The last trimester of my pregnancy was spent on nutrition classes, visits to my endocrinologist and daily injection of insulin. This was due to gestational diabetes that I developed on the 27th week of my pregnancy.
Gestational Diabetes (GD) occurs when our body cannot produce enough insulin to cope with the effects of changing hormone levels due to a growing baby inside us.
I was put on a diet of high protein and strictly no sugar. I love my table sugar (sucrose), but it shoots up my glucose level, so I was prohibited by my dietitian from consuming it. However, to my surprise, artificial sweeteners was allowed to replace my sugar intake.
This puzzled me, since I always thought that artificial sweeteners are worse than sugar. In fact, my husband even stopped drinking diet soda due to the articles he read about their adverse effects. And he warned me never to consume artificial sweeteners during my pregnancy.
I understand where my husband was coming from. There are many conflicting reports in the media and on the internet about artificial sweeteners. Attending nutrition classes and doing my personal research helped me address my concerns on their safety.
Dear readers, let me share the facts that may be able to shed light on the controversial question that most moms-to-be are concerned about: are artificial sweeteners safe during pregnancy?
Artificial sweeteners: To take or not to take.
Artificial sweeteners are sugar substitutes that have a sweet taste that can be found in pre-packaged foods and drinks. Some artificial sweeteners may be added to coffee and tea, or may be used for baking and cooking.
Health Canada is more direct on its take on the issue: consumption of sugar substitutes during pregnancy does not pose a health risk.
However, it is important to note that pregnant women should use artificial sweeteners in moderation. The publication also warns that we should avoid consuming too many food products with artificial sweeteners, since they may be replacing more nutritious options for a healthy pregnancy.
Furthermore, there are different kinds of artificial sweeteners and some are not advisable to be taken during pregnancy. Read on to familiarize yourself on sugar substitutes and avoid using the types that are not advisable for pregnant women.
Types of Artificial Sweeteners.
There are two main types of artificial sweeteners: those that have calories (sugar alcohol) and those without.
Sugar alcohol have fewer calories than table sugar and have small effect on the blood glucose level. They are used in pre-packaged foods and drinks and in some liquid medication. Large amounts (more than 10 grams/day) can cause diarrhea, cramps, gas and bloating.
Artificial sweeteners with no calories do not have an effect on the blood glucose level. However, they are often used in very small amounts since they can be 30 to 3000 times sweeter than table sugar.
The US Food and Drug Administration and the Dietitians of Canada enumerate the types of sweeteners that have been approved for use.
- Aspartame (more popularly known under the brand names Equal™ and Nutrasweet™)
- it is used in soft drinks, yogurt, candy and as a table-top sweetener.
Warning: people with a condition called phenylketonuria (PKU) must avoid foods with aspartame.
- Sucralose (brand name Splenda™)
- it is used for home cooking and baking.
- it is widely used in soft drinks, candy, baked goods and frozen desserts and ice cream products.
- Acesulfame potassium
- it is not used as a table top sweetener.
- it is used only by food manufacturers as an ingredient for sweetening soft drinks and candy.
- Sugar alcohols (sorbitol, mannitol, maltitol, xylitol)
- cannot be bought as table sweeteners but are used by food manufacturers in foods and beverages such as candy, frozen desserts and ice cream products.
- Saccharin (table top sweetener Hermesetas®)
- It can only be bought at pharmacies in Canada.
Warning: For pregnant women, check with your doctor before using saccharin.
- Stevia leaf and extract of stevia leaves
- approved for use as ingredients in certain natural health products in Canada. Purified stevia extract is approved as a table top sweetener and food additive in some foods such as candy, gum, baking mixes and snacks.
- Whole leaf and crude stevia are not permitted for use as sweeteners in the United States.
- No clear research that provides it is safe to take during pregnancy
- Cyclamate (marketed as the table top sweeteners Sucaryl®, Sugar Twin® and Sweet ‘N Low®)
- it is not permitted as a food additive in Canada.
- it is currently prohibited by FDA for use in the United States.
Sweet Advice on Artificial Sweeteners
The following are important guide for pregnant women:
- Always read the ingredients list to determine if there is artificial sweetener in a package of food or bottle of beverage you have purchased.
- Sweeteners may be listed in many different names. Know your sweeteners; some types may be best avoided during pregnancy such as saccharin.
- If you have concerns about using your sweeteners, talk to your doctor or a dietician.
Do not forget: consume artificial sweeteners in moderation. I was under strict diet monitoring, but I was allowed to have diet soda after meals once in a while, and I took artificial sweeteners for my occasional coffee. The only time my blood sugar went up was when I used saccharin; I avoided it all through out my pregnancy.
Be sure to eat healthy while you are pregnant. As my dietitian sternly reminded me when I failed to stick to my diet: this is not about you, this is about the health of your baby.
Her words stung! But in the long run, I realized that was the sweetest advice I had ever received. Although I had to be induced a week earlier, my baby girl came out healthy and strong.
And may I say, she is one sweet bundle of joy.