Are sugar substitutes healthier?

When we talk sugar, we’re often referring to cane sugar – the stuff you buy in bags at the supermarket. This is also known as sucrose. Sucrose is one glucose and one fructose molecule bonded together. Other sugars include lactose, found in milk, and maltose. But most sugar substitutes are still sugars, just in slightly different forms to cane sugar. The exceptions are sweeteners from stevia, monk fruit and artificial sweeteners which are sugar free.

How much sugar should we be eating?   

The World Health Organisation recommends adults consume no more than 50g (that’s about 12 level teaspoons) of ‘free’, or simple, sugars. Free sugars don’t include sugars naturally found in whole fruit and veggies or milk products, but does include the stuff that’s added to foods and drinks, as well as fruit juices, honey and other syrups.

But there could be additional health benefits in terms of dental health for reducing sugar intake to even less than the recommended amount, to just 6 teaspoons of sugar a day. These recommendations are being revised at the moment, and it may be that the new guidelines end up being to eat no more than 6 teaspoons of free sugars a day.

What’s the issue with sugar?

Foods that are high in free sugars provide a concentrated source of calories and they are easy to over-consume, especially when combined with fat (think cake, biscuits and chocolate). This means they can contribute to unhealthy weight gain. Minimising added sugar intake isn’t only important for maintaining your weight; high-sugar foods are more often than not low in nutritional value too.

A high intake of sugar can also contribute to raised triglycerides – a type of fat in the blood. High triglycerides are a risk factor for heart disease as well as fatty liver disease.     

Some believe fructose is the part of sugar that has negative health effects. That’s because fructose turns to fat when it’s processed, increasing triglycerides and leading to insulin resistance and a fatty liver.

But in healthy people, only a small amount is turned to fat – most is converted to glucose, some is stored as glycogen (glucose that’s been stored by your body to use later for fuel), some is converted to lactate and only about 3 per cent is turned to fat. 

Studies that do show fructose has a negative effect on health are generally animal studies or look at high doses of fructose in the context of a diet that contains excess energy – but fructose isn’t generally eaten in those amounts. The bottom line is, too much of any sugar isn’t healthy.  

Are sugar substitutes any healthier?     

Some substitutes for cane sugar do provide small amounts of minerals and antioxidants, but the amounts are insignificant.

Some unrefined sugar substitutes have a lower glycemic index than cane sugar, meaning they have a less rapid effect on blood sugar levels. Simply, that translates to a more steady release of energy.

Stevia doesn’t contain sugar, so it can be used as an alternative. But it’s a good idea to learn to reduce your preference for sweet foods by reducing all added sweeteners. Recipes containing significant amounts of unrefined sugars (or any sugar for that matter!) should also still be kept as treats and only eaten occasionally.

What about sugar in fruit?

Sugar is sugar, but the form that you get your sugar in is what’s important. 

Sure, fruit contains sugar. But when you’re eating fruit, you’re eating sugar in the context of fibre, vitamins, minerals, antioxidants and other beneficial phytochemicals.

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Compare an apple to a handful of lollies which contains no fibre, vitamins or minerals. It’s much easier to overeat lollies than fruit, and you don’t have to be a nutritionist to realise that an apple is a healthy snack whereas lollies are a treat food.

How to eat less sugar

The best way to eat less free sugar is to focus on eating a wholefoods diet and avoiding highly processed foods. This naturally reduces sugar consumption.

Also read the nutrition panel on the foods you do buy and take serving size into account.      

Rather than replacing sugar with substitutes, it’s a good idea to retrain your taste buds to enjoy foods that are less sweet. Over time, your tolerance for sweet flavours will reduce and you’ll find you don’t crave sugar as much. 

Popular sugar alternatives

Rice malt syrup

This sugar is made by cooking brown rice with enzymes to break down the starches into sugars. This syrup is less sweet tasting than table sugar. It has a high glycemic index. Some believe rice malt syrup is one of the healthiest sugars because it is low in fructose. But this is not the case; it quickly raises your blood sugar levels and, like all sugars, provides very little nutritional value.

Honey

Honey has been a popular sweetener for a long time. It does contain small amounts of vitamins, but they are really insignificant when compared to the amounts found in other foods. Honey – especially darker varieties – also has some antioxidants. This sugar alternative is generally medium glycemic index but it does vary quite a bit depending on the variety.

Agave

Agave syrup is extracted from the sap of a cactus-like plant from Mexico. Agave syrup has a very low glycaemic index, because it contains high quantities of fructose. Beware – the Agave that is produced today is actually highly processed, not the “natural” type of sugar that some believe it to be.

Coconut sugar

Coconut sugar comes from the sap of flowers on the coconut tree. It’s reported to contain a range of vitamins and minerals including B vitamins, potassium, magnesium and zinc. But these are in very small amounts and don’t contribute much nutritional value. This sugar alternative has a low glycemic index and a caramel-like flavour.

Stevia

Stevia is a plant-based sweetener that’s around 300 times sweeter than sugar. Because it’s natural, it’s become a popular alternative to other artificial sugar-free sweeteners. Stevia sweeteners are often blended to improve the flavour. One common brand in New Zealand is blended with monk fruit, and another brand contains the sugar alcohol called erythritol.

Stevia contains no calories, or sugar of any type, therefore it has no effect on blood glucose levels. But, when mixed with erythritol, this sweetener can be problematic for those with Irritable Bowel Symdrome. Also be aware that the taste of Stevia isn’t the same as sugar, but it can be an alternative for those wanting a sweet taste.

Nicola Jackson is a New Zealand Registered Nutritionist with a passion for helping people find an individual approach to good health and helping people develop a healthier relationship with food. She has worked both in public health and nutrition practice in the areas of weight management, irritable bowel syndrome, prediabetes, emotional eating and general nutrition for health. You can read more of Nicola's thoughts on nutrition and wellbeing at eatwellnz.co.nz.