According to the Centers for Disease Control and Prevention, 3 in 5 Americans aged 2 or older, exceed the recommendation of no more than 10% of total calories coming from added sugar. While we can conclude added sugar consumption is higher than recommended, and increasing risk for chronic disease, a common approach has been to replace sugar with alternative sweeteners. The rising question is, which one do we pick and can too much of any alternative possibly have other implications? Let’s break it down. There are different type of sweeteners; sugar, sugar alcohols, artificial sweeteners, and naturally-derived sweeteners.

Sugar is a carbohydrate naturally occurring in fruits, vegetables, grains, and dairy. In addition, sugar can be added to foods and found on nutrition labels as corn syrup, high fructose corn syrup, cane sugar, maple syrup, honey, and others. While the body knows how to effectively metabolize sugar when consumed in moderation, excess consumption can lead to weight gain, obesity, diabetes, and cardiovascular disease.

Sugar alcohols such as sorbitol, xylitol, erythritol, or maltitol are naturally occurring compounds of sugar found in some foods, but often are manmade. They have become a more common way to sweeten food products while achieving a lower calorie and carbohydrate content. While they provide about half the number of calories of sugar, fewer carbohydrates, and don’t cause blood sugar spikes, ongoing research is suggesting they may present other side effects because of the body’s inability to full digest them, especially when over-consumed. Some of these suggested side effects include gastrointestinal issues and weight gain.

Artificial sweeteners such as aspartame, saccharin, and sucralose are artificially composed and intended to provide a high level of sweetness compared to sugar. They are used to sweeten foods without adding calories and carbohydrate content, making them a common alternative for individuals seeking to lose weight or with medical conditions such as diabetes. It is also important to consider, your taste buds may adapt to the high-level of sweetness which may change the way we taste food and alter cravings.

Naturally-derived, low-calorie sweeteners such as stevia and monk fruit are sweeteners derived from all-natural ingredients. Once again, these are used to reduce total calories and carbohydrate content compared to sugar. Like sugar alcohols and artificial sweeteners, they do often undergo processing before they reach the shelves in the grocery store and therefore, this does not necessarily imply they are “all natural” though, can be a considered alternative to sugar.

Research on this topic is ongoing and currently, alternative sweeteners are generally recognized as safe by the FDA when consumed in moderation. While there are several options for adding sweetness to our food, it is important to consider your health, medical conditions, and the potential side affects you experience. It is important to remember, too much of anything, even when it is good, can become not-so-good when moderation is lost. Keep in mind, whole foods are an important base to a balanced, healthful diet. I would encourage focusing on inclusion of these foods versus replacing them with “diet foods.”

Also consider, strategies to reduce sugar consumption versus replacing with sweetener alternatives:

• Limit soda intake (diet or regular) and replace with carbonated water or water with fresh fruit infused if you are looking for flavor

• Be mindful of added sugars when reading a nutrition label, and practice moderation

• When baking, consider swapping out sugar with unsweetened applesauce, if it suites the recipe

• Select juice with “no added sugar”

• Simply reduce portions (maple syrup/honey, desserts, candy, etc) and prioritize adding in whole foods

References: Centers for Disease Control and Prevention, U.S. Food & Drug Administration, Michigan State University, Mayo Clinic,   Cleveland Clinic, Harvard Health