Stevia, monkfruit, agave, maltodextrin, brown rice syrup- what in the? It is so hard to keep up sometimes. There seems to be a new term for sugar popping up or a new product on our shelves. It is tough to distinguish the goods, from the bads, to the uglies. Let’s take a dive into the sweetener world.
Before a sweetener can be legally added to a food or beverage in the U.S., it must either achieve FDA approval or be accepted as GRAS (generally recognized as safe).1 The FDA lists food substances that are exempt from testing before putting them on the market. The list includes “any substance that is intentionally added to food… generally recognized, among qualified experts, as having been adequately shown to be safe under the conditions of its intended us.”2
An easy way to break down all things sweeteners is by splitting them into two categories- caloric vs. non-caloric.
Caloric means they have calories and they raise blood sugar. Some, of which, are found naturally in food. Non-caloric sweeteners do not have calories, do not raise blood sugar, and can come from natural and artificial sources.
What are the different types of sweeteners
Examples of caloric sweeteners are: sucrose, fructose, lactose, glucose, honey, maple syrup, agave nectar, sugar alcohols, high fructose corn syrup to name a few. Believe it or not there are 61 alternate names for sugar listed on food labels, per University of California, San Francisco’s Sugar Science- The Unsweetened Truth. 61?! They go on to say “These include common names, such as sucrose and high-fructose corn syrup, as well as barley malt, dextrose, maltose and rice syrup, among others. While product labels list total sugar content, manufacturers are not required to say whether that total includes added sugar, which makes it difficult to know how much of the total comes from added sugar and how much is naturally occurring in ingredients such as fruit or milk. That makes it very difficult to account for how much added sugar we’re consuming.”
The sweeteners in the table3 below are among the most common caloric sweeteners.
16 calories per 1 teaspoon
21 calories per 1 teaspoon
20 calories per 1 teaspoon
Sweeter than sugar
2 x sweeter
1.5 x sweeter
Sugar Beets and Sugar Cane
Adds sweetness with no aftertaste. Browns well.
Minimal processing. Unsafe for infants. Not vegan
White sugar, Turbinado Sugar, Sugar in the Raw
Sugar alcohols are carbohydrates but provide fewer calories than sugar and have less impact on blood sugar than other carbohydrates. Used to sweeten candies, chewing gum, pudding, ice cream, cookies and syrups, items made with sugar alcohol can be labeled “sugar-free” or “no sugar added. However, this can be very misleading because the sugar-free version may be similar to the regular product, despite the deceiving claim.
Some sugar alcohols may cause gas, cramping or diarrhea in some users. Products sweetened with mannitol or sorbitol must carry a label warning of risk for laxative effect. Common sugar alcohols are: Mannitol, Sorbitol, Erythritol, Glycerol, Hydrogenated Starch Hydrolsates (HSH), Isomalt, Lactitol, Maltitol, Xylitol.
Sugar alcohols are not absorbed as much as regular sugar; therefore, it is best to estimate half of the sugar alcohol grams on a food label will be absorbed and ultimately affect blood glucose levels.
Non-caloric sweetener examples are: Acesulfame-k (Sunett, Sweet one), Aspartame (Nutrasweet, Equal), Saccharin (Sugar Twin, Sweet n Low, Sucralose (Splenda), Stevia rebaudiana (Ideal, Truvia)*, Monkfruit extract* (*from a natural source). See chart4 below for comparisons.
4 cals per gram
4 cals per packet
5 cals per packet
0 cals per ¼ teaspoon
Sweeter than sugar
200 x sweeter
200 x sweeter
200-700 x sweeter
600 x sweeter
30 x sweeter
Very stable at high temps, no effect on blood glucose, slightly bitter aftertaste
May trigger headaches; People with Phenylketonuria do not use
No Effect on blood glucose; aftertaste
Very stable; no effect on BG
No effect on blood glucose
NO effect on blood glucose
All, except meat and poultry
Processed diet foods, drinks
All, except meat and poultry
Sunette, Sweet One
Sweet ’n Low
Splenda, Candys, Sucraplus
Stevia, Sweetleaf, Truvia, PureVia
Nectresse, Monk Fruit in the Raw, Skinny Girl Monk Fruit
There are pros and cons to non-caloric sweeteners.
The pros being that: they have little to no effect on blood sugar, they help to control calories (compared to sugar-sweetened products), and they reduce sugar effect on dental health.
The cons: non-caloric sweeteners taste sweet but provide no calories and do not satisfy hunger, they may increase sugar cravings and appetite, there are concerns regarding consumption of artificial sweeteners changes to the gut biome, to name a few.
The book “The Mind-Gut Connection” by Emeran Mayer, MD dives into the affects of artificial sweeteners on gut health. Mayer states, “Despite their ubiquity, evidence for their promised health benefits is mixed at best, and evidence for dangers of artificial sweeteners has emerged, including weight gain and increased risk of metabolic diseases such as type 2 diabetes.” There have been studies done at the Weizmann Institute of Science in Jerusalem that showed commercial sweeteners (saccharin, sucralose, and aspartame) can induce glucose intolerance and signs of metabolic syndrome in mice. They noticed that by analyzing the animals’ microbiota, the artificial sweeteners led Bacteroides bacteria to flourish in the animals’ gut, just as a high-fat diet does.
In addition, the researchers also showed additional calories were absorbed by the colon, when artificial sweeteners were consumed due to evidence showing the metabolic pathways were altered in gut microbes causing them to produce more short-chain fatty acids. Mayer goes on to say, “It suggests that trying to cut calories with artificial sweeteners won’t work because your gut with the help of its microbes, will just extract proportionally more calories from the food you eat.”
Contrastly, Stevia and monk fruit extract are newer to the category of non-caloric sweeteners. They are not considered artificial because they are from natural sources. However, watch out when buying them in bulk in supermarkets because a sugar alcohol, erythritol, is commonly added for bulking and anti-caking purposes.
It seems, like many things in the world of nutrition, it is best to limit the use of non-caloric sweeteners. You’re likely sick of hearing the word moderation, but it also applies to use to sweeteners. Consider limiting artificial sweeteners to a “treat”.
1. Barclay, Alan W. The Ultimate Guide to Sugar & Sweeteners. 2014
2. “Generally Recognized as Safe (GRAS)”. U.S. Food and Drug Administration, last modified July 14, 2014.
4. FDA Approved High-Intensity Sweeteners Approved for Use in Food in the United States, 2018
Academy of Nutrition and Dietetics (2012) Position of the Academy of Nutrition and Dietetics: Use of Nutritive and Nonnutritive Sweeteners. Journal Academy of Nutrition and Dietetics (Volume 112) Number 5 p 739-758
Kristen Garron RD, LDN, CDE
Director of Group Education.
Kristen joined IDS in 2018 after working for seven years as a clinical dietitian in a community hospital and eight years as lead instructor for a diabetes self-management education company. With a knack for making complex issues seem simple and relating to people with a strong sense of empathy, group diabetes education has become her specialty and her passion.
“I think it’s important to create a warm, welcoming atmosphere,” says Kristen. “Everyone at IDS is that way – with patients and with each other. It’s tough enough living with diabetes; the least we can do is make those around us feel like family.”
A graduate of LaSalle University (go Explorers!), Kristen majored in Nutrition while earning All- Conference honors in division-1 lacrosse. In keeping with IDS tradition, she remains very active with distance-running and weight-lifting.
Kristen lives in West Chester, PA with her husband Tim, daughters Grace & Sadie, and dog Kirby. She enjoys traveling (visited 30 of 50 states and more than a dozen foreign countries so far), scrapbooking, and being outside with the kids and Kirby.