Are Sugar Substitutes Any Better For You Than Regular Sugar?

Sugar is a carbohydrate—a necessary nutrient that can boost your mental and physical energy. But the amount of sugar you eat daily can add up quickly. Many foods and beverages contain added sugar, even condiments like ketchup and barbeque sauce.

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Too much sugar adds calories and increases your risk of heart disease, obesity and diabetes. That’s why the American Heart Association recommends women eat no more than six teaspoons and men no more than nine daily.

Many people turn to sugar substitutes to reduce sugar and lose weight without sacrificing sweetness and taste. But are they a healthy alternative?

According to Ellen Gillespie, RDN, a registered dietitian at Henry Ford Health, they can be—if you manage portion size. “Sugar substitutes may help you lose weight by reducing your overall daily calories. People with diabetes can enjoy foods with a sugar substitute with less risk of spiking their blood sugar. Some studies link sugar substitutes to health problems. But the Food and Drug Administration (FDA) has done extensive research and approves these products if consumed in reasonable amounts,” says Gillespie.

Types Of Sugar Substitutes

You can find sugar substitutes in granular or liquid form to flavor your food or drinks. Food manufacturers also use these sweeteners in various products, including diet drinks, chewing gum, baked goods and processed foods.

Most zero or low-calorie sweeteners work because they interact with the sweet receptors on our tongue. But these sweeteners are not fully processed (metabolized) by our bodies. That’s why we don’t absorb the calories.

There are three categories of sugar substitutes:

• Artificial sweeteners: Acesulfame K (Sunett®), aspartame (Equal® and NutraSweetM™) and saccharin (Sweet ‘N Low®, Sweet Twin® and NectaSweet®)
• Sugar alcohols: Erythritol (Swerve®), sorbitol, xylitol and maltitol
• Plant-based sweeteners: Stevia®, monk fruit and allulose

Benefits And Risks Of Artificial Sweeteners

There are pros and cons to eating sugar substitutes as part of a healthy diet. “If you choose to flavor your food or eat foods made with these products, do so in moderation,” says Gillespie.

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The benefits of using sugar substitutes include:

• Safe alternatives to sugar: The Food and Drug Administration (FDA) has approved all available sugar substitutes as safe for consumption.
• Fewer calories: Sugar substitutes have little or no calories. They may help you lose weight if used to replace higher-calorie natural sweeteners.
• A little goes a long way: Sugar substitutes have a higher degree of sweetness than natural sweeteners. So you can add a smaller amount to foods or drinks.
• Less likely to spike blood sugar: Sugar substitutes have less impact on blood sugar, making them a sweetener alternative for people with diabetes.

Consumption of large amounts of artificial sweeteners can carry some risks, including:

• Lack of nutritional value: Sugar substitutes are also called non-nutritive sweeteners because they don’t contain any nutrients. In contrast, when you eat a piece of fruit, you also get fiber and an array of vitamins to support your health along with the fruit sugar.
• Risks for people with certain health conditions: People with phenylketonuria (PKU), a rare genetic disorder, should avoid the artificial sweetener aspartame. These individuals cannot process phenylalanine, one of the amino acids in aspartame . People taking insulin to manage their diabetes should check with their doctor before eating sugar substitutes. This switch could lead to low blood sugar levels (hypoglycemia).
• Digestive problems: Some sugar substitutes, including sugar alcohols, can cause digestive problems. Bloating, stomach pain and diarrhea can occur because sugar substitutes are not fully digested. Sugar substitutes may also worsen symptoms of existing digestive conditions.
• Research linking sugar substitutes to other health problems: Studies have shown a correlation between health conditions such as heart disease and stroke and sugar substitutes. More recently, the World Health Organization classified aspartame as a Group 2B substance—possibly carcinogenic. Gillespie warns this listing is not cause for panic. “It’s important to view these results with some perspective. The items in Group 2B have limited evidence of cancer in humans. Many studies have not demonstrated that sugar substitutes alone cause these health conditions. The FDA has confirmed the safety of aspartame and continues to monitor the safety of all sweeteners."

Tips For Reducing Sugar In Your Diet

Whether you eat natural sugars or sugar substitutes, balance is key to a healthy diet. Eat mostly whole foods, such as fruits, vegetables, legumes and lean protein. Use fresh or frozen fruit to sweeten foods and beverages.

Read food labels to spot added sugars and track your consumption. Gillespie also suggests eliminating sugary sodas and beverages to reduce sugar in your diet. Replace them with water to stay hydrated throughout the day.

“If you have questions about whether to eat natural sugars or sugar substitutes, talk with a dietitian or your doctor. They can help you create a dietary plan to maintain a healthy weight and improve your overall health,” says Gillespie.

In the food industry, both simple and complex carbohydrates are utilized to give foods a wide spectrum of functional attributes, including increased sweetness, viscosity, bulk, coating ability, solubility, consistency, texture, body, and browning capacity. The differences in chemical structure between the different carbohydrates confer their varied functional uses in foods. Starches, gums, and pectins are used as thickening agents in making jam, cakes, cookies, noodles, canned products, imitation cheeses, and a variety of other foods. Molecular gastronomists use slow-releasing carbohydrates, such as alginate, to give shape and texture to their fascinating food creations (Video 5.8.1). Adding fiber to foods increases bulk. Simple sugars are used not only for adding sweetness, but also to add texture, consistency, and browning. In ice cream, the combination of sucrose and corn syrup imparts sweetness as well as a glossy appearance and smooth texture. Added sugars include white, brown, and raw sugar, corn syrup, H.F.C.S., malt, and maple syrups, liquid fructose, honey, molasses, agave nectar, and crystal dextrose. We refer to these sweetening agents as nutritive sweeteners as they provide energy when digested.

Due to the potential health consequences of consuming too many added sugars, food manufacturers use sugar substitutes or non-nutritive sweeteners (do not contribute energy when digested) to replace sugar in many foods and beverages. Sugar substitutes may be from natural sources or artificially made. Those that are artificially made are called artificial sweeteners and must be approved by the FDA for use in foods and beverages. The artificial sweeteners approved by the FDA are saccharin, aspartame, acesulfame potassium, neotame, and sucralose. Stevia is an example of a naturally-derived sugar substitute. It comes from a plant commonly known as sugarleaf and does not require FDA approval. Sugar alcohols, such as xylitol, sorbitol, erythritol, and mannitol, are carbohydrates that occur naturally in some fruits and vegetables. However, they are industrially synthesized with yeast and other microbes for use as food additives.

The FDA requires that foods disclose the fact that they contain sugar alcohols, but does not require scientific testing of it. (Though many of them have undergone studies anyway.) In comparison to sucrose, artificial sweeteners are significantly sweeter (in fact, by several hundred times), but sugar alcohols are more often less sweet than sucrose (Table 5.8.1). Artificial sweeteners and Stevia are not digested or absorbed in significant amounts and therefore are not a significant source of calories in the diet. Sugar alcohols are somewhat digested and absorbed and, on average, contribute about 2 kilocalories/gram, which is about one-half of the calories in sucrose (4 kilocalories/gram). These attributes make sugar substitutes attractive for many people—especially those who want to lose weight and/or better manage their blood-glucose levels.

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