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Sweet without the Sugar: Too Good to Be True?

Sugar has come under fire in recent years. The substance that makes a lot of our food sweet and enjoyable is also linked to weight gain, dental issues and an increased risk of cancer, diabetes and heart disease. In response, alternative sweeteners have gained popularity as people seek replacements for sugar. But are they any healthier?

Generally, sugar alternatives are appealing because they offer sweetness without the calories or spike in blood sugar. However, their health impacts are still being debated. The World Health Organization recently warned against long-term use of artificial sweeteners, citing potential health risks. There are several different families of sweeteners, and each comes with its own pros and cons. Knowing the risks and benefits of each can help you make an informed decision about what’s best for your dietary and health needs.

Artificial Sweeteners

Artificial sweeteners are synthetic compounds that are often hundreds of times sweeter than sugar itself. Popular examples include aspartame (Equal), sucralose (Splenda) and saccharin (Sweet’N Low). All of these are low-calorie and have little-to-no effect on blood glucose levels. Generally, these are considered safe by the FDA, but there are claims that certain artificial sweeteners can cause cancer. Most of these claims haven’t been substantiated, however, recent research found that a chemical in sucralose is genotoxic, meaning it damages DNA within cells. There’s concern this type of damage can induce genetic activity linked to cancer, but more research is needed. In the meantime, it’s advised to avoid high amounts of sucralose.

Sugar Alcohols

Sugar alcohols (erythritol, xylitol and sorbitol) are carbohydrates that naturally occur in fruits and vegetables. These compounds aren’t as sweet as sugar and typically contain about half to one-third fewer calories. However, because they’re carbohydrates, they can still raise your blood sugar if too much is consumed. Excessive sugar-alcohol consumption can also cause uncomfortable side effects like bloating and diarrhea.

Research has shown erythritol might increase risk of cardiovascular disease. A recent study found that people with more erythritol in their blood were at higher risk for major heart problems and that the substance enhanced blood clot formation in animal subjects. Erythritol is difficult to avoid, as it’s found in many processed foods like sports and energy drinks, sugar-free candies and chewing gum, and current laws don’t require sugar alcohols to be listed on nutrition labels. However, more research is needed to determine the actual risk of erythritol and how much is reasonably safe to consume.

Novel Sweeteners

Novel sweeteners are a group of natural, plant-derived sweeteners. They are typically less processed, but still provide the same low-calorie and low-glycemic benefits of their artificial counterparts. The most popular examples of these include stevia, allulose and monk fruit extract. Generally, these are the most recommended sweeteners by dieticians and health professionals.

Natural Sweeteners

A variety of sweeteners are found in nature, such as maple syrup, honey, agave nectar, molasses and coconut sugar. These are generally regarded as healthier than table sugar, as they provide some nutrients. However, they’re still high in calories and behave like normal sugar in the body, so it’s advised to enjoy natural sweeteners in moderation.

Getting Your Sweet FIx

  • Choose whole foods whenever possible. If you’re craving something sweet, snacking on fruit may curb your craving.
  • Keep your portion – of whatever sweetener you choose – small. When you do indulge, try to limit your portion. A bowl of ice cream or a can of diet soda once in a while is unlikely to do much harm, but a pint of ice cream or six diet sodas a day isn’t advisable.
  • Skip the processed sugar-free alternatives when possible. For example, instead of reaching for a packaged diet iced tea with an unknown amount of aspartame, opt for the unsweetened version and sweeten it to your taste with your sweetener of choice. Or instead of a diet soda, try a flavored seltzer water with a bit of juice or your sweetener of choice. This way you can control how much sweetener you use and choose the one that’s best for your goals.

Weighing Your Options

People with diabetes or prediabetes may need to avoid all sources of sugar to manage their health, but sugar isn’t inherently bad for most people. Our bodies run on carbohydrates, which are turned into glucose (sugar) that’s used for fuel and energy. Removing all natural sugars and carbohydrates from your diet isn’t healthy for most groups. But when consuming desserts or sweetened beverages, you have a choice where that sweetness comes from.

The healthiest source of sugar is the natural sugar found in fruits and vegetables. That’s because these foods also contain beneficial vitamins and minerals, as well as fiber, which slows down the digestion of sugar and prevents blood-sugar spikes. Conversely, added sugar that’s found in sodas, juices and other processed foods has no nutritional benefit.

The American Heart Association recommends no more than 25 grams of added sugar per day for women and no more than 36 grams for men. For reference, 12 ounces of soda contains about 39 grams of added sugar. The Centers for Disease Control’s dietary guidelines suggest limiting added sugar intake to less than ten percent of your daily calories. So in a 2,000 calorie diet, no more than 200 calories should come from added sugars (about 50 grams). Both measures can be helpful in determining a goal for your added sugar intake.

Ultimately, sugar substitutes can be helpful to those looking to cut down their sugar intake or manage their weight in the short term, but their long-term effects on health are still inconclusive. The end goal for most people should be to consume all sugars and sweeteners in moderation and focus on eating primarily whole, unprocessed foods. Talk with your doctor to discuss your individual disease risk and what sweeteners might be best for you.

[Hannah Sabitoni]

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