Living With Chronic Pain

Sweeteners Can Increase Pain Symptoms

We all know that eating healthfully is important. Different foods can increase inflammation and impact our pain- for better or worse. Food is medicine and fuel for the body. Just as our cars are affected by the quality of the fuel we use, so too are our bodies. That’s why it’s important to be aware of which foods cause inflammation and needlessly increase pain. 

Sugar is one of the leading causes of inflammation because it promotes the release of cytokines. While these proteins can be either pro or anti-inflammatory cytokines, sugar causes the release of the pro-inflammation variety. This is because our bodies have difficulty processing artificial ingredients and it sees sugar as a toxin or foreign body that needs to be attacked and then expelled. This triggers an immune response, causing inflammation.

Research in the 1970’s and 1980’s cast doubt on the safety of some artificial sugar substitutes, but since then, reviews of the data from these studies have called these results into question. Natural sweeteners aren’t off the hook either: Some, like agave, are charged with being too processed, while others are no different calorically and metabolically than sugar. If you think you can eliminate sugar and its impact on pain by switching to an artificial sweetener, they may be far worse.


Sugar 

Sugar has many negative effects on the body that make maintaining control more difficult. It depletes important minerals, upsetting overall mineral balance which leads to a build-up of free-radicals in the bloodstream. This, in turn, results in a decrease in the amount of oxygen in the body’s tissues and an increase in free-radical damage. Both conditions can worsen degenerative conditions like arthritis since free radicals are a common cause of inflammation. Sugar also can depress or even paralyze the immune system, making it harder to fight disease, and inflammation. 

Artificial sweeteners 

And while it may seem reasonable to just substitute a sweetener for the real thing, multiple studies have shown a direct association between artificial sweeteners with inflammation and swelling in the joints. Even minimal use can cause increased pain which makes it all the more concerning since over 4,000 products incorporate one in particular into their products today – aspartame. Substitutes are often hidden in processed food, condiments, and spice mixes.  

With so many products to choose from, it can be a challenge to pick the right one. Complicating the picture is that the history of some artificial sweeteners – such as aspartame and sucralose – are controversial.

Aspartame

Nutrasweet and Equal, this artificial sweetener has gotten more negative publicity than any other. Rumors and concerns about aspartame causing a number of health problems, including cancer, have been around for many years. Some of the concerns about cancer stem from the results of studies in rats published by a group of Italian researchers, which suggested aspartame might increase the risk of some blood-related cancers (leukemias and lymphomas). The results of epidemiologic studies (studies of groups of people) of possible links between aspartame and cancer (including blood-related cancers) have not been consistent. It was approved by the FDA in 1981, and is regularly used in a wide variety of food products because it is 200 times sweeter than table sugar – so a little goes a long way.

People with a rare hereditary disease called phenylketonuria, a rare hereditary disease, may have difficulty metabolizing a phenylalanine, one of the components in aspartame. If the person consumes this substance, the body doesn’t digest it properly, and it can accumulate- essentially working as a neurotoxin to their brain. Still, people without the disease may experience sensitivity to aspartame and experience headaches and migraines. Its seen as a foreign object in the body so the immune system immediately begins attacking it, which leads to inflammation and pain that can last for days. 

In some people, aspartame consumption may result in:

  • Joint pain
  • Headache
  • Mood swings
  • Nausea and vomiting
  • Fatigue
  • Muscle aches
  • Insomnia
  • Abdominal pain

Sucralose

Splenda has the catchphrase “tastes like sugar… because it’s made from sugar.” Right there, warning bells should go off. This sweetener is rated at 600 times sweeter than sugar and has one gram of carbs per teaspoon (or packet) – so if you consume enough of it, blood glucose levels will be elevated. Some people will use such high amounts of it thinking since it’s “calorie free” that they can use as much as they want – but this is entirely incorrect thinking. Even the calories will add up when used in excess. 

People that consume sucralose may experience:

  • Inflammation of the face
  • Headaches
  • Migraines
  • Rashes
  • Palpitations
  • Joint pain

Saccharin

Sweet ‘N Low, is 300 – 500 times as sweet as sugar and by itself has no impact on blood sugar levels. The downside to this sweetener, however, is that it will leave a rather unpleasant metallic-like aftertaste in your mouth. A study from 1977 found that it may have caused cancer in rats, which left many questions about its safety; the FDA allowed it to hit the shelves with a warning label stating the potential cancer risk.

But, that warning label is no longer needed, says Ruth Kava, PhD, RD, director of nutrition for the American Council on Science and Health. Further research has shown that male rats have a particular pH factor that predisposes them to bladder cancer. What may be true for male rats does not necessarily hold true for humans (or even for female rats); hence, no more warning labels for saccharin. “A lot of things that cause harm in animals don’t always cause harm in humans,” she says. You’ll have to decide for yourself if you feel safe putting it into your body. Recent research shows of all the artificial sweeteners it has the least inflammatory effect.


Natural sweeteners

Novel sweeteners

Stevia, along with trehalose, tagatose, stevia, and others, falls into the category of novel sweeteners. Novel sweeteners comprise a loosely defined grouping that includes sweeteners that, while providing differences in sweetness and caloric content, are derived from natural sources. Stevia has no effect on blood sugar levels and zero calories, so it does not promote weight gain. It is available as a dietary supplement (as opposed to a sweetener) and has no vitamins or minerals. It is rated as being 300 times sweeter than regular sugar.

Stevia is the most researched of the novel sweeteners because of its popularity in foods. Studies have found that Stevia supports healthy blood pressure. Similarly, Stevia supports processes in the body that mitigate such conditions as obesity, diabetes, and imbalanced cholesterol profiles. As with any ingredient, over-consumption has its drawbacks, and Stevia can interact with certain medications, so it is important to discuss with a doctor before consuming the product.

While purified steviol glycosides can be added to foods and are generally recognized as safe (GRAS) by the Food and Drug Administration, the same is less true of whole leaf stevia as well as crude Stevia Extracts, which have not been approved by the FDA as novel sweeteners.

Sugar alcohols

Some variations of sugar alcohols include mannitol (similar in taste/flavor to sugar), sorbitol (commonly found in sugar-free foods and drinks), xylitol (often found in chewing gums), lactitol, isomalt, maltitol and hydrogenated starch hydrolysates (HSH). They are not easily absorbed through the digestive tract and can cause gas, diarrhea, headaches and other ailments (you can read more here).

Agave nectar and honey

Raw, unprocessed, organic honey is the preferred form. It is a potent antioxidant, antibacterial and a nutritional powerhouse. Honey contains glucose, fructose and numerous minerals including calcium, iron, phosphate, copper, sodium chloride, magnesium, manganese and potassium. It also contains vitamin B6, niacin, riboflavin, thiamin, pantothenic acid and many amino acids. The great news? Honey may alter anti-inflammatory and immunostimulatory mediators, leading to inhibition of pain. 

It is a wonderful natural sweetener. But use cautiously since it does raise blood glucose levels and contains quite a few calories. Other than dental decay, it has not been linked to other serious health issues. It is probably the safest sweetener to use.

Agave nectar (even organic) is made by exposing the agave juice to high heat and breaking it down into fructose, with some agave nectars having levels as high as 90% fructose- compared to just 50% for table sugar and 55% for the often-criticized high fructose corn syrup. The way in which agave sweetener is made, using heat and enzymes, destroys all of its potentially beneficial health effects. The end product is a highly refined, unhealthy syrup.


There’s no question sweeteners in any form aggravate pain. They are a foreign toxin the body tries to dispel resulting in a slew of medical issues. Work to limit your intake and monitor how you feel as you decrease the amount of sweeteners in your diet. You may be surprised in the difference you feel.


-arthritis.org/health-wellness/healthy-living/nutrition/foods-to-limit/sugar

-pubmed.ncbi.nlm.nih.gov/17711612/

-cancer.org/cancer/cancer-causes/aspartame.html

-healthline.com/health/food-nutrition/agave-nectar-vs-honey#sugar-components

-ncbi.nlm.nih.gov/pmc/articles/PMC3043331/

-health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030

-mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936

-arthritis.org/health-wellness/healthy-living/nutrition/foods-to-limit/8-food-ingredients-that-can-cause-inflammation

-healthydirections.com/foods-that-cause-inflammation

-sciencedirect.com/science/article/pii/B9780128051863000102

-researchgate.net/publication/313351539_Honey-A_Natural_Remedy_for_Pain_Relief

-medicalnewstoday.com/articles/319837#who-should-not-use-stevia

-thorne.com/take-5-daily/article/the-science-behind-sugar-alternatives

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