Sugar is a sweet crystalline substance obtained from various plants, especially from sugarcane and sugar beet. It essentially contains sucrose and is used as a sweetener in food and drinks. Having said that, we consume sugar in many other forms through the food we eat. Lactose (a sugar present in milk) is a disaccharide containing glucose and galactose units. Fructose, a sugar of the hexose class, is found especially in honey and fruits. Maltose is a sugar produced by the breakdown of starch, e.g. by enzymes found in malt. Plants and most algae mainly make glucose, a simple sugar, during photosynthesis from water and carbon dioxide, using energy from sunlight, where it is used to make cellulose in cell walls, which is the most abundant carbohydrate. Thus one may come across Ice-Cream brands claiming to have ‘No Added Sugar’ and yet taste sweet. That is because they have lactose present in them. That does not make them ‘Sugar-Free’ though. Similarly, a manufacturer of fruit juice claiming to have ‘no added sugar’ does that as no sucrose has been added in the juice. However, the juice will contain fructose and is therefore not ‘sugar-free.

Before buying any product with the label ‘No Sugar or Sugar-free’ on a food packet consumers blindly buy the product, which is not a good practice at all, from the awareness point of view, what you really need to do is read the food label carefully and with a little more patience than you normally would because of the fact that food labels are confusing and not easy to understand for a lay person and the ambiguity is higher if consumer wants to know how much sugar is actually added. With the advancement in food industry and awareness among health conscious consumers while entering grocery store they may have commonly come across the labels ‘No added sugar’, ‘Unsweetened’ or ‘Sugar-free’ on various products. Let’s understand the technical knowhow of the available products in the market with a special context to diabetes.

No added sugar:

During the processing of food product, if no sugar or sugar-containing products are added, then a product can be labeled as ‘No Added Sugar”. Though it can’t be presumed to be free from sugar, which simply means that the manufacturer didn’t add any sugar during the process of manufacturing. A product with a ‘No Added Sugar’ label may contain traces of natural sugars, sweeteners or sugar alcohols. Foods carrying this claim are generally confectionaries, chocolate bars, spreads, fruit juices and preserved foods.

Unsweetened:

While purchasing any food product with this term on a food label, it means the product contains no added sugars, no artificial sweeteners, and no sugar alcohols. However, it doesn’t mean the food contains no sugar at all, as it may have naturally occurring sugars. Well, at least there are no artificial sweetening additives in your product. For instance, even single-ingredient products like juices will have fructose or fruit sugar. Yet it will be labeled as ‘No Added Sugar’ or ‘Unsweetened’ on the food pack wherein the natural sugar fructose present in the fruit may contribute as much as 20g of sugar in a 200ml glass of juice (Source V Rao).

Sugar-free

For obvious reasons the food products with this label are most popular among those consumers with relation to diabetics, In order for a product to be labelled as sugar-free, it shouldn’t contain more than 0.5g of naturally occurring or added sugars per serving. The point to ponder here is that artificial sweeteners or sugar alcohols should be excluded in this 0.5g. Before buying products with a sugar-free label on the packaging always have a look onto the above mentioned parameter. Scan the ingredients to check if other sources of sugar are on the list. If there are other ingredients like artificial sweeteners or fructose, know that they will contribute to your total calorie intake from that product. Common foods that carry this claim are chewing gums, syrups, candies and juices.

In order to meet the regulations laid down by authorities like FDA in the US and FSSAI in India, food manufacturers add sweetening agents like sugar alcohols (also called polyols) to the product. Sugar alcohols have a chemical structure that partially resembles both sugar and alcohol, hence the name. However, they do not contain any alcohol. By adding these substances, they can make the product sweet and at the same time reap the benefits of adding labels like ‘no added sugar’ or ‘sugar-free’ on the product. These substances are either natural or artificial, have the same or higher sweetness quotient and are lower in calories. These products are as palatable as any regular sugary processed food. They also work as a bulking agent in the product, but provide you with almost no nutrition. Erythritol, Isomalt, Maltitol, Mannitol, Sorbitol, Xylitol are the most commonly used sugar alcohol additives. Occasional consumption of artificial sweeteners and sugar alcohols is comparatively okay, however excessive consumption of these products should be avoided because the products are definitely low on calories and could help one’s transition from a regular sugary diet to one with reduced sugar, but they do have a flip side to them.

• If you are a diabeticor you are on a keto diet, you need to watch out for polyols, as these substances are essentially carbohydrates and will set your sugars off. You may consume these under the impression that they are helping to keep your sugars in control or supporting your keto diet. But, sugar alcohols like Isomalt, Maltitol, Mannitol etc. can contribute to anywhere between 1.5kcal to 3 kcal/gm. (V.Rao)
• Over consumption of products with sugar alcohol could have a laxative like effect and you may experience gas, bloating and diarrhea. (V.Rao)
• Most of these sweeteners are way higher on the sweetness index as compared to natural sugar. Overconsumption of these can impair the sweet receptors in the body due to over-stimulation. Consequently, you will not find sweet foods sweet enough and will have to add extra sugar. It will also hamper your tastes for naturally sweet foods like fruits and certain vegetables. (V.Rao)
• There’s also a psychological angle to this. If you think you have controlled your calorie intake through the day because you had more of “Sugar-free” foods, you may be tempted to reward yourself by having extra servings of other sweet foods. This could be especially detrimental to diabetics. Teens tend to binge on colas because they believe that choosing the diet version makes it less harmful, and they end up consuming much more than they usually would. (V.Rao).

Sugar Substitutes available in market

{Saccharin (Sweet-n-low), Aspartame (NutraSweet, Equal), Acesulfame potassium (Sunett), Sucralose (Splenda), Stevia (Pure Via, Truvia)}. Artificial sweeteners, also called sugar substitutes, low-calorie sweeteners or nonnutritive sweeteners, offer the sweetness of sugar without the calories. Artificial sweeteners are many times sweeter than sugar, so it takes a smaller amount to sweeten foods. This is why foods made with artificial sweeteners may have fewer calories than those made with sugar. Sugar substitutes don't affect your blood sugar level. In fact, most artificial sweeteners are considered ("free foods") foods containing less than 20 calories and 5 grams or less of carbohydrates because they don't count as calories or carbohydrates on a diabetes exchange. However, those other ingredients in foods containing artificial sweeteners can still affect your blood sugar level. Some studies have found that the benefits of substituting sugar-sweetened food and beverages with those that have been sweetened artificially may not be as clear as once thought. This may be especially true when artificial sweeteners are consumed in large amounts. One reason may be a "rebound" effect, in which some people end up consuming more of an unhealthy type of food because of the misperception that it's healthy because it's sugar-free. Also, be cautious with sugar alcohols including Mannitol, sorbitol and xylitol. Sugar alcohols can increase your blood sugar level. And for some people, sugar alcohols may cause diarrhea (Source Journals).

Regulations by Food Authorities

The Food Safety and Standards Authority of India (FSSAI) have spelt out the meaning of these terms in the Food Safety and Standards (Advertising and Claims) Regulations, 2018 (the ‘Regulations’) which govern advertising and claims made by food business operators, to prevent consumers from being misled. A “claim” is any representation which is printed, oral, audio or visual and states, suggests, or implies that a specific kind of food/ food product has particular qualities relating to its origin, nutritional properties, nature, processing, composition or otherwise.

• Interestingly, as per Schedule I of the FSSAI Regulations, a ‘Sugar-Free’ product is one, which contains not more than 0.5 g of sugar per 100 g for solids or 100 ml for liquids. Thus, the product may not be with zero-sugar at all, as is presumed by a majority of people.
• As Per Schedule II of the FSSAI Regulations, the FSSAI has permitted certain synonyms, which may be used by Food Business Operators for claims defined in the Regulations, as long as there is no change in the intent and meaning of the claim. For the word ‘Free’, the words ‘Zero, No, Without, Negligible Source’ can be used. This, therefore, means that products claiming to be ‘Sugar-Free’ can actually claim to state ‘No Sugar’ or ‘Zero Sugar’ or ‘Without Sugar’ although they may well contain up to 0.5 g of sugar per 100 g for solids or 100 ml for liquids. This would not only be grossly misleading, but could create a health hazard. On the other hand, a product claiming to have ‘Low Sugar’ contains not more than 5 g of sugars per 100 g for solids or 2.5 g of sugars per 100 ml for liquids. When a brand makes a claim that its product has ‘No added sugar’ in it, it is claiming that no sugar or sugar containing products have been added during processing/ manufacturing the food item. However, that should not lead one to conclude that the food product is sugar-free.
• The FSSAI has mandated that where claims regarding the non-addition of sugars are being made, where sugars are naturally present in the food, in advertisements and packaging, the following indication should also appear on the packaging ‘CONTAINS NATURALLY OCCURING SUGARS’. It is advisable to look beyond the claims on the labels on the front of the packaging, and always look at the label on the back. The nutrition facts provided there will enable you to make an informed decision based on your needs and your preferences. Consuming excess sugar may lead to a raft of health issues, ranging from a rise in blood sugar levels, sudden drop and inflammation in the body to chronic illnesses like heart problems and diabetes, trouble in concentration, mood swings, etc. It is no wonder then that many individuals who want to avoid consuming sugar in its sucrose form, opt for alternatives such as artificial sweeteners. Amongst the most popular kinds of alternative used are Stevia (extracted from the stevia plant in South America, which is virtually calorie-free), Xylitol (a sugar-alcohol, lower in calories than sugar), Yacon syrup (derived from plants in South America), Aspartame (artificial non-saccharide sweetener 200 times sweeter than sucrose), Sucralose (an artificial sweetener made from sugar), Saccharin (an artificial sweetener with effectively no food energy, about 300–400 times as sweet as sucrose but has a bitter or metallic aftertaste, especially at high concentrations), Neotame (a non-caloric artificial sweetener, 8000 times sweeter than sucrose), and Acesulfame potassium (calorie-free sugar substitute). Some commonly known brands are Equal (Aspartame), Splenda (Sucralose), E950 (Acesulfame potassium). One should consume them (if at all) with care, as certain artificial sweeteners have recently be known to be harmful for the health, as they can raise one’s blood sugar levels more than sugar.

Note: (The author is an Aspiring Food Technologist/Writer and opinions expressed in this article are based on scientific research carried by scholars, and has nothing to do with the organization he works for).