Many of us are trying to avoid table sugar with sweetener in an attempt to control blood sugar. Because sugar negatively affects metabolic health further leads to high blood sugar or diabetes and numerous related diseases including heart disease if you consume more. You may also choose artificial calorie-free sweetener but there are raising questions in the use of artificial low calorie or calorie-free sweetener. In many cases, artificial sweeteners had shown negative effects on health. And we also have natural sweeteners. But natural doesn’t always mean good for health. Here we go with Benefits & hidden risk of top natural sweeteners for sugar control.
Also, read about what added sugar can do to your body.
Difference between sugar and sweetener
Our health problems come with the increased consumption of the simple form of sugar mainly as glucose and fructose. Fructose sugar from fruits is used to make your dist sweet normally. Table sugar sucrose ( a combination of glucose and fructose) also sometimes is referred to as empty calories due to the absence of other nutrients. A sweetener may not have calorie that makes differ it from sugar. For that reason, many choose calorie-free sweeteners over sugar. However, one problem is that sugar hides in foods by many different names. Apart from that sweeteners are also not completely risk-free.
Artificial sweeteners and your health
Usually, artificial sweeteners don’t contain calories and so may not spike insulin. (1) But it can harm your health in some other ways. I personally don’t like artificial sweeteners. Although occasional use may not cause that much of harm, the use of artificial sweeteners is in question. For example, research has shown that artificial sweeteners used as sugar substitutes including sucralose, saccharin, and aspartame can harm the beneficial gut bacteria. (2) A 2019 published US study on 5158 adults over 7 years, researchers found the consumption of artificial sweeteners alter gut microbiota which may lead to weight gain and risk of type 2 diabetes. (3)
Your gut is a very important organ and connected to many organs. And an unhealthy gut can lead to many diseases.
Also, read 7 steps towards perfect health.
Benefits & hidden risk of top natural sweeteners for sugar control
Agave nectar and Maple syrup and other fruits sugar
Agave nectar or syrup is made from the agave plant and about 1½ times as sweet as white table sugar. (4) However, it also contains a large amount of sugar mainly as fructose. (5)
Similarly, although maple syrup from maple tree has nutrients along with antioxidants, it still contains a high amount of sugar. Maple syrup contains about 2/3 portion as sugar without any dietary fiber. (6)
Why the whole fruit is better than fruit extract
The fact is that these sugars mostly come from fruit sources and manufacturers usually extract fruit sugar from them. Thus these become more concentrated with sugar, don’t have the same effect as the original fruits. While fruit extract or fructose or added sugar doesn’t contain fiber part, a natural whole fruit contains fiber. That prevents the sudden rise of blood sugar. That’s why the whole fruit is more preferable than a glass of fruit juice. However glycemic load varies with the type of fruits. So you need to look at fruits with a low glycemic load if you have insulin resistance or diabetes. Moreover, you should limit fruit consumption because your body can’t efficiently metabolize fruit sugar fructose.
Stevia and health risk
Stevia leaves are around 200-400 times sweeter than common sugar but have no calories. That means stevia leaves don’t spike your blood sugar level and a very small amount is enough to make your foods sweet. One or two drops of liquid stevia are enough to make sweet your coffee or tea. FDA approved stevia as Steviol glycosides, a natural constituent of the leaves of Stevia Rebaudiana. (9) WHO also says stevia as safe when to use it in a typical amount. (10)
However, there is still some question and it may slightly alter gut bacteria. And you should not exceed the intake of 4mg per kg body weight per day. (11,12) Overall considering stevia to stop sugar craving is a reasonable strategy at present.
Monk fruit is about 150-200 times sweeter than general sugar but has no calorie that also means monk fruit doesn’t spike your blood sugar and also need a much smaller amount than sugar. (13) Also, the FDA has considered monk fruits as safe in general within the typical limits. (14) Studies also reported about the health-protective antioxidant property of monk fruit as well as anti-diabetic properties. In mice, monk fruits reduce damage to insulin-producing beta cells of the pancreas and also reduced diabetic symptoms. (15 ,16, 17) In test-tube and animal studies, monk fruit exhibits anti-cancer properties. (18,19)
As per a Nov. 2019 review published in the journal of Frontier in Pharmacology, monk fruit has no known adverse effect. Therefore currently considered as low in toxic and safe. (16) However, monk fruit lacks extensive research until now.
You can have monk fruits in different forms like liquid, powder as well as granules.
Stevia vs Monk Fruit
As a sweetener stevia may more sweet taste than monk fruit. How it may require a lesser amount for the same effect. But, unlike stevia, monk fruit has no known negative effect in the gut at least for now. However, some may experience allergies. Monk fruit also doesn’t have the bitter aftertaste like stevia. But monk fruit is comparatively expensive than stevia and also availability is low.
Yacon syrup is a sweetener extracted from the tuberous roots of the yacon plant. It also posses antidiabetic properties. That has been observed in the animal as well as human clinical studies. Studies showed yacon consumption increased glucose absorption in peripheral tissues, decreased gluconeogenesis, improved insulin tolerance in the liver and increased insulin secretion in the pancreas. (20)
It also contains a considerably high amount of fructooligosaccharides, that acts as dietary fiber, prebiotic for stimulating the growth of non-harmful intestinal microflora. It may also help in constipation due to its dietary fiber content. (20,21,22,23)
However, due to the fructan content as fructooligosaccharides, it falls in the group of FODMAPS. And therefore if you have gastrointestinal conditions like SIBO, IBS, you should better avoid yacon. (24) One reason for contributing to the development of SIBO or small intestine bacterial overgrowth is not having enough stomach acid and continuous acid suppression with over the counters without physician’s consultation. (25,26)
Although I have included honey in the list, it contains a considerable amount of sugar and no advantage over sugar in diabetics. I am keeping honey because it has some health beneficial properties like antibacterial. Raw honey has antibacterial effects against pathogenic bacteria such as salmonella, E. coli, Shigella along with many other gram-negative species as well as Porphyromonas gingivalis. Also, it is a source of prebiotics that support the growth of friendly bacteria Lactobacillus and Bifidobacteria. (25, 26) Manuka honey is the most effective honey. Other kinds of honey, like mountain honey and forest honey, also work well.
Other Sugar alcohol
Although Erythritol is found naturally in some fruits, it is also available as a powder through industrialization. It contains minimal calorie, considerable sweetness and doesn’t spike insulin. (27) However, with higher intake, it may cause digestive upset. (28)
One major reason for digestive upset, heartburn or acidity is not having enough stomach acid. Read more about how weak stomach acid develops acidity or heartburn.
Also, read about 6 hidden causes of acidity and heartburn.
Xylitol is another sugar substitute with comparatively low calorie than sugar. It also doesn’t increase blood insulin levels, but can cause digestive issues with high doses. (29, 30) Xylitol may have toxic effects on dogs, so you need to keep xylitol away from dogs. (31)
In conclusion, although natural sweeteners appear as healthy and have some benefits in sugar control but also posses some hidden risks. Syrups like agave or maple, fruit extract, and honey have no such advantage over sugar in controlling high blood sugar. Use of stevia, sugar alcohol, etc is the reasonable strategies to stop sugar craving while used within the limit. Monk fruit is a good sugar alternative with no known major adverse effect until now. Yacon is another good sugar substitute but can act negatively in people having IBS or SIBO. A whole fruit with a low glycemic load is better than its extract and juice part.
Disclaimer: Information provided here are generalized information for entertainment purpose only, not intended to provide one to one health consultation or replace practice of a qualified practitioner. Different people may have different health condition and may have different reaction to the same food. Hence it has been advised to consult with health care provider before application of any of above information Source and references: 1. Maria Buffini, Séverine Goscinny, Joris Van Loco, Anne P. Nugent, Janette Walton, Albert Flynn, Michael J. Gibney, Breige A. McNulty. (2018) Dietary intakes of six intense sweeteners by Irish adults. Food Additives & Contaminants: Part A 35:3, pages 425-438. 2. Ruiz-Ojeda FJ, Plaza-Díaz J, Sáez-Lara MJ, Gil A. Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials. Adv Nutr. 2019;10(suppl_1):S31–S48. doi:10.1093/advances/nmy037 5. Kim, Y., Keogh, J.B. & Clifton, P.M. Non-nutritive Sweeteners and Glycaemic Control.Curr Atheroscler Rep 21, 49 (2019) doi:10.1007/s11883- 019-0814-6 4. Jacqueline B. Marcus MS, RD, LD, CNS, FADA, Carbohydrate Basics: Sugars, Starches and Fibers in Foods and Health in Culinary Nutrition, 2013 5.https://en.wikipedia.org/wiki/Agave_syrup 6.https://en.wikipedia.org/wiki/Maple_syrup#Nutrition_and_food_characterist ics 7.https://en.wikipedia.org/wiki/Coconut_sugar 8.https://en.wikipedia.org/wiki/Date_sugar 9.https://www.fda.gov/food/food-additives-petitions/additional-information- about-high-intensity-sweeteners-permitted-use-food-united-states 10.https://apps.who.int/iris/bitstream/handle/10665/259483/9789241210164- eng.pdf;jsessionid=091B18A2E0114F9D91ACF927D7A11558?sequence=1 11. Lohner S, Toews I, Meerpohl JJ. Health outcomes of non-nutritive sweeteners: analysis of the research landscape. Nutr J. 2017;16(1):55. Published 2017 Sep 8. doi:10.1186/s12937-017-0278-x 12. Francisco Javier Ruiz-Ojeda, Julio Plaza-Díaz, Maria Jose Sáez-Lara, Angel Gil, Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials, Advances in Nutrition, Volume 10, Issue suppl_1, January 2019, Pages S31–S48, https://doi.org/10.1093/advances/nmy037 13.https://foodinsight.org/everything-you-need-to-know-about-monk-fruit- sweeteners/ 14.https://www.fda.gov/food/food-additives-petitions/additional- information-about-high-intensity-sweeteners-permitted-use-food-united- states#Luo_Han_Guo_fruit_extracts 15. Liu H, Wang C, Qi X, Zou J, Sun Z. Antiglycation and antioxidant activities of mogroside extract from Siraitia grosvenorii (Swingle) fruits. J Food Sci Technol. 2018;55(5):1880–1888. doi:10.1007/s13197-018-3105-2 16.Gong X, Chen N, Ren K, et al. The Fruits of Siraitia grosvenorii: A Review of a Chinese Food-Medicine. Front Pharmacol. 2019;10:1400. Published 2019 Nov 22. doi:10.3389/fphar.2019.01400 17. Xu Q, Chen SY, Deng LD, Feng LP, Huang LZ, Yu RR. Antioxidant effect of mogrosides against oxidative stress induced by palmitic acid in mouse insulinoma NIT-1 cells. Braz J Med Biol Res. 2013;46(11):949–955. doi:10.1590/1414-431X20133163 18.Takasaki M, Konoshima T, Murata Y, Sugiura M, Nishino H, Tokuda H, Matsumoto K, Kasai R, Yamasaki K., Anticarcinogenic activity of natural sweeteners, cucurbitane glycosides, from Momordica grosvenori, Cancer Lett. 2003 Jul 30;198(1):37-42. 19.Liu C, Zeng Y, Dai LH, et al. Mogrol represents a novel leukemia therapeutic, via ERK and STAT3 inhibition. Am J Cancer Res. 2015;5(4):1308– 1318. Published 2015 Mar 15. 20.Caetano BF, de Moura NA, Almeida AP, Dias MC, Sivieri K, Barbisan LF. Yacon (Smallanthus sonchifolius) as a Food Supplement: Health-Promoting Benefits of Fructooligosaccharides. Nutrients. 2016;8(7):436. Published 2016 Jul 21. doi:10.3390/nu8070436 21. Sabater-Molina M, Larqué E, Torrella F, Zamora S., Dietary fructooligosaccharides and potential benefits on health, J Physiol Biochem. 2009 Sep;65(3):315-28. doi: 10.1007/BF03180584. 22.Coussement PA, Inulin and oligofructose: safe intakes and legal status. J Nutr. 1999 Jul;129(7 Suppl):1412S-7S. doi: 10.1093/jn/129.7.1412S 23.Mônica de Souza Lima Sant'Anna, Vivian Carolina Rodrigues, Tatiane Ferreira Araújo, Tânia Toledo de Oliveira, Maria do Carmo Gouveia Peluzio, and Célia Lúcia de Luces Fortes Ferreira.Journal of Medicinal Food.Sep 2015.980-986.http://doi.org/10.1089/jmf.2014.0115 24.Keiichi Goto, Katsuhiko Fukai, Junko Hikida, Fumio Nanjo & Yukihiko Hara(1995) Isolation and Structural Analysis of Oligosaccharides from Yacon (Polymniasonchifolia),Bioscience, Biotechnology, and Biochemistry, 59:12, 2346-2347, DOI: 10.1271/bbb.59.2346 25. Pasupuleti VR, Sammugam L, Ramesh N, Gan SH. Honey, Propolis, and Royal Jelly: A Comprehensive Review of Their Biological Actions and Health Benefits. Oxid Med Cell Longev. 2017;2017:1259510. doi:10.1155/2017/1259510 26. Eick S, Schäfer G, Kwieciński J, Atrott J, Henle T, Pfister W. Honey - a potential agent against Porphyromonas gingivalis: an in vitro study. BMC Oral Health. 2014;14:24. Published 2014 Mar 25. doi:10.1186/1472-6831-14-24 27. Noda K, Nakayama K, Oku T., Serum glucose and insulin levels and erythritol balance after oral administration of erythritol in healthy subjects, Eur J Clin Nutr. 1994 Apr;48(4):286-92. 28.Storey D, Lee A, Bornet F, Brouns F.,Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid, Eur J Clin Nutr. 2007 Mar;61(3):349-54. Epub 2006 Sep 20. 29. S. Salminen, E. Salminen, V. Marks, The effects of xylitol on the secretion of insulin and gastric inhibitory polypeptide in man and rats, Diabetologia,June 1982, Volume 22, Issue 6,pp 480–482 https://doi.org/10.1007/BF00282594 30. Storey, D., Lee, A., Bornet, F. et al. Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid.Eur J Clin Nutr 61, 349–354 (2007) doi:10.1038/sj.ejcn.1602532 31. Dunayer EK, Gwaltney-Brant SM.,Acute hepatic failure and coagulopathy associated with xylitol ingestion in eight dogs, J Am Vet Med Assoc. 2006 Oct 1;229(7):1113-7, https://doi.org/10.2460/javma.229.7.1113