Sugar Substitutes

If you follow a low glycemic lifestyle you likely avoid refined sugar (sucrose), a food that is about as "high glycemic" as it gets. But come on. Who really wants to live without sweeteners or sweet treats? Enter the world of sugar substitutes.

Here, we take a closer look at the most common of these "alternative sweeteners". Our goal is to cut through the morass of speculation and opinion, and instead focus on known science - not internet rumors or advertising junk.

Basically, what we really need to know is:

For convenience sake, we can divide sugar alternatives into two distinct categories: (1)"Artificial" (Synthesized) Sweeteners, and (2) "Natural" Sweeteners

Artificial Sweeteners

Human-synthesized (i.e., "artificial") sweeteners are regulated by the U.S. Food And Drug Administration (FDA) as food additives, and as with all such products they must undergo a satisfactory review process review before FDA approval for sale in the U.S.

Splenda is now the most popular sugar substitute in the USA

In some cases, the FDA may bypass the general review process and instead declare a food additive or substance "generally recognized as safe" (GRAS). GRAS substances don't require FDA approval before sale as they are deemed "safe" by qualified professionals based upon known scientific data, or simply because they have a sufficiently lengthy history of safe common use in food.

The FDA also establishes acceptable daily intakes (ADI) for each of these substances. ADIs represents the maximum daily amounts of each additive considered safe to consume over the course of a lifetime, and represent about 1% of the amount that might cause health concerns, allowing a large margin for error.

Popular artificial sweeteners currently approved by the FDA include:

  • Equal and NutraSweet (aspartame-based)
  • SugarTwin and Sweet'N Low) (saccharin-based)
  • Splenda (sucralose-based)

A quick internet search of any or all "artificial sweeteners" would doubtlessly deliver numerous articles advising you to beware of alleged hidden dangers of these substances at all costs. Such popular media sources typically offer lengthy reasons to back up their warnings, along with scary testimonials about ill effects.

However, when evaluating such claims it would be wise to consider that numerous research studies have confirmed that these artificial sweeteners are generally safe sugar substitutes when used in approved limited quantities (ADIs), even for pregnant women. Thus, the National Cancer Institute and other well-recognized health agencies have concluded that in fact there is no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems.

"Natural" Sugar Alternatives

So-called "natural sweeteners" are sugar substitutes that naturally occur in plants. In that sense, they do not differ from plain old table (cane) sugar. But - from the perspective of utility in a low glycemic dieting - such products can be separated into the good, the bad, and the ugly.

The Good: Stevia and Lo-Han

Two naturally occurring plant products - stevia and lo-han - have been used for centuries in various parts of the world as sweeteners.

Both are classified by the US FDA as a "generally recognized as safe" (GRAS); there are no known negative health impacts associated with consuming them. Both are naturally very low glycemic.

Stevia is an extract from one of a group of plants of the genus Stevia, native to the Americas. Stevia plants and/or extracts have been used as sweeteners for centuries in parts of South America (and since the 1970s in Japan), but only recently have gained the attention of U.S. consumers.

Stevia can be purchased in both powder and liquid form. The most popular of the powdered forms is called Truvia, and is readily available online or in stores.

My personal favorite stevia product is a liquid form sold under the trade name Sweet Leaf Sweet Drops; it comes in a variety of flavors.

Lo-han is an extract of the fruit known as luo han guo (monk fruit), which is native to southern China and Northern Thailand. It has been used by the Chinese as a sweetener for over a thousand years. It is available commercially in both powder and liquid forms.

Lo-han is about 300 times as sweet as sugar, but with only about 2/3 of the carbohydrate content (ounce for ounce). That means that it can be used as an effective sweetener in quantities far too small to affect blood sugar or caloric intake in any meaningful way.

The taste of these products is simply a matter of personal preference - some folks like them, others don't. The only way to know is to try them.

The Bad: High Fructose Sweeteners

It is critical to note that despite the name "natural" (highly promoted by the food industry), many of the most commonly used (in the USA) high fructose sweeteners undergo extensive processing and refining. Such modifications often result in products with far higher concentrations of fructose than those found in naturally high-fructose foods such as dates, maple sap, fruit juices, and honey.

agave nectar
Agave nectar is low glycemic, but far from healthy for use as an everyday sugar substitute

The most notorious (and to be avoided) of these "enhanced" fructose sweeteners are agave nectar and high fructose corn syrup.

Both have been implicated in adverse health impacts by many highly respected medical professionals because of their highly elevated fructose concentrations. Nonetheless, the FDA simply classifies such products as "added sugars" that are "generally safe for consumption".

The Ugly: Sugar Alcohols

Sugar alcohols are forms of carbohydrates that naturally occur in some vegetables and fruits. They can also be synthesized as sugar substitutes by manufacturers.

These products do contain calories and DO have a glycemic impact.

For most of the often-used sugar alcohols like malitol that impact is less than that of sugar, but by no means negligible. The American Diabetes Association recommends that lo-carb dieters INCLUDE 50% of the grams of sugar alcohols in a given food portion as part of the "net carbs" calculation.

Commonly used, FDA-approved sugar alcohols include Isomalt, Lactitol, Maltitol, Mannitol, Sorbitol, Xylitol, and Erythritol. Sugar alcohols are often combined with other sweeteners to lower concentrations while maintaining desired sweetness.

While the FDA classifies most of these substances as "generally recognized as safe" (GRAS), moderate or excessive consumption (generally in the range of 10-50 grams) can have a strong laxative effect.

(Updated October 31, 2016.)

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