A long time ago, in a fitness industry far far away, we used to think fat was the enemy and would slash it wherever we could, creating fat free snacks and desserts galore. But, we slowly began to understand that fat was not the enemy, and sometimes it is actually the solution (look up ketogenic diets if you don’t know what I’m referring to). We then redirected our attention to sugar, the real bad guy that has been shown to cause obesity, hypertension, the metabolic syndrome, type 2 diabetes, and kidney disease in children and adults (1).
It didn’t take long for sugar-free alternatives to start popping up all over the place, but something needed to take its place to keep the sweetness of whatever was losing the sugar. In steps artificial sweeteners and sugar alcohols, a solution of much debate and controversy that still rages on today.
Different Types of Sweeteners
A lot of us are familiar with those packets of Splenda and Equal that seem to be everywhere now, but what are they really? Sweeteners can be put into three different
categories: caloric sweeteners, artificial sweeteners, and sugar alcohols (2), all of which react differently in the body. Examples of calorie sweeteners are sucrose (table sugar), glucose (blood sugar), fructose, high fructose corn syrup, honey, agave nectar, dextrose, and maltodextrin (this list isn’t all inclusive but includes some of the most popular sweeteners).
Calorie sweeteners aren’t usually healthy due to their varying glycemic index and to fully understand caloric sweeteners prior knowledge on how insulin sensitivity and the glycemic index works is recommended. Caloric sweeteners can be separated into two different types: monosaccharides or disaccharides, Monosaccharides are the simplest, most basic units of carbohydrates and are made up of only one sugar unit. Glucose and fructose are monosaccharides and are the building blocks of sucrose, a disaccharide. Thus, disaccharides are just a pair of linked sugar molecules (3). All types of caloric sweeteners should be limited to 50 grams a day from all sources.
Glucose is the preferred energy used in the body and is what causes the insulin spike from carbs (due to its high glycemic index of 100). Fructose occurs naturally in fruits and veggies (where it is healthier for you) but is also added to many sodas and fruit juices which take away the fiber and nutrients that make it healthy. It is different from glucose in the way that it is metabolized in the liver which gives it less of an insulin spike when digested (it has a glycemic index of 25), but conversely will make fructose more likely to be stored as fat.
Table sugar or sucrose has no nutritive value and has the baseline for sweetness and insulin spiking with a glycemic index of 70. Table sugar is made up of 50% glucose and 50% fructose. High fructose corn syrup has similar sweetness (slightly higher) to sugar because it is 55% fructose and 45% glucose with a glycemic index of 58, meaning it has a higher likelihood of being stored as fat do to the higher level of fructose than regular table sugar, both should be minimized in your diet.
Agave nectar comes from the plant of the same name and is referred to as “diabetic safe” because it has less of an insulin spike in your body with a glycemic index of 13. Although it comes from a plant, the syrup is usually highly processed, it contains a large amount of fructose (as high as 7090%) and actually has more calories than sugar (60 calories per tablespoon compared to 48 in sugar). For these reasons agave nectar is much more likely to be stored as body fat due to its level of fructose and even though it is sold as a “healthy alternative” it is the exact opposite!
Honey is different in the fact that it comes from more natural sources and might even have antioxidant benefits, but keep in mind that honey also contains plenty of calories and does have a glycemic index of 50 so it shouldn’t be used in excess (also try to find more natural honey that has a cloudy appearance instead of clear). Dextrose has 3.4 calories per gram and actually spikes blood sugar higher than sugar (with its glycemic index of 100) which is why it is popular post workout to help deliver nutrients to the body. The same goes for maltodextrin with an even higher glycemic index of 110, both have been considered safe by the FDA but be warned that if you don’t use the energy delivered in some sort of exercise it will be stored as fat.
Next are artificial sweeteners that are becoming very abundant in our western diet. They are mostly considered an alternative to sugar because they have a glycemic index of zero meaning they won’t spike blood sugar whatsoever. They either contain less calories per gram or are much sweeter meaning less is needed to be added to foods to get the same amount of sweetness.
A few artificial sweeteners include: Saccharin, Aspartame, AcesulfameK, and Sucralose (not to be confused with sucrose or table sugar). Controversy has arisen that even though they contain less carbs and calories, artificial sweeteners can spike blood sugar just in the presence of sweetness! Luckily a recent study found that tasting Aspartame, Saccharin, or Sucrose did not cause any greater insulin release than tasting plain water (4).
Saccharin should be avoided and thanks to all the negative attention it has received most companies have discontinued its use. Probably the most controversial sweetener on this list is Aspartame, which does have four calories per gram and is 70 times sweeter than sugar which is why so little is used to sweeten things like diet sodas. This sweetener has been blamed for everything, from causing cancer to previously mentioned tricking your body to spike insulin without the calories. All these claims have been disproven and this sweetener shouldn’t be worried about if consumed in moderation.
Acesulfame Potassium (or Acesulfame K as it is also known) is calorie-free and passes through the body unchanged. It has also been linked to raising blood sugar levels and types of cancer but have never been proven, this sweetener should be safe to consume in moderation. Lastly is Sucralose, also known as Splenda. This sweetener is also calorie free and has not been linked to any negative effects to the human body and can be consumed safely.
The last category are sugar alcohols (no they don’t contain actual alcohol and cannot get you drunk) and are different than artificial sweeteners as some can actually have health benefits (some, while others at the worst can cause bloating and other digestive issues in some people). While they do have a low glycemic index ranging from from 1 to 12, the lack of fructose and glucose make them less likely to be stored as body fat.
Sugar alcohol can be easily recognized because most of them end in –ol. Examples include: Sorbitol, Mannitol, Erythritol, Maltitol and Xylitol. Sorbitol has 2.6 calories per gram while Mannitol has 1.6 and are considered safe by the FDA, but should be consumed in moderation do to a laxative effect they can have. Maltitol has been linked to many negative side effect including abdominal pain, diarrhea and excessive gas, although this sweetener isn’t dangerous it should probably be avoided if you can help it.
Erythritol has 0.2 calories per gram and has almost no impact on blood sugar with its glycemic index of 1. Where this sugar alcohol is different from the previous three is that it doesn’t affect tooth decay or digestive health and is considered safe. Lastly, Xylitol which has 2.4 calories per gram, is probably the healthiest of the sugar alcohols because it can prevent bacteria from sticking to teeth and prevent cavities, it has a glycemic index of 12(the highest out of all the sugar alcohols), meaning it barely spikes insulin at all (5).
A sweetener that has becomes extremely popular in the past years (even though it has been around for centuries) but doesn’t seem to fit in with the other categories is Stevia, which comes from the plant Stevia rebaudiana native to Japan, China, Kenya, Vietnam, India, Argentina, Colombia, Thailand, Paraguay, and Brazil. The part of the plant that is actually sweet is called steviol glycosides and is calorie free.
The reason why this sweetener is so different is because it is not regulated by the FDA (like fat burners or whey protein it is considered a dietary supplement, although in 2008, the FDA declared that stevia was safe in foods and beverages), it is a natural sweetener with very little processing, it has no calories, has a glycemic index of 0 and while it is over 300 times sweeter than sugar, Stevia has numerous cited health benefits including helping to lower high blood pressure, lower the risk of pancreatic cancer and managing diabetes (6)(7).
With all this information it can be a lot to take in and commit to memory. The take-home message from this article is that all of these sweeteners can be used relatively safely in moderation but the best option is limit them as much as possible. But keep in mind it is always a good idea to check out the ingredients list of all goods you buy and keep in mind that sugar alcohols are actually listed below sugars on the nutrition label, while artificial sugars are no. It is always a good rule of thumb to dig deeper into the ingredients to see what companies are really putting into these products. If you could pick any sweeteners to use try to prioritize natural and healthy ones, including organic honey, Xylitol, Erythritol, and Stevia.
Lastly, if you are strategically spiking your blood sugar using something like dextrose or maltodextrin, make sure to pair your simple sugar with a protein (maybe in a whey protein shake?) because the insulin secreted from your pancreas due to the insulin spike will shuttle all the nutrients into your muscles instead of being stored as fat. We can’t always stop ourselves from resisting our sweet tooth, but remember there are always healthy and smarter ways to indulge!
(1) Johnson, Richard J. Potential Role of Sugar (fructose) in the Epidemic of Hypertension, Obesity and the Metabolic Syndrome, Diabetes, Kidney Disease, and Cardiovascular Disease . Potential Role of Sugar (fructose) in the Epidemic of Hypertension, Obesity and the Metabolic Syndrome, Diabetes, Kidney Disease, and Cardiovascular Disease . American Society for Clinical Nutrition, 5 Mar. 2007. Web. 16 June 2016
(2) “The Other 26 Sweeteners.” The Sugar Association . N.p., n.d. Web. 16 June 2016.
(3) Ancira, Kimberly. “What Is the Difference Between Sucrose, Glucose & Fructose?” Healthyeating.sfgate.com . Demand Media, n.d. Web. 16 June 2016.
(4) Sweet Taste: Effect on Cephalic Phase Insulin Release in Men. Pubmed.gov . Monell Chemical Senses Center, Philadelphia, PA 19104, USA., June 1995. Web. 16 June 2016.
(5) “Dental Benefits of Xylitol.” Xylitol.org . N.p., n.d. Web. 16 June 2016.
(6) Cox, Lauren. “What Is Stevia?” Livescience.com . N.p., 12 Sept. 2013. Web. 16 June 2016.
(7) Nichols, Hannah. “Stevia: Health Benefits, Facts, Safety.” Medicalnewsdaily . N.p., 18 Apr. 2016. Web. 16 June 2016.