DEAR DR. ROACH: I have questions regarding sugar substitutes. I have come to the overwhelming conclusion that sugar is a poison to the human body. However, I have never read any information regarding the safety of sugar substitutes. My questions are: Are they harmless to our bodies; are some safer than others; and do any benefits exist in using some over others? — J.R.K.B.
ANSWER: While I think the term “poison” is too strong, I agree that excess sugar is unhealthy and contributes to both Type 2 diabetes and to obesity. Natural sugars, such as from whole fruits, appear to be treated differently in the body from added sugars, such as those in soft drinks, sports drinks and energy drinks.
Your question is about sugar substitutes, and there are many. There’s no way to comprehensively cover them all, but let me talk about the different types.
Artificial sweeteners include aspartame (Equal, NutraSweet), saccharin (Sweet’N Low), sucralose (Splenda) and others. Most experts agree that these are safe in reasonable doses, but some people may have unpleasant reactions to any of them. Aspartame and saccharin have been linked to cancer in laboratory animals, but never in humans.
The natural sweetener Stevia also is generally welltolerated and safe.
Sugar alcohols, such as sorbitol, xylitol and mannitol, raise blood sugars somewhat and often cause cramping, gas and diarrhea if taken in large quantities or by people sensitive to their effects.
So, while all are generally safe, any can cause side effects. I don’t recommend any of them above the others, though I have seen reactions to sugar alcohols most frequently.
DEAR DR. ROACH: I have been diagnosed with Holmes-Adie syndrome. I cannot find much information on this syndrome other than that it is rare, caused by a virus or bacteria and affects the autonomic nervous system. What is the autonomic nervous system? Can you provide any information on this condition, if it will progress and what to expect? What kind of doctor treats it? — N.W.
ANSWER: The Adie pupil, also called Adie’s tonic pupil, is found when the eye loses part of its nerve supply. This causes one pupil to be bigger than the other during light exposure but smaller than the other when looking at objects close up. An Adie’s pupil usually occurs without other problems in the autonomic nervous system, but it can occur alongside other problems, such as Ross syndrome, where the Adie pupil is associated with abnormal reflexes and partial loss of sweating. Syphilis causes a similar pupil, but on both sides, in which case a test for syphilis should be done.
An eye doctor can help fit special glasses with one lens that’s different from the other to help correct the vision issues that may occur. Fortunately, most cases do not progress.
The booklet on macular degeneration explains another common eye ailment. Readers can order a copy by writing: Dr. Roach — No. 701W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med. cornell.edu.
©2014 North America Synd.