Wednesday, March 7, 2012

Carbohydrates, Sugars, and Sweeteners, Oh My!

You know the saying, “A spoonful of sugar helps the medicine go down.” And, unfortunately it usually helps more food and drinks go down too. One could argue that our innate love for sweetness combined with an abundance of cheap concentrated sugary food sources is responsible for our current obesity epidemic. 100 years ago sugar was a scarce commodity, only enjoyed on special occasions but today it’s hard to avoid added sugars and fake sweeteners as they even show up in foods like ketchup, bread, and crackers. 

Sweet tooth

Increased consumption of real and fake sugars (yes, that includes diet soda) has raised our “sweet threshold”. Many people require more sweet stuff to feel satisfied. Before I discuss all of the available sweeteners and sugar alternatives available, I want to make the point that we should first all try to reduce our sweet threshold. Learn to love water without Crystal Light in it, add only fruit to plain yogurt, and slash in half (or more) the sweetness of your tea or coffee. Over time, the amount of “sweet” required to make you feel satisfied will decrease and hopefully cravings will decrease as well.

Diet soda

I know there are a lot of diet soda lovers out there; I used to be one too. In the last 30 years or so the popularity of diet sodas containing aspartame or sucralose has soared, along with our ever-expanding waist lines. Recent studies have found that drinking diet soda on a daily basis can increase the risk of excess belly fat, high blood sugar, and being overweight.  In 2011 the University of Texas completed a ten year-long study looking at the effects of frequent diet soda consumption. The shocking results were presented at the 2011 American Diabetes Association annual meeting. Researchers found that frequent diet soda drinkers who consumed two or more diet sodas a day experienced a 500 percent increase in their waist circumference (a technical term for belly fat!) compared to non-drinkers. Anyone get a craving for plain tea just now?

Besides drinking diet soda, the free and easy use of NutraSweet (aspartame) and Splenda (sucralose) sprinkled on or in everything should be limited. Many diet products, “light” yogurts, etc. also contain these sweeteners. One theory is that diet sweeteners may trick the brain into thinking it has received some calories. Then when the body actually doesn’t receive calories, we unconsciously seek out those calories from other sources therefore consuming more throughout the day. 


Carbohydrates in their most natural, unprocessed form are vital to our health. Vegetables, fruits, whole grains, beans, and peas all contain carbohydrates required for energy production and fiber needed for digestive health.  Most of our carbohydrate intake should come from these foods, with fruit being the natural sweet treat most of the time. Fruits contain fructose- the sweetest of the simple sugars. It should not be confused with high-fructose corn syrup (HFCS), which is not actually true fructose, but we’ll get to that in a bit. Fructose that is naturally found in fruit, honey, and some veggies appears to cause a smaller rise in blood glucose levels than other sugars if used in small amounts.  Large amounts of fructose may increase triglycerides however. Whole fruit provides a nutrient dense, antioxidant and fiber-rich vehicle for carbohydrates to enter the body. Fiber helps slow digestion and the breakdown of carbohydrate giving you a slower and smaller glycemic response. Straight juice, without the fruit vehicle, is digested very quickly and would cause a greater spike in blood sugar.

White Sugar vs. Raw

Common table sugar (sucrose), derived from cane sugar or sugar beets, is probably in your cabinet. Refined white sugar goes through bleaching and a variety of chemical processes to remove impurities. Raw sugar on the other hand goes through less processing and retains some color from molasses from the sugar cane. Any nutritional benefit from raw sugar is minimal. It does contain traces of minerals and even a measureable amount of antioxidants, but intake should still be limited.

High Fructose Corn Syrup (HFCS)

Move over trans fats, HFCS is the new “four letter word” in nutrition. HFCS is the main sweetener used in many processed foods (look at your ketchup, crackers, and bread). It is not natural fructose. It is actually processed by combining glucose and fructose and has been shown to raise blood glucose and insulin more than plain fructose in diabetics. Many products, following the current hot trend, are removing HFCS and going back to cane sugar. Ultimately, whether there is cane sugar in your soda or HFCS, they are both sources of empty calories. The ultimate goal is to limit consumption of both. This can be done by limiting your intake of  processed foods.

 Alternative Natural Sweeteners

Stevia is an herb that is naturally sweet. I have grown the herb in my backyard and when you chew on the leaf it tastes super sweet.  It has no calories and is actually hundreds of times sweeter than sugar. I find it does have a bit of an aftertaste and only a very small amount is needed. Just like with other no-calorie sweeteners, use only the minimum to meet your sweetness threshold. Truvia is a brand name product using stevia combined with erythritol-a sugar alcohol. According to their website, erythritol is less sweet than sugar and balances the super-sweetness of the stevia.

Agave nectar comes from the “Blue Agave” plant, which also gives us tequila. It contains mostly natural fructose and has a lower glycemic index than sugar or honey, but contains about the same amount of calories. It is very sweet so a small amount will go a long way.

 Brown rice syrup is less sweet than white sugar and has a mild buttery flavor. It actually contains a small amount of protein, about 1 gram. The carbohydrate and sugar content comprises about 50% complex carbohydrates, 45% maltose, and 3% glucose. Maltose and the complex carbohydrates take a longer time to digest and won’t cause a rapid spike in blood sugar.

 Xylitol can be found in a variety of fruits and vegetables and is also produced by the body. It is made commercially using corn or birch bark. Xylitol is a sugar alcohol which has a similar sweetness to sugar, but it actually can help prevent dental cavities. It has about 40% fewer calories than regular sugar and is slowly digested and not fully absorbed by the body so it won’t raise blood sugar and insulin levels like regular sugar. Another interesting use of xylitol includes helping to reduce the risk of ear infections in children. The only negative side effect may be some digestive distress if consumed in unusually high doses.

The use of honey dates back thousands of years and you really can’t get a more natural sweetener. It is produced by honey bees from the flower nectar they collect and can be up to 60% sweeter than sugar.  Honey has antioxidant and antimicrobial properties. It appears to be more effective at relieving coughs in children than cough medicine (and much safer). Preliminary research suggests that honey can improve glycemic control in those with type 2 diabetes and additional research is currently being done in that area.

While these are considered more “natural” alternatives to table sugar, all of them with the exception of stevia still do contain calories. They all should still be used in moderation in the least amount possible to satisfy your sweet tooth. If you do have diabetes, monitor your blood sugar carefully when making any changes to your diet.

Megan Witt, RD, LD, CLT                                            Registered Dietitian/Nutritionist
MegaNutrition Works, LLC
Certified LEAP Therapist for chronic conditions caused by food sensitivities including irritable bowel, migraine, fibromyalgia and more.

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