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Q. I am looking for some healthy alternatives to table sugar that I can use in my oatmeal, tea and desserts. Can you give me some suggestions?

A. Table sugar is a form of sugar called sucrose, which when broken down by our digestion system, is actually turned into two different forms of sugar: glucose and fructose. The health issue with sucrose is that it causes a rapid rise in blood glucose upon ingestion, a situation that you want to avoid if you are diabetic or looking to balance your blood sugars for better health.

Today, there are a number of different alternatives to table sugar that are available. I actually keep a few different types in my pantry and use them for different purposes. Table sugar alternatives can be placed into several categories, including natural sweeteners, sugar alcohols, and artificial sweeteners. Below is a summary of some of the most common alternatives with their benefits and drawbacks.

Common “Natural” Sweeteners:

Stevia is my sweetener of choice in most instances, especially in tea, coffee, creamy desserts, or recipes such as a sweet and sour marinade calling for a touch of sweetener. It is a non-caloric herbal extract with an intensely sweet flavor. Stevia is an excellent choice for diabetics as it has no calories, and it will not raise your blood glucose levels.

Some earlier Stevia products had a somewhat bitter aftertaste, but today a number of great tasting products such as Truvia, containing Stevia and a small amount of erythritol are commercially available. It is also now available through a number of companies in better tasting packet form as well as in liquid forms with flavors such as lemon drop and even a chocolate flavor. Because refined Stevia is two to three hundred times sweeter than sugar, a few drops or sprinkles in your cereal or coffee are all you need. Unlike sugar, more is not better. Use too much Stevia and it will turn bitter. Stevia may also be used in cooking, but it does require some recipe modification in baking.

Agave Nectar is made through the extraction and purification of the juice of the agave cactus. Agave is high in fructose which is mainly metabolized in the liver, and therefore it has a lower glycemic index and does not cause a rapid rise in blood sugars when ingested. But, fructose is incorporated into triglycerides more readily than glucose (blood sugar); therefore, it has a greater propensity to increase serum triglycerides. I use agave nectar only on occasion and very sparingly.

Sucanat is non-refined cane sugar and is essentially pure dried sugar cane juice. The juice is extracted by mechanical processes, heated and cooled at which point small brown grainy crystals are formed. Unlike refined and processed white sugar, Sucanat retains its molasses content. Sucanat contains less sucrose than granulated white sugar because of its production method. This makes Sucanat a relatively more healthful sweetener, because its effect on the body’s blood sugar levels will not be as severe. If you are diabetic, you might choose to use Sucanat on occassion for baked goods, where it works well as a substitute for more processed white sugar. Also, because it is sweeter than more refined sugar, you can use less of it in your recipes.

Sugar Alcohols:

Mannitol, Maltitol, Sorbitol, Xylitol are actually neither a sugar nor an alcohol, but they do have carbohydrate calories, approximately ½ to ¾ the calories of regular sugar. Derived from plant products, the carbohydrates are altered through a chemical process. They are more slowly and incompletely absorbed from the small intestine than sugar, thus producing a much smaller and slower rise in blood glucose levels and consequently also a smaller and slower rise in insulin.

But, it should be noted that the rise in blood sugar differs depending on your individual makeup, and some of the sugar alcohols may have a laxative effect. When considering products with sugar alcohols, moderation is key. One exception to the common laxative effect of other sugar alcohols is the consumption of erythritol.

Erythritol is sugar alcohol that occurs naturally in fruits and fermented foods. It is 60-70% as sweet as table sugar, yet it is almost non-caloric and does not affect blood sugar levels. A major benefit of using erythritol is that it is absorbed into the bloodstream in the small intestine and then for the most part excreted unchanged in the urine. Because erythritol is absorbed before it enters the large intestine, it does not normally cause the laxative effects that are often experienced after over-consumption of other sugar alcohols. Most people can consume erythritol with no side effects.

Artificial Sweeteners:

I prefer to avoid artificial sweeteners, and recommend that my clients either avoid them or use them very sparingly. Here is a short description of the most common artificial sweeteners, and a delicious recipe for your own healthy version of diet soda that avoids the use of artificial sweeteners.

Sucralose: Sucralose, or SPLENDA® Brand Sweetener, is made from a patented multi-step process that begins with sugar (sucrose). Three hydrogen-oxygen groups on the sugar molecule are replaced with three chlorine atoms. Pure sucralose is not recognized by the body as sugar or as a carbohydrate. It should be noted that additional ingredients are added to SPLENDA® to give it volume and texture. These fillers include maltodextrin and/or dextrose which contribute a small amount of calories per serving. (less than 5 calories).

There is some controversy remaining over the safety of Splenda which relates to the molecular makeup of sucrolose. The sucralose molecule is an organochloride (or chlorocarbon). The root of the controversy is that while some industry experts claim the molecule is similar to table salt or sugar, other researchers claim that it has more in common with pesticides. That is because the bonds holding the carbon and chlorine atoms together are more characteristic of a chlorocarbon than a salt — and most pesticides are chlorocarbons.

Saccharin: Saccharin was the first widely available chemical sweetener. Most researchers agree that in sufficient doses, saccharin is carcinogenic in humans, but the question remains pertaining to the level at which the danger occurs. That being said, some practitioners think saccharin in moderation is the best choice if you must have an artificially sweetened beverage or food product. It’s been around a relatively long time and seems to cause fewer problems than aspartame.

Acesulfame K, Sunette (Sweet One):Acesulfame potassium is a calorie-free artificial sweetener, marketed under the trade names Sunett and Sweet One. The ingredient, which is 200 times sweeter than sugar, has been used in numerous foods in the United States since 1988 As with other sweeteners in this class, there are opposing views pertaining to the overall safety of Acesulfame K.

Aspartame, Equal (NutraSweet): Aspartame, the main ingredient in Equal and NutraSweet, is one of the most problematic chemical sweeteners, because the body actually digests it. Recent studies in Europe show that aspartame use can result in an accumulation of formaldehyde in the brain, which can damage your central nervous system and immune system and cause genetic trauma. The FDA admits this is true, but claims the amount is low enough in most that it shouldn’t raise concern. With so many alternatives available, my advice to my clients is to avoid aspartame..

Unfortunately, aspartame is present in many popular diet sodas, so whenever I go out and would like to have a carbonated drink, I order club soda with lime or sparkling water with a splash of cranberry. For those of you who like to have soda on occasion at home, here is a delicious alternative to diet soda.


8 ounces sparkling water

2-3 slices of lemon and/or lime

2-3 drops Liquid Stevia (Sweet Leaf Brand- Plain or Lemon Drop)

Ice cubes (as desired)


Pour the sparkling water into a glass

Slice the lemon/lime and squeeze some of the juice into the sparkling water, then add the lemon/lime into the sparkling water

Add 2-3 drops of the Stevia to the sparkling water.

Add ice cubes and enjoy!

(For variety, you can experiment with other fruits such as Oranges or Strawberries, and you can try different flavors of Liquid Stevia as well)

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