Have a sweet tooth? You’re far from alone—U.S. adults consume an estimated average of 17 teaspoons of added sugar per day, which is double the amount recommended by the American Heart Association[1]Get the Facts: Added Sugar. Centers for Disease Control and Prevention. Accessed 7/17/2023. [2]Added Sugars. American Heart Association. Accessed 7/17/2023. . Added sugar can contribute to a wide range of health problems, including obesity and chronic disease. For this reason, many may turn to sugar substitutes to try and reduce their intake of added sugars.
Keep reading for more details on how sugar substitutes can impact health, plus the top sugar alternatives recommended by nutrition experts.
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How Do Added Sugars Impact Health?
Added sugars are a type of sugar added during the processing of foods. They are also found in packaged sweeteners, syrups and honeys and concentrated fruit or vegetable juices.
Meanwhile, naturally occurring sugars found in fruits, vegetables or dairy products are not considered added sugars. Instead, the total amount of sugar found in a food—including both naturally occurring sugars and added sugars—is listed as “total sugars” on a nutrition label. Unlike added sugar, there is currently no recommendation for the amount of total sugar you should consume per day.
Added sugars are often found in the following products:
- Soda
- Sports drinks
- Baked goods
- Cookies
- Cakes
- Candy
- Breakfast cereals
- Syrups or toppings
Consuming high amounts of added sugar can negatively impact health and contribute to chronic inflammation and increase the risk of several conditions, including type 2 diabetes and heart disease, as it can overload the liver.
Plus, excessive intake of added sugars, particularly those found in sugary drinks, can lead to weight gain by turning off your body’s appetite-control system, making it easier to fill up on high-calorie drinks without feeling satiated, notes Harvard Health.
The American Heart Association recommends limiting your intake of added sugars to less than 6% of total calories per day. For most women, that translates to about 100 calories, or 6 teaspoons of sugar daily. For men, it equals approximately 150 calories, or 9 teaspoons of sugar, the organization notes.
Are Sugar Substitutes Safe?
Sugar substitutes are used in place of sugar to enhance the flavor or add sweetness to foods and beverages. They typically have far fewer calories and are significantly sweeter than sugar, meaning that you only need a very small amount to achieve the same level of sweetness.
Sugar substitutes are typically plant or chemical-based. A few sugar substitutes are Generally Recognized As Safe (GRAS) by the Food and Drug Administration (FDA), including stevia and monk fruit—this means they don’t require FDA approval, due to the general agreement among qualified experts that they are safe for use in food and drinks.
Sugar alcohols are another type of sugar substitute that are GRAS by the FDA. Unlike artificial sweeteners, these compounds occur naturally in some foods and can also be manufactured. They have a chemical structure that is similar to sugar but contain less calories. Examples include sorbitol, mannitol and xylitol.
Meanwhile, several other types of sugar substitutes are approved by the FDA as food additives, including artificial sweeteners such as:
- Aspartame (Equal and NutraSweet Natural)
- Advantame
- Neotame (Newtame)
- Sucralose (Splenda)
- Saccharin (Sweet ‘N Low and Sugar Twin)
- Acesulfame K (Sunett and Sweet One)
Though artificial sweeteners are approved for use as a food additive by the FDA, there are some concerns associated with certain types. “Recent research shows that certain sugar substitutes can cause health problems,” says Amy Shapiro, a New York-based dietitian and founder of Real Nutrition NYC, a private nutrition practice.
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“Some research points to artificial sweeteners altering the gut microbiome and leading to weight gain, even though they are zero calories, as they can increase sweet cravings,” explains Shapiro. She notes that sugar alcohols can also cause digestive issues like bloating, gas and diarrhea for some people, especially if consumed in large amounts.
Aspartame, in particular, has recently faced some controversy. In fact, it was recently labeled as “possibly carcinogenic to humans” by the World Health Organization and the International Agency for Research on Cancer. However, keep in mind that this conclusion was based on limited evidence. Additionally, scientists note that consuming up to 40 milligrams per kilogram of body weight is safe, meaning that an adult weighing 154 pounds (70 kilograms) would need to drink 9 to 14 cans of diet soda each day to exceed this limit.
Regardless, some experts advise using these sugar substitutes with caution. “I recommend limiting or avoiding consumption of artificial sweeteners such as aspartame, saccharin or sucralose due to unknown long-term effects on health,” says Sarah Olszewski, a registered dietitian based in Syracuse and owner of Sarah Lynn Nutrition, a nutrition counseling service. Olszewski also notes that it might be a good idea to limit your intake of sugar alcohols, especially if you experience digestive issues after eating them.
Still, Olszewski explains that including these ingredients in your diet from time to time is probably safe, noting that while they may have negative effects when consumed in large quantities on a regular basis, their impact is likely small when used in moderation. Emily Spurlock, a Boise-based registered dietitian, agrees, stating, “the overall consensus is that the artificial sweeteners approved for use in the U.S. are safe when used in reasonable quantities.”
4 Sugar Substitutes, Recommended by Experts
There are several nutritious ingredients that you can swap in for refined sugar in your diet. Here are a few of the top choices recommended by experts.
Monk Fruit
Monk fruit is a low-calorie sweetener derived from Siraitia grosvenorii, or Swingle fruit. Olszewski notes that it’s a good choice because it’s derived from plant sources, is free of calories and doesn’t have a significant impact on blood sugar levels. While more research is needed to evaluate the potential health benefits of monk fruit, some studies show it may help reduce inflammation, protect brain health and even act as an antioxidant[3]Li H, et al. Research Progress of Pharmacological Effects of Siraitia Grosvenorii Extract. J Pharm Pharmacol. 2022;74(7):953-960. .
Stevia
Shapiro recommends stevia, as it’s natural and sourced from the leaves of the Stevia rebaudiana plant. Stevia is lower in calories than refined sugar, and it might even offer some health benefits.
According to one systematic review, stevia may actually help reduce blood pressure levels in people with type 2 diabetes[4]Bungaard Anker CC, et al. Effect of Steviol Glycosides on Human Health with Emphasis on Type 2 Diabetic Biomarkers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2019;11(9):1965. . In another study, supplementing with stevia for 24 weeks improved blood sugar control, insulin resistance and cholesterol and triglyceride levels in people with type 2 diabetes. On the other hand, researchers found that it also increased body weight in people with obesity[5]Rashad NM, et al. The Impact of Stevioside Supplementation on Glycemic Control and Lipid Profile in Patients With Type 2 Diabetes: A Controlled Clinical Trial. Egypt J Intern Med. 2019;31:22-30. .
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Raw Honey
Raw honey is another natural sugar to consider, notes Olszewski. In fact, research suggests that certain compounds in honey may offer antioxidant, anti-inflammatory, antimicrobial and anti-cancer effects, which could be beneficial for a variety of conditions.
A review of 18 studies suggests raw honey could reduce fasting blood sugar and total cholesterol levels when consumed within a “healthy dietary pattern”[6]Ahmed A, et al. Effect of Honey on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis. Nutr Rev. 2023;81(7):758-774. . Another study in over 18,000 adults linked increased consumption of honey to a decreased risk of prediabetes[7]Zhang S, et al. Honey Consumption Is Inversely Associated With Prediabetes Among Chinese Adults: Results From the Tianjin Chronic Low-Grade Systemic Inflammation and Health (TCLSIH) Cohort Study. Br J Nutr. 2020;1-8. .
As with any sugar, it’s best to enjoy honey in moderation. Additionally, experts note that high-risk populations, such as older adults, people who are sick, people who are pregnant and lactating and kids younger than 6, should not eat raw honey.
Maple Syrup
“Although still high in sugar, [maple syrup] does contain some minerals,” says Shapiro. In addition to zinc, manganese, potassium and calcium, maple syrup also contains small amounts of other important nutrients, including amino acids. It contains antioxidants, too, especially if you opt for darker varieties.
However, because it’s still high in sugar, Shapiro recommends limiting your intake to about 1 teaspoon at a time to avoid going overboard.
Consuming high amounts of added sugar can have negative health consequences and might even contribute to certain chronic conditions. Additionally, while some sugar substitutes are considered safe, they might also be associated with health concerns if consumed in excess.
Therefore, enjoying ingredients like honey, stevia, monk fruit or maple syrup in moderation might be a better option for long-term health.
