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Published on June 09, 2020

close-up of sweetener packets in container

Is There an Ideal Substitute for Sugar?

Sugar has always been a hot topic in nutrition, but even more so in this era of paleo and keto dieting. Even the Atkins Diet is returning.

Sugar and its role in food is also becoming an increasingly complicated topic, because the types and number of sugar substitutes are changing. I think the best place to start is with a look at the vocabulary. Let’s look at a few key ideas:

Artificial Sweeteners

Synthetic sugar substitutes, often referred to as intense sweeteners, are many times sweeter than regular table sugar. Although they are “synthetic,” artificial sweeteners are often derived from things like herbs or sugar itself. Artificial sweeteners add little to no calories, and examples include saccharin, acesulfame k, aspartame, sucralose and neotame.

Sugar Alcohols

These are also known as polyols, and they occur naturally in certain fruits and vegetables, but they can also be manufactured. Don’t be thrown by the name: they are not alcoholic. Sugar alcohols are about the same or slightly less sweet than regular table sugar. They do contribute some calories, but not as many as regular sugar. Examples of sugar alcohols are sorbitol, mannitol, erythritol and xylitol.

Novel Sweeteners

This term can be used to describe some of the newer sweeteners that don’t quite meet other definitions, like tagatose and some forms of Stevia.

Natural Sweeteners

Natural is often used to describe fruit juices, nectars, honey, molasses and maple syrup. Nutritionally they are very similar to regular table sugar and are processed by the body in the same way.

Nutritive and Non-Nutritive Sweeteners

When a sweetener provides significant calories, like regular table sugar, high fructose corn syrup and other natural sweeteners, they are known as nutritive. Sweeteners that provides little to no calories, like artificial sweeteners and sugar alcohols, are called non-nutritive.

What You Should Consider

Sadly, I have to point out that any added sugar or sweetener is completely non-essential in the diet. So regardless of what color sweetener packet you pick – be it white, blue, pink or yellow –moderation is key.

It’s well-researched that diets high in sugar are linked to type 2 diabetes, high blood pressure, heart disease, stroke, certain cancers and fatty liver disease. That’s why it makes sense that when we switch to sweeteners with fewer calories, it can result in weight loss and reduce health risks.

But the research isn’t finding those results. In a study that compared people who drank water and diet soda, the diet soda drinkers were much more likely to become overweight or obese. We don’t really know why, but one theory is that consistently overstimulating taste buds with artificial sweeteners leads to more cravings. Studies on sugar substitute use have shown similar risk for metabolic syndrome, stroke and type 2 diabetes as regular sugar use.

Organizations like the Academy of Nutrition and Dietetics and the American Heart Association take positive stances on sugar substitutes. However, they do strongly encourage moderation. Substitutes should be a step toward less or no sugar. When a regular soda drinker goes to diet soda, the ultimate goal should be water, be it unsweetened, flavored or carbonated.

Using sugar substitutes in moderation has minimal risk. Some may complain of stomach upset, bad aftertaste or headaches when they eat some artificial sweetener, but it varies. Large amounts of sugar alcohol can have a laxative effect, but they are often used in chewing gum because they reduce tooth decay. The FDA has developed acceptable daily intakes for many of the sugar substitutes. 

An Ideal Substitute

No, there’s no perfect substitute, in part because sweetened beverages and bakery items will never be ideal choices for our health, regardless of the calorie content. A large European study recently concluded that there were no clear health benefits from using sugar substitutes. It also said there were no clear differences in health outcomes between people who used sugar substitutes often or not at all.

My take away: if using any sugar substitutes in moderation can help you cut calories and serve as a stepping stone to better food choices, then I think you should use them.

For example; transitioning your breakfast from a heaping bowl of “Sugar-Os” to a half-cup of oatmeal with cinnamon and a pack of artificial sweetener is a great idea. But I wouldn’t start snacking on diet soda and sugar-free brownies thinking it is the answer to a health problem.   

Lauren Cornay, RD, LN, is a registered dietitian at Avera Heart Hospital

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