by Sugar is like a drug in many ways. It affects mood, digestion, sleep, and can profoundly affect cognition. Sugar triggers the brain’s reward system in a similar way to drugs, although it’s much more complex than “Oreos are like cocaine.” Withdrawal symptoms are also not uncommon and sugar consumption can be compulsive; However, it’s probably not as addictive as heroin or alcohol. “Sucrose use disorder” is not an actual diagnosis like a substance use disorder.
Regardless, society seems to have a problem with sugar. Aside from its negative environmental and social impacts, excess sugar consumption is linked to a wide range of health outcomes, including metabolic diseases such as obesity and diabetes, cardiovascular damage and tooth decay. But avoiding sugar seems impossible even if you try, as unscrupulous companies unnecessarily inject it into food products like bread, salad dressings, soups, pasta sauces, cereal, tonic water, beef jerky and more.
Avoiding sugar is hard, but we crave it for good reason. Sugar is high in calories, but it was much rarer before industrial society made it the roughly $70 billion business it is today. To survive in a nutrient-poor world millions of years ago, humans evolved to seek out sugar wherever we could find it. In plants, sugars come in the form of fructose, sucrose, and maltose, while lactose is a sugar found in milk. The body breaks down all of these chemicals into glucose, which is used for energy and fat storage.
But humans have devised ingenious ways to ensure we always have a supply of sugar on hand, perhaps too much of a good thing. And we love having our cake and eating it, too, so we’ve also invented chemical alternatives to sugar that don’t occur in nature, or chopped natural sugars to make them even more potent.
In fact, there is a long history of developing sugar alternatives. In ancient Rome, it was common to boil grape syrup into a concentrated form called “sapa” or “defrutum,” which was often used to enhance the flavor of wine. However, it was brewed in lead-lined kettles or pots, creating lead acetate, also known as the “salt of Saturn” or “lead sugar.” Although lead acetate is sweet, it is highly toxic.
Scientists recreated these antiquarian concoctions from ancient recipes and found that between 240 and 1,000 milligrams of lead were present in these toxic drinks. Even a single teaspoon (five milliliters) would have been enough to trigger chronic lead poisoning. Some anthropologists believe such tainted wine contributed more to the fall of Rome than leaden plumbing.
Unfortunately, even today, these sweet shortcuts come at a price, which is becoming increasingly clear thanks to advances in scientific research. The latest bombshell concerns erythritol, a slightly sweet sugar alcohol widely used in everything from chocolate and chewing gum to dietary supplements and soft drinks. (It also appears to kill bugs.) Although this tiny molecule (consisting of just four carbon atoms) was first discovered in the 19th century, it became widely available in 1990 thanks to breakthroughs in Japanese fermentation technology that made it possible to produce it on a large scale.
Due to the fact that erythritol has literally zero calories, it has quickly become one of the most popular sweeteners in the world. This is because the body throws it out too quickly to metabolize it, too tough even for the bacteria in our gut to break it down. Despite this, it is still associated with weight gain and the development of type 2 diabetes.
Erythritol is derived from plants like corn, so it’s often marketed as “natural” and isn’t technically an artificial sweetener. Our bodies produce it naturally, even in small amounts. But researchers at the Cleveland Clinic published a study in the journal Nature Medicine last month and found that erythritol use was linked to a dramatic increase in heart attacks and strokes. Given that some people consume up to 30 grams of erythritol per day — far more than is found in fruit or vegetables — this is a serious risk of death.
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So far this link is just an association, but the underlying mechanism suggests that erythritol increases the risk of blood clots, which is particularly important for people with diabetes, obesity or a history of cardiovascular disease – the same groups of people who those who may be affected tend to avoid sugar and reach for an alternative in the first place.
Future studies are needed to really elucidate this relationship, but in the meantime, many organizations including the Food and Drug Administration (FDA) and the European Food Safety Authority consider erythritol safe for human consumption. Of course, the dose also plays a big role, but these agencies do not put limits on the daily consumption of erythritol. The level of exposure and associated risk depend on how much erythritol you ingest. But another big concern is that many people often can’t tell how much of this stuff they’re eating.
“The FDA does not require disclosure of erythritol levels in foods, making it difficult to track its levels in foods as an additive,” the Cleveland Clinic researchers wrote. ‘The present findings underscore the need to establish reporting requirements, safety profiles and daily intake margins as widespread use continues to increase. Public policy decisions need to be evidence-based and better informed.’
As Salon reported, the FDA may soon change its definition of what constitutes “healthy” foods, potentially addressing the common practice of adding sugar to low-fat foods and labeling them as nutritionally beneficial. However, some companies, such as KIND, a New York City-based snack food company, have resisted these proposed changes, claiming it would encourage companies to use artificial sweeteners. The FDA has no plans to regulate these alternatives.
In a way, we can imagine alternative sweeteners being more like drugs than sugar, if not directly. These are foreign chemicals that are profoundly altering our biochemistry, as shown in a study published in Cell Press last August. In a randomized controlled trial of 120 adults using four sweeteners—including stevia, aspartame, saccharin, and sucralose—researchers at the Weizmann Institute of Science found that these additives have a negative impact on the human microbiome, the microbes that reside in our gut that are closely linked to our health are, have changed significantly.
The implications of this research are still not clear, but it is another indication that alternatives to sugar are not without consequences. It also doesn’t mean these products are “hazardous” or radioactive, but given the widespread and serious trend of companies loading food products with artificial sweeteners, consumers could use better information and better science to inform their dietary choices.
