“Sugar is poison at the right dose,” says Mark Hyman, MD, in Food: What the Heck Should I Eat?. “Most adults consume an average of 22 teaspoons a day, and kids consume up to 35 teaspoons.”
Most humans have a sweet tooth, and we’re well familiar with how easy overeating sugary foods can be. For years, manufacturers positioned artificial sweeteners like saccharin, aspartame, and sucralose as the ideal guilt-free alternative to sugar. With artificial sweeteners, you could supposedly enjoy all of sugar’s sweetness without the calories and its detrimental side effects.
Recent studies reveal the darker side of artificial sweeteners — how they might not be the cure-all solution for weight loss or a safer alternative to people with diabetes and other blood sugar issues. Some people complained about migraines or other side effects after they consumed an aspartame-sweetened soda or ate cookies sweetened with sucralose.
Over time, accumulating research revealed that artificial sweeteners aren’t a free pass and could even create weight gain, gut imbalances, and other health problems. Studies appeared with titles like “Gain weight by ‘going diet?’” or “Artificial sweeteners and the neurobiology of sugar cravings.” It turns out that artificial sweeteners probably aren’t that free pass after all.
What’s the Alternative to Sugar and Artificial Sweeteners?
If sugar is bad for you and artificial sweeteners are potentially worse, what’s the solution to satisfy your sweet tooth? Manufacturers have skillfully positioned natural sweeteners as that healthier alternative. Many (but not all) of these sweeteners, which you’ll find at your health food store or local grocer, don’t carry problems associated with artificial sweeteners. They may even be able to provide certain nutrients or benefits table sugar can’t provide. Emphasis on may. Natural sweeteners fall under a broad category, and some are better than others. A few examples include:
- Honey: Perhaps the original go-to healthy table sugar alternative, honey, has been used for thousands of years for its medicinal and therapeutic benefits. It provides small amounts of proteins, enzymes, amino acids, minerals, vitamins, and antioxidants. However, honey still breaks down to the same simple sugars (glucose and fructose) as regular sugar and therefore carries similar adverse effects as table sugar. Clever marketing surrounds honey, and you might not be buying what you think you’re getting. If you opt for honey as a sweetener, research the company, preferably look for raw, organic, unfiltered honey, and treat it like sugar.
- Molasses: This is another old-school sugar alternative that can actually provide some health benefits. “Molasses is the by-product of sugar refining that contains all the nutrients from the raw sugarcane plant,” says Jonny Bowden, PhD, in The 150 Healthiest Foods on Earth. He recommends blackstrap molasses, which contains the lowest sugar content of the molasses, but with many more nutrients found naturally in the sugarcane plant. As with honey, treat molasses as a slightly more nutrient-dense form of sugar; which is to say, use it sparingly.
- Coconut sugar: Coconut in all its many forms — oil, butter, milk, and flour — has a stellar health reputation. Unfortunately, coconut sugar doesn’t make the pass. Besides providing a few nutrients, coconut sugar has essentially the same chemical makeup as table sugar. That doesn’t make it bad, but treat organic coconut sugar like you would regular sugar.
- Agave: Agave contains up to 90 percent fructose, the most metabolically damaging sweetener. Table sugar, on the other hand, contains about equal amounts of fructose and glucose. “Agave nectar, which sounds like it should be good for us, is almost pure fructose, a giant metabolic red flag,” says Hyman. “Even raw cane sugar has more going for it.” In other words, despite its healthy glow, skip this one.
- Monk fruit: This zero-calorie sweetener, which has become increasingly popular, comes from a small fruit native to Asia that has been used as a sweetener and therapeutically for centuries. Monk fruit carries some health benefits including normalizing inflammation levels.
- Yacon syrup: Derived from the roots of the yacon plant, yacon syrup provides a rich source of the prebiotic fiber fructooligosaccharides (FOS). Studies show FOS can increase satiety to help manage weight, as well as conditions like diabetes. MaxLiving Essential Bars contain small amounts of yacon syrup.
With a few exceptions (such as monk fruit), most of these natural sweeteners behave like regular sugar and contain some calories. Natural sugar alternatives, on the other hand, taste sweet and provide some nutrients while having very few or zero calories. The most popular ones include sugar alcohols and stevia.
Researchers define these sweeteners as, “compounds which have a sweet taste and contain no calories or those which sweetness is so intense so can be used at very low concentrations, thus, their impact on the total caloric value of the product is negligible.” You’ll find these sweeteners at many health food stores and even conventional supermarkets, and the right ones can provide health benefits while enjoying the pleasure of sweetness without the problems of sugar and artificial sweeteners.
Sugar alcohols, also called polyols, are naturally occurring zero- or very-low-calorie sweeteners include sorbitol, xylitol, mannitol, lactitol, maltitol, and erythritol. Your body cannot metabolize sugar alcohols so you mostly excrete them in urine. Researchers find they have a minimal (if at all) impact on blood sugar and insulin levels, making them ideal for people with blood sugar imbalances or type 2 diabetes. Among the healthiest sugar alcohols are erythritol and xylitol:
- Erythritol. Whereas artificial sweeteners like sucralose are often many times sweeter than sugar, ounce-for-ounce erythritol carries about 60–80 percent of sugar’s sweetness. Erythritol works as an antioxidant, and one study found it helps maintain and improve oral health better than sorbitol and xylitol. “As sugar alcohols go, there’s one that may be better than the rest,” says Hyman. “Erythritol is… the only sugar alcohol that doesn’t cause digestive distress because your intestines absorb it rather than sending it to your colon to ferment and cause trouble.” Hyman notes that erythritol also won’t raise your blood sugar or insulin levels. “There seems to be only one problem,” he continues. “New research links it to weight gain because it can be absorbed and metabolized. Sorry, no free lunch, or free cookies, as the case may be.”
- Xylitol. Xylitol powders typically are extracted from birch wood or even corn. Researchers first discovered its oral health benefits decades ago, and in 1975 the first xylitol-sweetened chewing gum that promised to help reduce cavities and improve oral health appeared in Finland. Among its benefits, xylitol increases saliva production and improves breath odor, making it an ideal sweetener for gums and breath mints. Unfortunately, many manufacturers use artificial sweeteners or the less expensive sugar alcohol sorbitol in these products. One meta-analysis concluded that xylitol could indeed support oral health and potentially prevent dental caries. To get those benefits, though, you’ll probably need more xylitol than gums or other oral products contain — research shows that you need one to 20 grams of xylitol daily for cavity protection and optimal oral hygiene. Xylitol has a pleasant sweetness ideal for baking or anywhere you use sugar. Be aware: even tiny amounts of xylitol can be fatal for dogs.
While some products contain small amounts of xylitol or erythritol, most commercial foods and beverages contain maltitol, one of the biggest sweetener offenders for gastric distress including gas, bloating, and diarrhea. Actually, any sugar alcohol can create these problems because they are not digested until they reach your colon, which has a field day fermenting them (hence the gastric side effects). A little xylitol, erythritol, or other sugar alcohol goes a long way. Some products contain excessive amounts (which can cause gastrointestinal issues), so always read ingredients and labels to know how much you’re getting.
You can find xylitol or erythritol in packets or a powder, but be aware some commercial brands combine these sugar alcohols with undesirable ingredients like dextrose (sugar). Always read labels and look for an organic powder that contains no other ingredients. Taste is subjective, and some people might not find xylitol or erythritol pleasant. Worth repeating: a little of these sugar alcohols goes a very long way.
Another popular natural sweetener is stevia, extracted and purified from the Stevia rebaudiana Bertoni plant, native to South America where it has been used as a sweetener for hundreds of years. Stevia is about 200 times sweeter than sugar, with minimal, if any, impact on blood sugar levels. In fact, research shows stevia can have therapeutic benefits including lowering blood glucose and normalizing blood pressure, potentially making it an ideal sweetener for people who want to manage their weight or type 2 diabetes.
Other studies find stevia can support gut health, help manage inflammation, and potentially inhibit cancer cell growth. Stevia even proves an effective agent against B. burgdorferi, the bacteria that causes Lyme disease.
Is stevia safe? While used for centuries throughout the world for its potential therapeutic properties, early studies suggested the sweetener may cause cancer, and stevia was banned in 1991. More recent evidence refuted this initial study, and in 1995, the FDA allowed stevia to be sold as a supplement, but not a sweetener.
So how can manufacturers market stevia as a sweetener? Most stevia you buy is actually Rebaudioside A, an isolated chemical in stevia that you’ll find in branded products including Truvia®. While the FDA has approved these high-purity steviol glycosides as safe, they have not approved stevia leaf and crude stevia extracts.
As with sugar alcohols, buying stevia can become especially confusing because they rarely just contain that sweetener. Stevia in the Raw®, a commercial brand of stevia, ironically contains dextrose (sugar) as its first ingredient. Truvia® combines stevia with erythritol and dubious natural flavors, while Splenda® Naturals combines erythritol with stevia leaf extract. Combining sweeteners is more cost-effective and “bulks up” the tiny stevia molecule.
If you’re looking for a stevia powder, find a product that contains only that sweetener (such as 100 percent pure organic stevia leaf extract). The only way to truly know what you are getting is by reading the ingredients. Do not pay attention to what the label promises. Meaningless terms like “all-natural” could include lactose, dextrose, or other undesirable additives. Because pure stevia cannot be labeled a sweetener, you might find these products in your supplement aisle. A tiny bit of stevia goes a long way, and using too much can create a bitter taste. Some people complain that stevia has an awkward aftertaste. While stevia in small amounts is safe for most people, those on certain medications (including blood-pressure and cholesterol-lowering drugs) should talk with a healthcare professional before using stevia.
What’s the Healthiest Sweetener?
Simply put: there is no perfect sweetener, even if some natural sweeteners (including stevia) can potentially provide health benefits. A better solution is to learn to appreciate the natural sweetness in foods like berries, vegetables, and nuts.
“There’s only one long-term solution to the sugar problem: We all need to wean ourselves off sweetness as much as possible,” says Hyman. “As long as we keep eating sweets, we’ll keep wanting more. Learning to live without them may take some time. It requires cultivating an appreciation for all the other tastes that make food so delicious—the savory, the sour, even the bitter. But it’s possible.”
Some people discover a newfound awareness of sweetness after they reduce or eliminate added sweeteners, realizing how overstimulated their taste buds became by using them. At the same time, some foods and beverages taste better with a little sweetener. You may want to, occasionally, enjoy a healthy snack that contains added sweeteners. On those occasions, small amounts of pure stevia, erythritol, or xylitol should be perfectly fine for most people, although please check with your healthcare professional with any specific concerns.
Alternately, you might choose products that contain a small amount of raw organic honey or yacon syrup. These are fine too. Just remember to treat these sweeteners as you would sugar and enjoy them moderately.