DECEMBER 2014 ;e Costco Connection 67
By Joseph Hanna
SUGAR SUBSTITUTES HAVE become a
popular way to satisfy a sweet tooth. Some are
synthetic, while others are natural, and each
has a di;erent level of sweetness compared to
sugar. ;ey are used in certain medications,
soft drinks and other foods labeled as
“sucrose-free” or “calorie-free,” and they are
also sold separately in packets. Although they
may seem like the healthy choice, this may
not always be the case. Here’s more information so you can make informed decisions on
Aspartame, sucralose, cyclamate and saccharin, marketed under di;erent brand names,
all fall into this category. Only tiny amounts are
needed to sweeten food because they are 30 to
3,000 times sweeter than regular sugar.
Arti;cial sweeteners are generally considered safe for most people in moderate amounts.
;ese products are particularly useful for those
with diabetes, as they not only contain fewer
calories, but also do not raise blood sugar.
Saccharin and cyclamate should not be
consumed by women who are pregnant or
breastfeeding. People who have phenylketonuria—a birth defect that causes the amino
acid phenylalanine to build up in the body—
should not consume aspartame, because phenylalanine is a component.
You may have heard the controversy
about some arti;cial sweeteners causing cancers and other illnesses; however, the U.S.
Food and Drug Administration has evaluated
these safety claims in studies and has not been
able to prove that these claims are valid.
Xylitol, mannitol and sorbitol are examples of sugar alcohols. Although the name
may imply that they have alcohol in them,
they are nonalcoholic because they do not
contain ethanol. ;ey are found naturally in
fruits and some vegetables, but they are usually made from sugar when used in commercial products.
Sugar alcohols are actually less sweet than
regular sugar. ;ey are used as a sugar alternative because they have fewer calories, which
is why they are o;en referred to as “
Although they are generally safe, taking
more than 10 grams a day can cause gas, diar-
rhea and upset stomach. Sugar alcohols may
also slightly a;ect blood sugar since they contain some calories from carbohydrates. People
with diabetes should monitor their blood
sugar when using them as substitutes.
Stevia is a natural sweetener derived from
the leaves of the plant Stevia rebaudiana.
Stevia is about 200 to 300 times sweeter than
regular sugar, and it has no calories.
Since it’s considered a food additive, puri-;ed stevia extract is regulated and has been
evaluated for safety. People taking medications for diabetes should monitor their blood
sugar closely when taking stevia, as it may
cause low blood sugars. Along with possible
stomach upset, stevia may also cause an allergic reaction in people who have allergies to
ragweed, chrysanthemums and daisies.
The advantages and disadvantages
Because sugar substitutes contain fewer
calories, you can bene;t from them as part of
a well-balanced diet accompanied by an
appropriate exercise plan, if you are trying to
control your weight. Since many have little to
no e;ect on blood sugar, they may be a good
alternative for people with diabetes.
However, just because a food contains an
artificial sweetener, it doesn’t necessarily
mean that it’s healthful and low in calories or
fat. ;at’s why it is always important to read
the product label to ;nd out exactly what
It’s easy to turn to sugar substitutes, but
they should never take the place of a nutritious
diet. Always read the
food or medicine label,
and if you choose to
enjoy an alternatively
remember that moderation is key. C
Joseph Hanna is director
of Costco Pharmacy
Your sweet optıons
SEPSIS IS RESPONSIBLE for more
American deaths each year than
breast cancer, prostate cancer and
AIDS combined. This toxic condition is
caused by an overwhelming immune-system response to infection—so overwhelming that it can injure healthy
tissues and organs, and quickly
become life threatening. It affects
more than 1 million people in the U.S.
each year, with 28 to 50 percent of
those cases resulting in death. Early
diagnosis is critical.
Sepsis is triggered by the body’s
reaction to an infection—maybe from
something “as seemingly benign as a
playground scrape or a nicked cuticle
from the beauty parlor,” according to
the Sepsis Alliance.
Common symptoms include fever,
chills, rash, confusion or disorientation,
rapid heart rate (pulse greater than
90 beats per minute), rapid breathing
(more than 20 breaths per minute) or
difficulty breathing. These symptoms
also occur in other conditions, making
early detection of sepsis difficult. Lab
tests are used to identify infection.
Sepsis can affect anyone, but
certain people are at greater risk,
including infants and children, elderly
people, those with chronic illnesses,
those who have experienced severe
burns or physical trauma and anyone
with a weakened immune system.
If you (or someone you know) are
experiencing sepsis-like symptoms
(abnormalities of body temperature,
heart rate, respiratory rate and possible infection), you need to immediately
go to an ER and mention that you’re
concerned about the possibility of
sepsis. Delay in seeking care could
For more information about sepsis,
try these resources:
• Sepsis Alliance,
• Centers for Disease Control and
• National Institute of General
(search “sepsis”)—David Wight
In our digital editions
Click here for The Faces of Sepsis,
a video from the Sepsis Alliance.
(See page 11 for details.)