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nutrition Q&A Answers by Ann Ruelle, RD, CDE, CLSC Q A Are artificial sweeteners bad for you? hemera/Thinkstock (sugar substitute packs) istockphoto/Thinkstock (stevia) (sugar bowl) Artificial sweeteners, also called nonnutritive sweeteners, lend sweetness to food without calories. Real Life: The Hands-on Pounds-off Guide, the lifestyle handbook from TOPS, indicates that artificial sweeteners can be helpful for weight management, diabetes management and the prevention of cavities. You can choose to use sugar substitutes, such as: Saccharin (Sweet'N Low), the oldest of the artificial sweeteners, remains the most studied—and thus, considered the safest. Aspartame (NutraSweet, Equal) is the most controversial, though it's been found to be safe in more than 200 studies. Methanol is a byproduct of aspartame digestion, but the metabolism of fruit juice generates more methanol. Aspartame has no effect on gastrointestinal secretions made by your digestive system, but people with the genetic condition phenylketonuria should avoid aspartame. Sucralose (Splenda) is manufactured from sugar. Because it is 600 times sweeter than sugar, little is needed. Most sucralose passes through your digestive system without being absorbed. The small amount that's absorbed leaves the body through urine. Twenty years of scientific studies have shown sucralose does not interfere with the digestive system. Acesulfame-K (Sunett) is a calorie-free sweetener often used with other low-calorie sweeteners. Opposition revolves around insufficient testing and lack of long-term studies. The sweetener may cause nausea. No other digestive problems were noted. At this time, the Food and Drug Administration (FDA) has not required more tests. Stevia (Truvia, Pure Via, SweetLeaf) is a natural herbal sweetener approved by the FDA since 2008. This sweetener may cause digestion problems—nausea, bloating and stomach discomfort. These symptoms typically While sugar substitutes do not offer nutritional value, they can help you manage weight and/or diabetes. decrease with continued use. The digestive problem may well be due to its mixture with erythritol, a sugar alcohol. As with all sugar alcohols (nutritive sweeteners), large amounts may lead to similar digestive problems. Please note that these artificial sweeteners have an acceptable daily intake level; you should not consume unlimited amounts of these additives. The FDA recommends using artificial sweeteners in moderation. Q A I have celiac disease and cannot have gluten. Can I still use the Food Exchange System? Celiac disease is an autoimmune disorder that damages or destroys the lining of the intestines in reaction to gluten—a protein found in wheat, rye and barley. To answer your question: Yes, you can use the Food Exchange System. These exchanges won't give you problems: Milk exchanges. Nonflavored milk and milk products such as lactose-free milk, soy milk, almond milk, low-fat coconut milk, rice milk and yogurt. Starch exchanges. All breads and rolls made from tapioca, arrowroot, corn or potato starch; corn, potato, rice or soy flour; glutenHEALTHY & ACTIVE 2014 33

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