SWEETENERS: TRICK or TREAT? (updated for 2025)

Remember when white sugar and brown sugar were our only sweetener choices?  Now we can choose from a rainbow of sweeteners in pink, blue, yellow and brown packets.  It seems that new and improved alternatives are added yearly.  While we're trying to reduce calories from added sugar or trying to reduce artificial sweeteners, they're hidden in unexpected foods such as salad dressings and breads, and even in plain sight with new names.  Artificial sweeteners are manufactured to be hundreds of times sweeter than sugar which may not be desirable if you're trying reduce cravings for sweet things.  

 In general, it's best to eat less sugar and any of the sweetener alternatives to allow our taste buds to adapt to how real food tastes and reduce our desire to reach for something sweet.  Let's try to lessen the confusion, start checking ingredient lists and become more aware of what we're really getting.  I've grouped them into three categories of "Most Desirable", "Less Desirable" and "Least Desirable".  Keep in mind that we want to reduce sugar and sweetener alternatives in our diet.

Note: a recent study found that some artificial sweeteners (saccharin, sucralose, or aspartame) may alter gut flora (the bacterial balance in your gastrointestinal system) and impair glucose tolerance leading to metabolic diseases such as type 2 diabetes. 

• Honey— Flower nectar collected, modified, and concentrated by bees.   Should not be given to children under two years old.


• Maple syrup— Made from the boiled sap of sugar maple trees.   High in potassium and calcium.  Don't be fooled by “fake” maple syrups or pancake syrup often made with high-fructose corn syrup.  Look for 100% pure maple syrup.


• Cane Sugar— Also know as “dehydrated or evaporated cane juice, or ”sucanat”, it's just that, sugar cane juice with the water removed.  Several varieties include: muscavado sugar, turbinado sugar and demerara sugar. Can be used in place of granulated or white sugar for cooking and baking.


• Barley Malt Syrup— Made from sprouted barley that’s roasted and cooked down to a syrup. It has a malt-like flavor.   Lightly sweet.


• Brown-Rice Syrup— Made by sprouting brown rice in water.   Lightly sweet.


• Agave— Extracted from the agave cactus, sweeter than sugar, has a low glycemic index.


• Stevia— Derived from a shrub (Stevia rebaudiana) , the sweet chemicals are stevioside and rebaudioside. Brand names are ”Truvia” and ”PureVia” which have been purified from the crude extracts of stevia leaves, this becomes a more processed product and intensifies the sweetness.  Stevia is often mixed with other sweeteners to mask a bitter aftertaste.  This is the only product in this category that does not raise blood sugar and has no calories.  


• Others Sweeteners— Fruit concentrates, blackstrap molasses, coconut sugar, and date sugar.

• Brown sugar— Granulated sugar coated with molasses.  Basically the same as granulated sugar, see below.


• Granulated Sugar— Refined sugar or white sugar from sugar cane or sugar beets which may be genetically engineered.   Refining sugar with the use of bone char is what makes granulated sugar white.  A better choice than high fructose corn syrup (HFCS).
  


• Xylitol, Sorbitol, Maltitol, Mannitol, Erythritol (Zero), Lactitol— Low calorie types of sugar alcohols derived from wood, corncobs, corn syrup, seaweed, lactose or sugar cane.  Since these are not digested by bacteria they do not promote tooth decay.  These in excess may cause stomach upset or diarrhea.
  Update on Erythritol: A 2023 study found those with higher blood levels of erythritol were at elevated risk of heart attack, stroke or death.  However, it was unclear whether erythritol in food was to blame, further research is needed.


• Allulose— This lower calorie sugar occurs naturally in small amounts in some foods like wheat, maple syrup, brown sugar and some fruits.  It's about 70 percent as sweet as sugar with only 1/10 the calories.  A larger part of allulose is excreted intact.  Furthermore, in a small study this sweetener caused gastrointestinal issues such as diarrhea, bloating or abdominal pain in amounts larger than 27 grams (approximately 6.5 teaspoons).  Some people may be more or less sensitive.  If using this sweetener, limit the amount to prevent gastrointestinal symptoms.


• High fructose corn syrup (HFCS)— Inexpensive sweetener derived from cornstarch.  It has the same number of calories as sugar.  Blamed for the obesity epidemic our population because rates of obesity have risen along with HFCS consumption.  HFCS appears to promote belly or liver fat thereby, increasing risk of heart disease.  Mostly found in sodas and processed foods.   Best to reduce or avoid HFCS in your diet.


• Monk Fruit Extract— Also known as Lo Han Kuo or Luo Han Guo.  Derived from a fruit with a long history in China and used as an herbal medicine.  A multi-step process is used to extract the sweet substance from the monk fruit.  This is not a whole fruit sweetener but an refined extract.  It is 200 times sweeter than sugar with no calories.  This product has not be well tested in animals.  Monk fruit extract appears to be safe but more research is needed.

• Sucralose/Splenda— One of the most common artificial sweeteners, sucralose is made by chemically reacting sugar (sucrose) with chlorine.  Some studies suggest sucralose may impair glucose tolerance (raising blood sugar) by altering the gut microbiome.  No long-term studies are available for this product.  Sucralose caused cancer in studies with mice.


• Saccharin/Sweet n’ Low— 350 times sweeter than sugar.  Derived from coal tar.   Tests have found saccharin to be associated with cancer, birth defects, and kidney damage in test animals.


• Aspartame/Nutrasweet/Equal— Combination of two amino acids, aspartic acid and phenylalanine.  Most commonly found in diet soda.  Suspected potential of altering brain chemistry, affecting mood and behavior.  Some animal studies show that it may increase risk of various types of cancer.  A study followed 120,000 adults for 20 years, who reported drinking at least one diet soda a day.  The men had a higher risk of developing multiple myeloma and non-Hodgkin lymphoma, as opposed to the men who drank no diet soda. Those with Phenylketonuria (PKU) a genetic disorder, should avoid this product.  In general best to avoid this product.


• Acesulfame-K/Ace-K— 200 times sweeter than sugar.  Derived from sulfur and potassium.   Controversial, as the few animal studies suggest this causes cancer.  Check closely, it’s easy to miss this one on the ingredient list.  It is often mixed with sucralose and aspartame.  In a study of breastfeeding mothers who drank 12 oz. Diet Rite Cola found high levels of Ace-K in breast milk.  More studies are needed to understand how this affects the breastfeeding infant.  Proceed with caution or avoid.


• Monatin, Thaumatin/Talin— These are artificial sweeteners are not widely used in the market but may be ones to watch.

Free introductory 15-minute appointments are also available.