplements. Her sculpted biceps hint at her former life as a champion bodybuilder.
"Shake it up really good, OK?" she says, handing a customer a tonic for adrenal support. A naturopathic doctor and nutrition consultant, Wilbert approaches diseases and disorders holistically, considering symptoms as clues to what is fundamentally wrong rather than simply treating symptoms as the disease itself.
"Ninety percent of what I do is focused on blood sugar," she says as she sips a cup of organic coffee. "The impact of blood sugar, which of course is the impact of insulin, is much greater than we give it credit for being. [Blood sugar] affects not just your weight, but your mood, energy and ability to focus and sleep."
Due to the steady increase of per capita sugar consumption rates and the correlating increase in rates of diabetes and obesity, manufacturers have capitalized on a booming market for artificial sweeteners. Calorie-free sugar alternatives such as aspartame (sold under the brand names Equal and NutraSweet), sucralose (Splenda) and saccharin (Sweet'N Low) appease the craving for sweetness without spiking blood sugar. But consumers are increasingly concerned about the long-term health effects of using artificial sweeteners. If, as anthropologist Claude Levi-Strauss posited, good food must first be good to think about before it becomes good to eat, then artificial sweeteners would leave a decidedly bittersweet taste in the mouth.
Aspartame, a chemical 200 times sweeter than sugar, has been subjected to continual scrutiny and studies since the FDA approved it in 1974, and remains a controversial subject. In an analysis of 164 studies of aspartame conducted in the United States and overseas, Dr. Ralph G. Walton, chairman of the Center for Behavioral Medicine at Northeastern Ohio Universities College of Medicine, found that 83 studies by researchers not associated with the FDA or sponsored by the aspartame industry reported health concerns with the sweetener, including formation of formaldehde in cells of the body, memory loss, development of several types of cancer and more. A 2006 study by the National Cancer Institute involving a half-million people, however, found no such links. Despite that finding, a group of 12 U.S. environmental scientists — including researchers for the National Institute of Environmental Health Sciences and scientists at Harvard Medical School, the University of Pittsburgh Cancer Institute, UCLA, George Washington University and others — wrote a letter to the FDA in 2007 asking it to evaluate a study conducted in Italy that showed strong links between aspartame and cancer, and to consider revoking its approval of the sweetener.
"Aspartame is a known excitotoxin," Wilbert says. "It overfires the neurotransmitters in your brain, so it is directly correlated to neurodegenerative diseases. I personally will not touch aspartame."
Wilbert has spent the last 10 years developing a product called Swerve (www.swervesweetener.com), which is made from the fibrous parts of fruits and vegetables using a natural enzyme process. A sugar alternative that measures, cooks and caramelizes similar to sugar, Swerve is calorie-free. "'You finally made sugar-free sugar,' was somebody's comment," Wilbert laughs, "and that's pretty much what it is."
The sugar substitute saccharin has a fairly long shelf life and is often partnered with aspartame in diet soft drinks. While saccharin was once linked to bladder cancer in rats, subsequent studies revealed that a biological mechanism in rats, which is not present in humans, caused the cancer. Saccharin is probably the most benign of all artificial sweeteners, according to Bernard Oser, a toxicologist and former president and director of the Food and Drug Research Laboratories; however, its flavor leaves something to be desired. "The metallic aftertaste is definitely a con," says dietitian Katelynn Phillips.
Sucrolose has a less bitter aftertaste and can be used for baking and frying. In its granulated form, it can be poured and measured just like sugar. Alternative health experts, though, are quick to point out that sucralose used in Splenda is synthesized by replacing sucrose's three glucose molecules with chlorine molecules.
"Splenda is chlorinated sugar," Wilbert says. "Chlorine should be reserved for the pool."
In a Duke University study published in the January 2008 issue of the Journal of Toxicology and Environmental Health, researchers wrote, "Evidence indicates that a 12-week administration of Splenda exerted numerous adverse effects," including imbalances in the digestive tract "known to limit the bioavailability of orally administered drugs."
On an intuitive level, it makes sense to keep carcinogens out of our bodies, but as Dr. Samuel Andrews, an endocrinologist and author of the best-seller Sugar Busters, explains, the presence of chlorine doesn't necessarily guarantee neurotoxicity. "I don't think there's any good evidence that artificial sweeteners are linked to brain cancer," he says. "I personally like Splenda, and I use that."
Andrews, whose Sugar Busters was seminal among low-carb diets, encourages diabetic patients to use artificial sweeteners. "Sugar raises your blood sugar, and that's not healthy, whereas artificial sweeteners do not raise the blood sugar unless you eat a whole gallon of ice cream."
Phillips echoes these sentiments. "For some people, artificial sweeteners are beneficial," she says. "I recognize that [artificial sweeteners] have their place, especially with diabetics."
Dr. Janet Hull, author of the book Splenda: Is It Safe Or Not, disagrees with Andrews and Phillips. On her Web site, www.splendaexposed.com, she writes, "New chemical sweeteners (like Splenda) and sweetener blends (aspartame, sucralose and acesulfame K blended together in one product) may be causing users to show signs of weight gain, disruption of sleep patterns, sexual dysfunction, increases in cancer, [multiple sclerosis], lupus, diabetes, and a list of epidemic degenerative diseases."
Dr. James Bowen, a physician and biochemist, also speaks out against Splenda, explaining that once chlorinated, sucralose "becomes a chlorocarbon, in the family of Chlorodane, Lindane and DDT. ... Chlorocarbons are never nutritionally compatible with our metabolic processes and are wholly incompatible with normal human metabolic functioning." In an article written for www.holisiticmed.com, he warns, "Any chlorocarbons not directly excreted from the body intact can cause immense damage to the processes of human metabolism and, eventually, our internal organs. The liver is a detoxification organ which deals with ingested poisons. Chlorocarbons damage the hepatocytes, the liver's metabolic cells, and destroy them."
Many sugar-free candies and cookies marketed for diabetics contain sugar alcohols such as sorbitol and maltitol, which have zero glycemic index. Some diabetics and dieters, however, suffer from the common misconception that sugar alcohols are calorie-free.
"All the sugar alcohols still have as much as two-thirds of the calories as sugar," Wilbert says. "They just have less impact on blood sugar, but only inasmuch as they don't permeate your intestines. And that is why they cause so much gastrointestinal upset. Basically, when you put in enough sugar alcohol to make a product sweet, it causes gas and bloating."
Growing concern about negative health implications of artificial sweeteners has spurred the development of natural sugar alternatives including stevia, a naturally sweet, zero-calorie herb. Coca-Cola has created a stevia sweetener called Truvia, which will be used in some of the company's beverages, including Odwalla juice and Glaceau Vitaminwater.
"There don't seem to be any side effects with stevia," Phillips says. "It comes from a plant, and they've been using it in South America for a couple hundred years."
Although the controversy regarding the safety of artificial sweeteners is long-standing, few dispute the human penchant for sweetness. The question is how to healthfully satisfy such cravings. Phillips advocates the use of natural sweeteners such as molasses and maple syrup.
"Maple syrup has small amounts of calcium, iron, potassium, phosphorus and some other minerals, plus trace amounts of other B vitamins," she says. "Blackstrap molasses has iron, calcium, copper, vitamin B6 and potassium, as well as selenium and manganese. I would much rather see a consumer use one of these sweeteners than a non-nutritive sweetener like Sweet'N Low or Splenda."
So which would Andrews advise a healthy adult to drink: a diet soft drink sweetened with aspartame or a regular soft drink sweetened with sugar? "I'd say consume water versus Coke or Diet Coke," Andrews says. "Water is a very good diet drink."