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Sugar vs. Sweetener: The sweet science behind sugar and alternatives

Product review by Nesrine Cheikh, RD


Is sugar the cause of chronic diseases such as obesity, diabetes, cardiovascular disease and dementia? Does switching to artificial sweeteners, like Splenda or Aspartame give you sweet taste without the negative health effects? Does using them help in reducing body weight, or can these sweeteners pose health risks, like increased risk of various cancers? Are natural sweeteners, like stevia, better than others? We get asked these questions in practice A LOT! For the purpose of this post, we will review sugar vs sweeteners and how they can impact our health.

Let’s talk SUGAR

On average, in 2004, Canadians consumed 110.0 grams of sugar a day, the equivalent of 26 teaspoons. In 2015, Canadian children consumed up to 25% of their total energy intake per day from total sugars, whereas adults consumed under 20% of their energy from total sugars. Health Canada is now addressing added and total sugars, setting a recommended daily maximum of 100 g per day (about 25 teaspoons) of sugar from both natural (i.e. whole fruit) and added (i.e. sweetened yogurt) sources. While introducing a daily value and recommended limit is a great first step, many experts argue that this cut-off is still too high.

There are also theories that the type of sugar you consume makes a difference. Sugar has many different varieties and includes white sugar, brown sugar, raw sugar, honey and syrups (with multiple varieties in each!). Each type of sugar has its own form of processing, flavor and source. Some types of sugar, especially those that come from more natural sources, can be metabolized differently in our bodies due to the presents of additional benefits like fiber and other macro and micronutrients. However, generally speaking, research tells us that these sugars all seem to have similar effects on the body, and no matter what type of sugar you choose, it is important to be mindful of your overall consumption.

Whether added or ‘natural’, Canadians generally consume too much sugar, which has lead to the development of no-calorie or low-calorie sugar alternatives. But are these sweeteners any healthier than sugar?

What’s the deal on SWEETENERS?

Artificial sweeteners, discovered in the late 1800s, are defined as no-calorie sugar substitutes that provide a sweet taste without the energy density of sugar. They seem to consistently get a lot of media attention due to their controversial nature. Some research suggests that they increase appetite and may contribute to weight gain. Others suggest that they may modify gut bacteria, while some even point to increased risk of cancer.

There are a wide range of artificial sweeteners including chemically synthesized products like aspartame, cyclamate, sucralose and plant-derived sugar alcohols such as xylitol, sorbitol, mannitol stevia or monk-fruit extract.  Each sweetener has been well-studied in the context of safety, effect on weight and metabolism, risk of cancer and comparison to sugar. When trying to understand research, it is important to realize that not all published studies come to valuable conclusions. Currently, there is insufficient evidence to prove that artificial sweeteners are unsafe or cause weight gain. What is important to note, however, is to still practice moderation. For example, some of these studies that evaluated the effects on weight gain found a psychological effect associated with sweeteners.  People would consume more calorie-dense foods simply because they felt they could indulge more after using “Splenda” in their tea or coffee.

Below I have summarized a few popular artificial and commercially-bought sugars (the ones often used in baking, cooking and in your morning coffee!).

sugars and sweeteners in glass bowls

Product reviews: artificial sweeteners

Sucralose (commercially known as “Splenda”

  • Derived from sucrose (sugar)
  • 600 times sweeter than sugar
  • Heat stable (can be used in cooking and baking)
  • Splenda (regular granulated and packets), Brown Sugar blend (addition of sugar, molasses and glycerin with sucralose)
  • Acceptable daily intake: 5mg/kg of body weight per day
  • Add into hot or cold drinks for added sweetness or use as a sugar substitute in baking/cooking for recipes such as muffins, cookies, jams and granola

Steviol Gylcoside (Stevia)

  • Naturally found herb
  • 10-15 sweeter than sugar (sucrose)
  • Body cannot metabolize it, therefore, no calories
  • Does not break down with heat, therefore, perfect for cooking and baking
  • Benefits to lowering blood pressure in some populations
  • No identified acceptable intake
  • Can cause bitter after-taste
  • Add into hot or cold drinks for added sweetness or use in substitute of baking/cooking for recipes such as muffins, cookies, jams and granola

Aspartame (also found as “Equal”)

  • Derived from two amino acids: aspartic acid and phenylalanine
  • 200 times sweeter than sugar
  • Acceptable daily intake: 50mg/kg of body weight per day
  • Health hazard for individuals with phenylketonuria (rare inherited disease)
  • Not recommended for use in baking or cooking
  • Used as a regular table-top sweetener, desserts, frozen sweets, beverages and chewing gum

Sugar alcohol: Mannitol

  • Chemically synthesized from fructose or found naturally in fruits and vegetables such as cauliflower, peaches, mushrooms, celery, snow peas, squash and sweet potato
  • Commonly used to sweeten foods like protein powder, “diabetic friendly” baked goods and chewing gum
  • Used medicinally as a “diuretic” in certain circumstances
  • No acceptable upper limit for sugar alcohol
  • Limited studies suggest it may damage healthy gut bacteria
  • Poorly absorbed in the intestines, therefore, consider avoiding if on low FODMAP diet for IBS

Sugar alcohol: Xylitol

  • Naturally occurring sugar from plants
  • Low calorie: 2.4 calories per gram
  • Helps to restore a proper alkaline/acid balance in the mouth
  • Commonly found in chewing gum
  • No acceptable upper limit for sugar alcohols
  • Limited studies suggest it may damage healthy gut bacteria

Product reviews: sugar

Coconut sugar:

  • Palm sugar produced from coconut palm
  • Primarily sucrose (combination of fructose and glucose)
  • Although commonly thought to be healthier than other sugars, there are no additional nutritional benefits when compared to other sugars like cane or beet sugar (that make white sugar)
  • Less processed than white sugar but the same caloric value (4 calories/gram)
  • Commonly found in Southeast Asian foods
  • Can be used in savory or sweet dishes

Raw cane sugar (Turbinado sugar):

  • Minimally processed and retains most of its natural molasses, which contains trace amounts of iron, calcium and potassium
  • 100% sucrose ( equal combination of glucose and fructose)
  • Same caloric value as white sugar (4 calories/gram)
  • Can be found in some baked goods and/or purchased from grocery stores for personal use

Agave syrup:

  • Made from the agave plant
  • Contains primarily fructose as it’s sweetening property
  • 3 calories/gram, slightly fewer calories per gram when compared to sucrose
  • Moderate source of vitamin C and some B vitamins
  • Used in savory dishes and sweetened desserts
  • Not recommended for individuals with IBS  3 calories/gram, slightly less calories per gram when compared to sucrose

High fructose corn syrup:

  • Produced from cornstarch and comprised of 55% fructose and 42% glucose + other trace disaccharides
  • Contains 4 calories/gram
  • Due to being primarily high in fructose, the liver has a greater likelihood of metabolizing it as fat when consumed in high amounts
  • Found mainly in drinks, candies, yogurts, salad dressings, canned fruit and some frozen desserts
  • A lot of scrutiny due to effects on obesity, however, limited studies on this association
  • May cause gastric upset and not recommended for individuals with IBS

Honey

  • Produced naturally from honey-bees and is comprised of 40% fructose and 30% glucose water
  • Contains 3 calories/gram
  • It is commonly thought that honey is more nutritious than sugar, however, nutrient content in honey is very low (1-3% vitamins and minerals)
  • Because of its syrup nature, honey is used to sweeten drinks, in dressings, marinades, desserts, yogurt or drizzled on top of fruit or bread
  • Metabolized slightly slower than refined sugar, however, still contributes similar caloric content

Key takeaways: sugar vs. sweetener

If you generally do not consume much/enjoy sugar, it might not be necessary to include artificial sweeteners in your diet. However; if you are someone that tends to have a strong sweet tooth and struggles to maintain a healthy lifestyle, then artificial sweeteners may be a better option to reduce energy intake in your diet.

There is no harm in experimenting with other types of sugar, however, they all have very similar effects on the body and should still be consumed in moderate amounts. While ‘sugar is sugar’, having whole foods with naturally-occurring sugar (like whole fruits and plain dairy products) can be part of a healthy diet, as these foods tend to be lower in sugar than processed foods. They can also provide additional nutrition such as fibre, protein and phytonutrients. If you’re looking to reduce your sugar intake, start by reducing your intake of foods with any added sugar (‘natural’ or not) and read labels for lower sugar options (<10g per serving of sugar) when buying packaged foods.

So, what should you choose? Regular store bought sugar? Natural sugars? Artificial sweeteners? To know what is the right choice for you, speak to a Registered Dietitian who can assess your overall sugar intake and let you know the best choice for you. https://www.nutriprocan.ca/request-appointment/ 

 

This review is a brief summary of sugars and artificial sweeteners and includes some but not all options in this fast-growing market. Research on sugars and sweeteners remain ongoing, therefore, new studies may provide further insight into this topic. If you have any questions regarding topics related to nutrition, contact an RD for the most up-to-date information.

 

References:
Sharma A, Amarnath S, Thulasimani M, Ramaswamy S. Artificial sweeteners as a sugar substitute: Are they really safe? Indian J Pharmacol. 2016;48(3):237–40.
 Toews I, Lohner S, Küllenberg de Gaudry D, Sommer H, Meerpohl JJ. Association between intake of non-sugar sweeteners and health outcomes: systematic review and meta-analyses of randomised and non-randomised controlled trials and observational studies. BMJ [Internet]. 2019 Jan 2 [cited 2019 Feb 27];364. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313893/
Newspapers AS Special to Tribune. Artificial sweeteners. What’s the difference? [Internet]. chicagotribune.com. [cited 2019 Feb 27]. Available from: https://www.chicagotribune.com/living/ct-xpm-2011-05-11-sc-health-0511-whats-the-difference-s20110511-story.html
Chattopadhyay S, Raychaudhuri U, Chakraborty R. Artificial sweeteners – a review. J Food Sci Technol. 2014 Apr;51(4):611–21
Muir JG, Rose R, Rosella O, Liels K, Barrett JS, Shepherd SJ, et al. Measurement of Short-Chain Carbohydrates in Common Australian Vegetables and Fruits by High-Performance Liquid Chromatography (HPLC). J Agric Food Chem. 2009 Jan 28;57(2):554–65.
Splenda­® | Sugar Alternative [Internet]. SPLENDA®. [cited 2019 Feb 24]. Available from: https://www.splenda.ca/index.php/en
Mäkinen KK. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and Other Health-Care Professionals. Int J Dent [Internet]. 2016 [cited 2019 Feb 27];2016. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5093271/
Types of Sugar [Internet]. The Sugar Association. [cited 2019 Feb 24]. Available from: https://www.sugar.org/sugar/types/

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