So what about sugar alternatives or artificial sweeteners? Are there healthier, albeit synthetic options available? Or should we just stick to what nature provides, and temper the amount we consume?
Time for a deep dive, into the world of sugar.
Do Humans Really Need Sugar?
As humans, our body utilises sugar quite readily for energy. From an evolutionary perspective, eating sugar is an effective way to fuel our brain and muscle tissue. This would have been especially important in times of high physical or cognitive demand, like hunting and fighting. The neurocircuitry involved with consuming sugar is strong, and its role is protective. Basically, humans have eaten foods that contain sugar and utilised this sugar rapidly to meet an imminent need, for survival.
But really, the body can also break down fats and protein and convert it to energy. So, it’s not that we need sugar, it’s that it’s a ready-to-go energy source for the brain and body. The issue is, once it’s used, it’s depleted. So it’s not a good idea to rely solely on sugar for energy every day. As long as you’re eating a mix of carbohydrates (which are complex sugars), proteins and healthy fats - you’ll be well stocked in the energy department.
In today’s world, this affinity for sugar has had a boomerang effect, negatively impacting our health and wellbeing. We have a glut of sweet foods available at our fingertips and we aren’t expending this energy to offset its consumption.
Understanding dietary sources of sugar, both natural and synthetic, will help you be aware of what’s going into your body. The more informed you are, the better chance you have of making healthier choices.
Is Sugar Really That Bad For You?
Food Standards Australia New Zealand (FSANZ) echo the recommendations of The World Health Organisation (WHO) when it comes to sugar consumption. Both governing bodies suggest that ‘free’ sugars comprise no more than 10% of an adult’s daily energy consumption. This roughly equates to about 12 teaspoons or 50 grams of sugar per day for a healthy adult. Anything greater than this amount is linked to a sequelae of chronic conditions, not least of which is obesity.
‘Free sugars’ simply means anything added to a food or product that increases the total available sugar content. For instance, a piece of fruit which contains natural glucose and fructose doesn’t fall into this category, and can therefore remain a regular part of anyone’s healthy diet. Importantly, it’s not always the sugar itself that’s the culprit for ill-health. It’s the packaged and processed foods that convey it.
A comprehensive review paper confirms this idea. Published in the European Journal of Nutrition, the authors of this review found that when sugars are consumed as part of a normal, varied and healthy diet, there’s no discernable link between sugar consumption and adverse health effects. Essentially, a teaspoon of sugar in your morning coffee is allowed, and won’t cause major metabolic issues.
The Insatiable Reward System For Sugar
Where sugar consumption really comes unstuck for me, is when it’s related to brain health, mood and behaviour. Sure, our bodies generally utilise sugar quite well in normal metabolic functions. Yet, for the brain, too much sugar can be inflammatory and addictive.
A 2019 meta-analysis that looked at the effects of carbohydrates and mood changes showed some compelling results. The findings from over 30 studies showed that categorically, carbohydrates have no beneficial effect on any aspect of mood. Furthermore, the authors confirmed that carbohydrate consumption lowers alertness and increases fatigue within 60 minutes and 30 minutes, respectively. Luckily, there’s plenty of other ways to use food to boost your mood.
Sugar is also famously addictive, according to both human and animal studies. An article from the British Journal of Sports Medicine illustrates sugar as having similar effects on the brain as opioid drugs. These behaviours include bingeing, food and substance cravings, withdrawal-effects and euphoric effects. Sugar consumption causes a release of naturally occurring opioids in the brain, which are possibly akin to illicit substances. Consuming sugar primes the brain toward seeking more of the same effect, particularly when the initial ‘sugar kick’ wears off.
Other research has shown that sugar consumption shifts the hunger-satiety continuum. This means that because sugar fails to induce a feeling of fullness, the body is signalled to keep eating. This leads to a surplus of food intake with damaging health effects as a result. Furthermore, this produces a neural loop in the brain that can be described as an insatiable drive for reward.
Are Sugar Alternatives Healthy?
So, you want to lower your sugar intake yet keep the sweetness?
Welcome to the world of artificial sweeteners and sugar alternatives. While you may think that straight up swapping table sugar for other sweeteners is a healthy choice, it’s not that simple. It turns out, substituting sugar with commonly found artificial sweeteners doesn’t always have beneficial clinical outcomes.
Between aspartame, sorbitol and monk fruit - there’s so many different sweetening agents used in commercial food products. It’s probably no surprise, however, that not all sugar alternatives are created equal. It pays to understand these ingredients, to make healthier choices. Taking a good look at food labels can help you understand what’s exactly in the food you eat.
Let’s now take a look at natural sugars, refined sugars, sugar alternatives and artificial sweeteners.
Natural sugars or sweeteners are terms used interchangeably in the food industry. A natural sugar should just be a simple sugar molecule, such as fructose, glucose or lactose, which occur naturally in fruits and dairy. Now, if we’re talking about sugar itself, as in table sugar, that’s classified as a natural sugar (obviously) and is derived from cane juice. Beyond all of this, everything else is a sugar alternative (natural or artificial). On food labels, you may see the terms ‘natural sweetener’ used. Typically, it should mean a natural source of sweetness is used, like fruit or nectar. Always check the ingredients list to be sure.
Examples of a natural sweeteners include:
Refined sugars are made by processing other foods to create sugar molecules. In most instances, sugarcane is the original food used to then create a range of sugary substances. Many of these molecules will be further processed, however all of them can be defined as refined sugar. In this way, these products are technically still made from a natural food and therefore are distinct from artificial sweeteners.
Examples of refined sugars include:
- White Sugar
- High-fructose corn syrup
- Invert Sugar
- Juice concentrates
- Malt sugar
We know that consuming excess sugar causes the body to produce insulin in large amounts. If this continues for long enough, the body can become resistant to the effects of insulin, or the pancreas stops releasing it adequately. This has led to the food industry’s creation of sugar alternatives that have long been marketed to diabetes patients or the public as a healthier alternative to sugar. Some alternatives to sugar are more ‘natural’, while others are completely synthetic.
Remember, none of these are actually sugar. Meaning, none of the following substances are derived from cane sugar, which classifies them as a ‘sugar alternative’. Let’s look at a few natural examples as well as some artificial sweeteners.
Natural Alternatives to Sugar
Stevia is quite common these days in the food industry as a healthier sugar alternative. It’s even found at most cafés alongside table sugar and good ol’ Equal sachets (more on that soon). But is stevia really a healthy alternative?
Well, it’s a sweetener that’s derived from a South American plant. It’s considered non-nutritive, which means it has no caloric value. Some products use stevia extract while others will use the individual glycosides (plant sugars). These include steviol and stevioside, for example. Some research has shown that these compounds that naturally occur in stevia have a wealth of health benefits. Stevia leaf lowers blood pressure and has anti-diabetic and even anti-cancer properties. It’s very sweet to the taste, and around half a teaspoon tastes just as sweet as 2 loaded teaspoons of sugar. All these factors together make stevia a decent alternative to table sugar.
Monk fruit or Luohan Guo is a fruit related to watermelon and squash that hails from southern China. It’s very sweet (around 250 times stronger than table sugar). Similar to stevia, research has confirmed that monk fruit has powerful anticancer and antioxidant properties. Monk fruit also has plenty of other health-giving qualities, including boosting immune function and protecting the liver. Monk fruit is found in yoghurt, drinks and cake mixes, among other foods. Like stevia, it makes for a reasonably good sugar alternative.
Now we’re in the territory of artificial sweeteners. Truthfully, for me this is a ‘steer-clear’ zone for very good reasons. Artificial sweeteners are synthetic sugar substitutes. Occasionally they’re made from naturally occurring substances. They often have a concentrated sweetness, usually tasting twice or three times as sweet as regular table sugar (raw sugar).
These sweeteners are popular in the weight-loss industry, as they contribute ‘no calories’ to the diet. Essentially, they’re a chemically-loaded sweet hit to the tastebuds that trick you into thinking you’re having sugar, without the added energy. Honestly, some of them really aren’t good for you, I’ll explain why.
Examples of artificial sweeteners include:
- Sugar Alcohols
If you ever wanted a ‘100% do-not-recommend’ endorsement on a food substance, here it is.
Aspartame is a crystalline powder made from aspartic acid and phenylalanine, two amino acid compounds. Aspartame is also known commercially as Equal or NutraSweet or as food additive - 951. Aspartame was made in the United States in the 1960s, originally as a drug. It’s been an approved artificial sweetener for commercial use since the 1970s. It’s used widely in products made in the States, found in chewing gum, carbonated beverages and frozen desserts. Like a lot of sugar alternatives, aspartame is around 200 times sweeter than table sugar.
While public opinion on aspartame is highly controversial, there is some evidence demonstrating that aspartame does not cause cancer. In fact, various studies have been ‘examined and dismissed by numerous scientific research projects.’ However, it’s not difficult to find articles that show clearly that aspartame is highly carcinogenic and not fit for human consumption.
FSANZ, which is the governing body of food safety here in Australia has a fairly reserved stance on aspartame as an artificial sweetener. While they concede that much of the available data shows aspartame to be safe for human consumption, they also recommended a thorough re-evaluation of the evidence.
Saccharin is an artificial sweetener made in 1879, by complete accident, from toluene. Saccharin is also known as Sweet N Low and boasts a whopping 300 to 500-fold sweetness strength, compared to table sugar. It famously has a bitter aftertaste and is therefore not as popular as some other sugar substitutes, whether they be natural or fake. As a food additive it’s labelled as 954.
Much like aspartame, there’s some contention around the safety of saccharin consumption. Some research has reported that saccharin causes bladder cancer in animal studies. In the US, there’s requirements for a warning label, some countries restrict the use, and in other countries, saccharin is flat-out banned.
Also known as Splenda and unsurprisingly, I don’t like this sweetener either. Sucralose is also a non-nutritive sweetener. This means it has no caloric value, on account of its chemical composition. It’s a chlorinated form of sugar (already sounds bad, right?) and is 600 times sweeter than table sugar! Sucralose is detectable on a food label as 955.
Of course, controversy is abundant with sucralose too. It’s been highly linked to insulin resistance and is poorly digested by the body. It’s also been found to alter the gut microbiome and liver enzyme activity in animal models. Yet, like the other sweeteners, sucralose is deemed safe to consume overall by most governing health authorities in the developed world.
This class of sugar alternatives is quite different to the three above. Sugar alcohols are also known as polyols and aren’t as sweet as most sugar substitutes. They are not calorie-void, but have a lower caloric value than table sugar. Examples of sugar alcohols include sorbitol, xylitol, mannitol and erythritol. Xylitol is a popular additive in toothpaste and chewing gum, due to its oral health promoting properties.
An important thing to keep in mind, is that sugar alcohols are only partially metabolised by the body. Undigested sugar alcohols have an osmotic effect and can cause gastrointestinal irritation, gas, bloating and diarrhoea in large quantities. Sugar alcohols aren’t really included in large amounts in commercial food production for this reason.
Summary of Thoughts on Sugar & Alternatives
It would seem that the argument for or against sugar depends on your individual health and wellbeing goals. That said, here’s a few final musings on sugar, in all it’s true and false variations. For me, artificial sweeteners are a non-food that has no place in your trolley, kitchen pantry or plate. Therefore, I’d suggest striking these chemical bombs off your shopping list. By and large, processed sugars (processed anything) are associated with major health problems. So we could probably say that refined sugars should be limited in the diet. Finally, this leaves natural sugars. It should really be no surprise that these are the best of the bunch and of course, the healthiest to consume. Unprocessed, natural sugar from sources like fruits or dairy products, as part of a balanced diet will always be the best option.
Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and biobehavioral reviews, 32(1), 20–39. https://doi.org/10.1016/j.neubiorev.2007.04.019
Cancer Treatment Centers of America (2016). Natural vs. refined sugars: What's the difference? Retrieved from: https://www.cancercenter.com/community/blog/2016/08/natural-vs-refined-sugars-what-is-the-difference
DiNicolantonio, J. J., O'Keefe, J. H., & Wilson, W. L. (2018). Sugar addiction: is it real? A narrative review. British journal of sports medicine, 52(14), 910–913. https://doi.org/10.1136/bjsports-2017-097971
Freeman, C. R., Zehra, A., Ramirez, V., Wiers, C. E., Volkow, N. D., & Wang, G. J. (2018). Impact of sugar on the body, brain, and behavior. Frontiers in bioscience (Landmark edition), 23(12), 2255–2266. https://doi.org/10.2741/4704
Greenberg, D., & St Peter, J. V. (2021). Sugars and Sweet Taste: Addictive or Rewarding?. International journal of environmental research and public health, 18(18), 9791. https://doi.org/10.3390/ijerph18189791
Hancock, S., Zinn, C., & Schofield, G. (2020). The consumption of processed sugar- and starch-containing foods, and dental caries: a systematic review. European journal of oral sciences, 128(6), 467–475. https://doi.org/10.1111/eos.12743
Landrigan, P. J., & Straif, K. (2021). Aspartame and cancer - new evidence for causation. Environmental health : a global access science source, 20(1), 42. https://doi.org/10.1186/s12940-021-00725-y
Mantantzis, K., Schlaghecken, F., Sünram-Lea, S. I., & Maylor, E. A. (2019). Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood. Neuroscience and biobehavioral reviews, 101, 45–67. https://doi.org/10.1016/j.neubiorev.2019.03.016
Mayo Clinic (2022), Artificial sweeteners and other sugar substitutes. Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/artificial-sweeteners/art-20046936
Mooradian A. D. (2019). In search for an alternative to sugar to reduce obesity. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 89(3-4), 113–117. https://doi.org/10.1024/0300-9831/a000531
Olszewski, P. K., Wood, E. L., Klockars, A., & Levine, A. S. (2019). Excessive Consumption of Sugar: an Insatiable Drive for Reward. Current nutrition reports, 8(2), 120–128. https://doi.org/10.1007/s13668-019-0270-5
Peteliuk, V., Rybchuk, L., Bayliak, M., Storey, K. B., & Lushchak, O. (2021). Natural sweetener Stevia rebaudiana: Functionalities, health benefits and potential risks. EXCLI journal, 20, 1412–1430. https://doi.org/10.17179/excli2021-4211
Rippe, J. M., & Angelopoulos, T. J. (2016). Sugars, obesity, and cardiovascular disease: results from recent randomized control trials. European journal of nutrition, 55(Suppl 2), 45–53. https://doi.org/10.1007/s00394-016-1257-2
Singh, M. (2014). Why A Sweet Tooth May Have Been An Evolutionary Advantage For Kids. Retrieved Aug 2022, http://www.npr.org/sections/thesalt/2014/03/19/291406696/why-a-sweet-tooth-may-have-been-an-evolutionary-advantage-for-kids