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Substitute your Sugar, Not your Smile.

nephroplus | April 6, 2016

By Mrinal Pandit, Chief Dietician, NephroPlus

Higher consumption of sugar & sugar products can lead to obesity, diabetes and progressively lead to kidney function decline. So, along with choosing correct food and quantity, life style modification and healthy eating habits need to be inculcated in daily routine to slower the progression of lifestyle related complication.

To maintain ideal body weight energy intake should be equal to energy output. Energy is derived from carbohydrate, proteins and fats. So, when a particular food is sugar free, it indicated it is sucrose free and not carbohydrate and fat – free .Careful reading of nutritional labels is important to understand the content of the food and determine which fits to requirement. Excessive consumption of sugar and sugar sweetened beverages should be limited. Replacing sugar with sugar substitutes can prove beneficial if taken in recommended amount. The food and Drug association has approved the use of 6 artificial sweeteners and their use by CKD guests with acceptable daily intake (ADI).GRAS (Generally recognized as safe) notices have been submitted to FDA for two types of sweeteners stevia plant and extracts obtained from Siraitia grosvenorii Swingle fruit, also known as Luo Han Guo or monk fruit).

The benefits of artificial sweeteners are more advantageous as most of the guests with CKD have diabetes mellitus. Artificial sweeteners do not add to calories and rise in blood sugars. In fact, the National Kidney Foundation’s guide, Planning for Emergencies, A Guide for People with Chronic Kidney Diseases, recommends an artificial sweetener as part of an emergency diet plan.

Acesulfame K — Brands Name: NutraSweet and Equal.

  •  200 times sweeter than sugar.
  • Used in baking and is often used in products requiring a longer shelf life.
  • Mostly used in combination with sucralose and aspartame in diet drinks and soda.
  • Used in pharmaceutical companies in chewable and liquid medication.
  • Generally recognized as safe; guest with kidney disease should limit potassium intake (10 mg potassium/packet)
  • Does not affect blood sugar.
  • Calories: 0/packet
  • Acceptable Daily Intake (ADI) =15 (mg/kg body weight/d)

Sucralose — Brand Name: Splenda.

  • 600 times sweeter than sucrose.
  • Heat stable, can be used for baking.
  • Mostly used to sweeten commercial foods labeled sugar free or no added sugar.
  • Calories: 0/packet
  • Acceptable Daily Intake (ADI) =5 (mg/kg body weight/d).

Saccharin — Brand Name: Sweet Twin, Necta Sweet.

  •  300-700 times sweeter than sugar.
  • Recommended for cooking and baking.
  • Reported to have little aftertaste.
  • Pregnant women are instructed to avoid saccharin because it can cross the placenta.
  • Does not affect blood sugar.
  • Calories: 0/packet.
  • Acceptable Daily Intake (ADI) =15 (mg/kg body weight/d).

Aspartame — Brands Name: NutraSweet and Equal.

  • 200 times sweeter than sugar.
  • Similar caloric value of sugar however; 200 times sweeter.
  • Contraindicated in person with phenylketonuria.
  • Not recommended for cooking.
  • Can be used tabletop sweetener.
  • Provides 4 kcal/ gram.
  • Calories: 0/packet, calorific value per packet is insignificant due to concentrated sweetness and the quantity used.
  • Acceptable Daily Intake (ADI) =5 (mg/kg body weight/d).

Neotame — No Brand Name.

  •  7000–13,000 times sweeter than sugar.
  • Artificial sweetener.
  • Used in many diet foods, Heat stable, can be used for cooking and baking.
  • Can be used as a tabletop sweetener.
  • Calories: 0/packet.
  • Acceptable Daily Intake (ADI) =0.3 (mg/kg body weight/d).

Stevia (≥95% pure glycosides) — Brand Name: Truvia, Pure Via, Sun Crystals, Stevia, Sweet leaf.

  •  200-300 times sweeter than sugar
  • Plant-based sweetener
  • Can be used as table top sweetener, food additives in dietary supplements.
  • Calories : 0/packet
  • Acceptable Daily Intake (ADI) =4 (mg/kg body weight/d).

Advantame — No Brand Names

  • 20.000 times sweeter than sugar
  • Can be used as a tabletop sweetener as well as in cooking applications
  • Can be used in baked goods, non-alcoholic beverages (including soft drinks), chewing gum, confections
  • Generally used as flavor enhancer in foods (except in meat and poultry).
  • Calories : 0/packet
  • Acceptable Daily Intake (ADI) =32.8 (mg/kg body weight/d).

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