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Stroke Smart Magazine

January/February 2008

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The Debate on Sweeteners

by Jonathan Bitz

Sugar has become a bad word. We all love it, but we try to limit or avoid it because it will make us fat. We use sugar substitutes — the pink and blue and yellow packets — but we heard they too have their dangers.


So what's the answer? Simply put: Sugar is not that bad, in moderation. Neither are sugar substitutes. The key for many stroke survivors and everybody else: how many calories taken in compared with how many are burned each day.


After a stroke, a survivor's body does not burn calories in the same way, in part because of “fidget factors,” or small movements we make each day. These movements, which include crossing and uncrossing our legs, tapping our fingers and other forms of fidgeting, help us burn calories. A stroke can result in lifestyle changes that include a decrease in fidgety behavior. This unforeseen change may accelerate weight gain.


Another accelerator of weight gain, according to Deb Vevea, RD, CDE, at North Memorial Medical Center in Minnesota, is the consumption of empty calories — in the form of sugar. The biggest offenders are often high-sugar beverages such as soda and juice.


The key for Vevea is moderation. Her rule is, “don't cut it out. Cut it in half.” A teaspoon of sugar in your coffee is acceptable. Three tablespoons is not.


In moderation, sugar is a healthy part of our diet. In fact, our bodies were designed to consume sugars. We have sweet sensing taste buds on our tongues.


But for diabetics and stroke survivors concerned with weight gain, sugar may not be the best choice. Instead, sugar substitutes can be effective. According to Vevea, sugar substitutes do not raise blood sugar levels. Substitutes such as Saccharin (Sweet 'N Low®), Aspartame (Equal®) and Sucralose (Splenda®) contain few or no calories and don't count as carbohydrates. Yet they are 180 to 600 times sweeter than sugar.


As for the concern that these products cause cancer, well, that's just a myth. According to the May 2006 issue of Dietician Journal, the 1960s Saccharin research that made this claim was poorly conducted. Later research found that these claims were inaccurate and that Saccharin is, in fact, safe for the consumer. All sugar substitutes in use have been approved by the Food and Drug Administration.


Life after stroke often calls for changes — from how you get around to what you eat. But while changes may be necessary, they don’t have to be severe. According to Vevea, survivors just need to manage sugar intake reasonably and responsibly, in line with their specific needs, sometimes with the help of a nutritionist, and preferably supported by caregivers and others in their lives. 

What you need to Know:



Sugar Free

Less than 1⁄2 gram of table sugar, but may contain other sugars.

No Sugar Added

No sugar has been added during processing, including ingredients

Calorie Free

< 5 calories per serving.

Low Calorie

< 40 calories per serving.

Reduced or Less Sugar

At least 25% less sugar than the regular food.

Reduced or Lower Calorie

At least 25% fewer calories than the regular food.

Light or Lite

1/3 less calories or 50% less fat than the regular product.


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National Stroke Association’s mission is to reduce the incidence and impact of stroke by developing compelling education and programs focused on prevention, treatment, rehabilitation and support for all impacted by stroke.

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