Your guide to sugar substitutes

The message about reducing intake of sugar is finally getting through, with the recognition that a high dietary sugar load is frequently one of the drivers behind obesity, diabetes, high cholesterol, worsened menopause symptoms and cognitive decline.  Going cold turkey is the easiest way to quit sugar but for some that is not an option. So how to navigate the increasingly complex world of alternative sweeteners?  Here is your guide.

First, fix cravings

Not a sugar substitute but cinnamon is a fantastic sweet spice that may help to better manage blood sugar highs and lows.  Various studies have demonstrated beneficial effects of the spice on glucose, insulin, lipids, blood pressure and lean body mass.  It needs to be used liberally for benefit, eg a teaspoon.  My favourite is on stewed apples with Greek yogurt.  Attending to sleep, high fibre from veggies and plenty of protein is also essential in fighting sugar cravings.

Still sugar but with good PR

Honey, maple syrup, coconut sugar, rice syrup, date syrup and molasses are popular with the healthy eating brigade, but the truth is the body still treats these as if they are sugar.  They may have slightly less fructose and some nice minerals but you would have to eat a lot of it to get any benefit.  If you are reducing sugar for health reasons, avoid these for now.  Molasses are slightly lower on the glycemic index than the others and is probably the best of the bunch.  It also has a huge amount of iron amongst other things so great for those who need to increase their intake.  Oh, and demerara, turbinado, cane and dark brown sugar is still sugar but looks fancy.

Possible Substitutes

I say ‘possible’ because in studies, whilst lower in calories, nearly all alternative sweeteners have resulted in an increase in insulin and glucose levels.  Additionally, a number of them contain FODMAP’s which stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols.  These are short-chain carbohydrates (sugars) that the small intestine absorbs poorly. Some people experience digestive distress after eating them, such as bloating, gas and diarrhoea. Choose wisely.

Stevia – normally in drops and touted as the best natural low-calorie sweetener.  Studies have noted that stevia does not significantly contribute to increased glucose and insulin levels.  The downside is that it can have a bitter aftertaste so shop around for a good one.  Low FODMAP.

Yacon syrup.  A favourite with people who eat keto style, harvested from the yacon plant it tastes like molasses.  It is high in fructo-oligosaccharides (FOS) – which feed good bacteria in the gut and helps with constipation.  Likely high FODMAP.

Inulin – another FOS, a prebiotic fibre.  Pretty good in tea and coffee but not as sweet as normal sugar.  High FODMAP.

Monk fruit.  Hard to get in the UK and like cinnamon, there is some research suggesting it may help blood sugar management.  It has a caramel taste and is safe to use.  Just check it has not been combined with other sweeteners.  Low FODMAP.

Erythritol (produced by fermentation from dextrose) and Xylitol (wood sugar from birch).  Both are sugar alcohols and are about 70% as sweet as sugar but without the big insulin spike.  Both are fabulous in low carb baking.  Avoid or take particular care with xylitol if you have dogs at home as it is highly toxic.  Erythritol is a low FODMAP, xylitol a high FODMAP.

Watch this space

Allulose.  Not yet available in the UK, but relatively new to the market in the US.  It’s known as a ‘rare sugar’, has the same chemical formula as fructose, but arranged differently, so it’s not processed in the body in the same way.  It does not ferment in the gut so does not lead to digestive issues. 

Avoid

Agave syrup.  Diabetic friendly, this a ‘natural’ sweetener but when processed it becomes 85% fructose so it’s actually worse than sugar – it overloads the liver causing raised blood trigylcerides, bad (LDL) cholesterol and increased belly fat.

High Fructose Corn syrup.  Used mostly in processed foods but thankfully not in the same quantities here compared to other countries.  Known as the key driver of obesity, poor metabolic health and non-alcoholic fatty liver damage.

Sorbitol and malitol.  The sugar alcohols known for the most severe digestive distress and very high FODMAP’s.

Aspartame, acesulfame-K, sucralose and saccharin.  These are chemical sweeteners often under brand names such as Canderel, Hermesetas, Splenda, Sweetex.  The jury is still out on the safety of these products and many people report side effects.