Sugar Alternatives 101

From erythritol to honey, there are dozens of choices to replace table sugar. The question is, are any of them healthier?

Defining Healthier as it’s used in this article is a sweetener that has nutritional value equal to or greater than its caloric value. In other words, we are comparing a food item's nutrient density to its energy density. The more the ratio favors nutrient density, the healthier it is.

 Defining Nutritive vs. Non-Nutritive sweeteners (NNS): Nutritive sweeteners add a caloric value to the foods that contain them while non-nutritive sweeteners do not. The specific line drawn between the two as regulated by the Food and Drug Administration (FDA) is 2% of the calories in an equivalent amount of sugar. 

Artificial Sweeteners (AS)

These are sweeteners created by humans and not found in nature under any circumstances. 

The list includes, but is not limited to:

  • Acesulfame Potassium (Sweet One®, Sunett®)

  • Advantame 

  • Aspartame (the only nutritive sweetener; Nutrasweet®, Equal®, Sugar Twin®)

  • Neotame (Newtame®)

  • Saccharin (Sweet and Low®, Sweet Twin®, Sweet'N Low®, Necta Sweet®)

  • Sucralose (Splenda®)

Although Generally Recognized as Safe (GRAS) by the FDA, these sweeteners may cause indigestion and diarrhea when consumed in higher amounts like in sugar-free candy, drinks, and processed foods, as they are not digested or absorbed and pass through the gastrointestinal tract unchanged.

Natural Sweeteners

Even under the category natural sweeteners, there are two subclassifications:

Unprocessed (found in nature or extracted from a natural source that is minimally processed)

  • Honey,

  • Maple Syrup

  • Agave Nectar

  • Coconut Sugar

  • And many, many, more.

These are, depending on the ratio of fructose to glucose, treated the same by the body. Strictly in terms of calories, they all contain four calories per gram, just like table sugar. So, while they may contain minute amounts of antioxidants or other nutrients (similar to the difference between table salt and pink himalayan salt), these unprocessed table sugar alternatives are not above and beyond table sugar.

Processed (found in nature, but not necessarily extracted from those sources)

  • Steviol Glycosides (Stevia®, Truvia®)

  • Erythritol-based sweeteners (Monk Fruit sweeteners, or 1:1 baking alternatives)

  • Other Polyols (like Erythritol which include, Maltitol, Xylitol)

  • Inulin (Chicory Root Fiber)

These ones are often touted as “natural” while using equivalent amounts of processing as artificial sweeteners. As a result, I set them into a category of their own. Erythritol-based sweeteners may not cause the same side-effects as steviol glycosides and other sugar alcohols, but the evidence base is still young and ever-updating. In small amounts, up to >.4g/KG of body weight, Erythritol has been shown to not cause as much fermentation in the large intestine as compared to steviol glycosides and other sugar alcohols.

So, what’s healthier than sugar?

While the research and general consensus point towards eating any Artificial or Processed “Natural” sweeteners in regulated, small amounts as being acceptable and assuredly lower calorie than table sugar, thus being healthier by the definition written above, it is most advisable to learn what sugar alternative works best for you. It is important to understand which sugar alternatives cause undesirable side effects to you and which ones do not, as well as which ones are safer than others. 

Generally speaking, avoid artificial sweeteners as much as possible and limit total added sugar consumption to the USDA’s dietary guidelines of less than 10% of total daily energy intake. With that, I recommend limiting total sugar intake to 10% or less of total daily energy intake and to instead replace it with complex carbohydrates (starches and fibers) that take longer to digest and don’t raise blood sugar or insulin resistance as much as simple sugars do. 

Do you need help determining what sugar alternatives may be right for you and if it’s recommended to reduce consumption of your sugar intake? Don’t hesitate to reach out over email or in-person at the club. Just ask for Kyler or email me using the address below.

-Kyler | kyler@ballardhealthclub.com

Cert. Nutrition Coach, CPT

Source(s)/Additional Reading:

¹FDA Information on High-Intensity Sweeteners

Effect of AS on Type 2 Diabetes Patients' insulin Resistance

Systematic Review on AS on the metabolic effects in youth

Systematic review of association between NNS and health outcomes

Comparison of Sugar Substitutes' benefits vs. risks