Written by Eng Jing Yuan & Andy Tan, AA Pharmacist.
All About Sugar
Sugar:
Your regular table sugar sucrose, also conventionally used to describe monosaccharide and disaccharide.
Sugar substitutes:
Any other sweetener other than sucrose as shown in Table 1.


Some Good-to-know Facts:
1. CHECK your food label!
i. No Sugar or Sugar-free
The product does not contain sugar (sucrose) at all, though it may contain sugar alcohols or artificial sweeteners. It also means this product has sugar content of less than 0.5 g per 100 g or 100 ml of food.
ii. No Added Sugar
During processing, no extra sugar was added. However, the original source might have contained sugar, such as fructose in fruit juice. Additional sweeteners such as sugar alcohols or artificial sweeteners also might have been added.
iii. Low in Sugar
This refers to food products with a sugar content of less than 5 g per 100 g of food.

Jam Labelled "No Sugar Added"
Example 1: Example of food labelled as ‘no sugar added’ and its ingredients showing the use of sorbitol as sweetener.

Drink Labelled "Zero Sugar"
Example 2: Example of drink labelled ‘zero sugar’ while using aspartame and acesulfame potassium as artificial sweetener and its nutrition facts showing 0% total sugar.
2. Where can you find sugar substitutes?
You can find them in processed foods, including baked goods, soft drinks, powdered drink mixes, candy, canned foods, chewing gums, candies and dairy products. These products are often marketed as ‘sugar-free’ or ‘diet’.
3. Recommends from WHO
WHO recommends that additional sugar be limited to not more than 10% of our daily energy consumption. Hence, the average amount of additional sugar intake for adults inclusive of hidden sugar should not exceed 10 teaspoons a day (50g).
4. Artificial sweeteners: a ‘sweet’ alternative for people with diabetes?
It is a challenge for diabetics to regulate their blood sugar levels as they often have to limit sugar intake in their diet. However, by substituting sugar with artificial sweeteners, they too can enjoy a varied diet. Some sugar substitutes release energy, but are metabolized more slowly, allowing blood sugar levels to remain more stable over time.
5. Can artificial sweeteners be used in cooking/baking?
Generally, sucralose, saccharin and acesulfame potassium are heat stable and suitable to be used in cooking. Aspartame however is not heat stable and loses some of its sweetness at high temperature. It is also important to note that baked products using artificial sweeteners may be lighter in colour because they lack of the caramelizing/ browning effect of real sugar. Stevia extract is heat stable, therefore can be used in cooking/baking too.
6. The form of sugar substitutes
Keep in mind that the use of any form of sugar substitutes should also be in moderation although they are considered generally safe to be consumed.
References:
- Mayo Clinic Staff (20/08/2015) Artificial sweeteners and other sugar substitutes, Available at: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936 (Accessed: 19 April 2018).
- U.S. Food and Drug Administration (02/08/2018) Additional Information about High-Intensity Sweeteners Permitted for Use in Food in the United States, Available at: https://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397725.htm(Accessed: 19 April 2018).
- U.S. Food and Drug Administration (12/19/2017) High-Intensity Sweeteners, Available at: https://www.fda.gov/Food/IngredientsPackagingLabeling/FoodAdditivesIngredients/ucm397716.htm(Accessed: 19 April 2018).
- Kirtida R. Tandel. ‘Sugar substitutes: Health controversy over perceived benefits’,Journal of Pharmacology and Pharmacotherapy. 2011 Oct-Dec; 2(4): 236–243. [Online]. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198517/ (Accessed: 19 April 2018).
- Ministry of Health Malaysia. (14/04/2018) Facts about sugar. Available at: http://www.myhealth.gov.my/en/facts-about-sugar/ (Accessed: 29 April 2018).
- Maria Sofia V Amarra , Geok Lin Khor , Pauline Chan (2016) ‘Intake of added sugar in Malaysia: a review’, Asia Pacific Journal of Clinical Nutrition, 25(2), pp. 227-240.
- American Diabetes Association (31/01/2014) Using Sugar Substitutes in the Kitchen. Available at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/understanding-carbohydrates/artificial-sweeteners/using-sugar-substitutes.html (Accessed: 29 April 2018).