“Sugar free”

Demystifying the “sugar free” buzzword

My Feature Published in Shifa News Magazine, March 2017 edition

Sugary foods especially ‘meethai’ (sweets) are rich part of our tradition and culture. Our tea is not complete without biscuits or cake rusks, weddings or births without meethais, and our meethi Eid also remains incomplete without desserts like siwaiyan. Interestingly, the very first dish the new bride cooks at her in-laws is also a sweet dish. Unfortunately, with increase in diseases like diabetes and lack of awareness, many people have turned to alternatives like “sugar-free” foods instead of avoiding sugary foods or controlling their portion size.

54 year old Rahat Hameed is one of them. Like most housewives, she is always looking out for ways to keep her family healthy. In fact, help manage their disease better. Her in-laws are fond of sugary foods though many among them are diabetics, including her husband. Concerned about their health, she decided to switch to sugar-free products like bread, rusks, biscuits, ice cream and meethai that were easily available in the market. “My husband always kept artificial sweetener in his pocket too as he had a sweet tooth and could not give up on sugar.” Thinking them to be “healthy alternatives”, the Attock based homemaker assumed she was doing the best for her family. Being weight conscious herself, she preferred having diet drinks. “I was happy I did not need to give up on my favorite foods and still keep me and my family healthy,” says Rahat, before adding, “but unfortunately, I was mistaken.” Despite these efforts, she found her husband’s sugar levels to be high. It was only after their visit to the physician that they came to know what they were doing wrong.

Well, Rahat is just one of the many who consider “sugar-free” products to be healthy. According to Muhammad Abbas, a fitness nutritionist based in Karachi, these products actually contain sugar substitutes which are various types of sweeteners. “They make the food taste sweet but are far more harmful than eating white processed sugar.”

Dr Sohail Anjum, an endocrinologist and diabetologist at Shifa International Hospital, Faisalabad seconds that artificial sweeteners are “not good for health” and are “100 times sweeter than white sugar.”

According to him, artificial sweeteners have been hailed as the “savior of diabetics” and those with persistent weight-loss efforts. “However, they are not metabolized properly by body and have no significant effect on blood sugar.”

Moreover, sugar alone does not make a food unhealthy or harmful. “Being sugar-free does not mean they are carbohydrate or calorie free too,” explains Dr Rezzan Khan, a nutritionist at Shifa International Hospital, Islamabad.

“Besides, the chemicals in them make them harmful too,” adds Muhammad Abbas.

Like Rahat and her husband, most people wrongly believe that only sugar increases glucose level in the body. “It can also be increased by high carbohydrate and fat content in the food,” says Dr Rezzan.


Generally, people especially diabetics also lack awareness about their daily food consumption. They are therefore easily influenced by strong media drive about fancy foods labeled as, “sugar-free”, “low calorie”, “no sugar added” or “diet” while maintaining “great” taste. “These are in fact perfect recipes for disastrous events in future,” emphasizes Dr Sohail.

On the other hand, meethai makers and artificial sweetener producing companies claim the opposite. Hassan Siddique, marketing head of Sucral, a popular sweetener manufacturer argues, “we produce best alternates to sugar which are safe for all ages and genders.”

Shifa News also contacted a sweet shop Chashni based in Karachi who offer sugar-free ladoos and gulab jaman. “We add artificial sweeteners. And they are absolutely healthy and safe for diabetics.”

However, according to Dr Salma Halai Badruddin, a nutritionist and founder of Pakistan Nutrition and Dietetic Society (PNDS), sugar free foods create a “false” sense of security in mind. “Diabetics take them as “safe foods” while they are not.”

Explaining the effects of added sugars on health Dr Sohail says, they contain a whole bunch of calories with no essential nutrients. Therefore are known as “empty” calories. “When people eat up to 10-20 percent of calories as sugar, it can become a major problem and contribute to nutrient deficiencies.”

According to Dr Rezzan, sugar substitutes can stimulate appetite, encourage sweet tooth and cause one to crave more sweet and sugary foods. That means people who routinely use artificial sweeteners may start to find less intense sweet foods, such as fruit, less appealing and unsweet foods, such as vegetables, downright unpalatable. “As a result, we may crave more sweets, tend to choose sweet over nutritious food, and gain weight.”

Furthermore, they are associated with changes in gut bacteria that “lead to increased fat storage in body,” she adds further.

Experts interviewed also believe that people gradually become habitual and addictive to artificial sweeteners. “Our mind releases a ‘happy hormone’ (endorphin) when we eat sugar. So, when a diabetic takes sweetener which is 100 times sweeter, it makes them happy. This tends to make them increase its use,” says Muhammad Abbas. Naturally, excess of anything can prove to be bad.

Talking further about their harmful effects, Dr Sohail reveals that regular use of sweeteners can also make one thirstier, raise cholesterol level, and cause loose motions, insomnia and memory problems.”

Dr Rezzan says, artificial sweeteners if used in moderation can reduce calories and prevent blood sugar spikes. People should therefore beware of some of the products that contain them. “So, only very small quantities should be used to elicit the sweet taste.”

There are many artificial sweeteners in the market but most commonly used and approved by the US Food and Drug Administration (FDA) are aspartame, sucralose, saccharin, stevia, neotame and acesulfame potassium (Ace-K) and advantame.

There are many kinds of sugars that are all processed, including regular white sugar. “Their excess can overload the pancreas,” informs Dr Shahid Hameed, a diabetologist at Shalamar Hospital, Lahore. He says, though approved by the FDA, aspartame also contains chemicals and is hence not recommended particularly to the diabetics.

More than 6,000 products worldwide contain aspartame including diet drinks. “It is the first generation of sweeteners which is 180 times sweeter than sugar,” reveals Dr Sohail.  Aspartame also slows our metabolism in the long run and loads the body with fats. This means it has the same effects as that of regular sugar.

“It can also cause migraines, vision changes, nausea, depression and memory problems, changes in heart rate and even cause cancer,” informs Mahnaz Nasir, a nutritionist and dietitian at Hameed Lateef Hospital, Lahore.

FDA suggests that foods containing aspartame should have an informational label with the statement: “Phenylketonurics: contains phenylalanine.” “Individuals with metabolic disorder, phenylketonuria, should therefore avoid using it,” says Rezzan.

Another artificial sweetener is sucralose which comes under the name splenda. Most sugar-free candies, biscuits, and sweets have this sweetener. “Although it is not as harmful as aspartame but should only be used in an amount that satisfies taste buds,” adds Dr Shahid.

Saccharin is also a widely used artificial sweetener. Jams, diet drinks, canned fruits and some bakery items contain it. According to Dr Shahid, it is also “unhealthy”.

“It can have side effects similar to that of aspartame,” says Mahnaz.

Sugar is a form of carbohydrate. According to Dr Salma, it is important to understand that we can do well even without sugar for days as long as we eat carbohydrates.

Therefore, the best solution recommended by experts is to reduce sugar intake in the first place. Mind your portion instead of using sugar free products.

“Our daily intake of sugar should not be more than five percent of overall calorie counts,” suggests Dr Salma.


Use artificial sweetener only when it becomes necessary. Avoid regular sodas, sweetened tea, flavored coffee and coffee with sugar and cream, chocolates and energy drinks. “Replace them with water, unsweetened tea (add a slice of lemon), fruits and use honey as a substitute for sugar,” adds Dr Sohail.


Furthermore, always make wise buying decisions. Learn to “read labels and count calories. Educate yourself on the nutritional value of the foods you eat,” recommends Abbas. Lastly, beware about false claims and avoid products with labels such as “diet”, “sugar-free”, “no sugar added”, or “low calorie”.



Artificial sweeteners have been hailed as the “savior of diabetics” and those with persistent weight-loss efforts. However, they are not metabolized properly by body and have no significant effect on blood sugar.








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