This article will highlight forms of sweets that are harmful, acceptable, or even helpful when it comes to your health. Given that this is generalized information, please consult with your doctor for dietary recommendations that specifically caters to your health goals.
There are very few universal truths when it comes to health advice. I believe that one truth is that chronic exposure to excessive refined sugar has negative consequences. You might assume that this was always common knowledge, but surprisingly, it was only just recently confirmed.
In September 2016, the prestigious medical journal, JAMA (Journal of the American Medical Association) published a paper which unveiled the truth that in the 1960’s, the sugar industry sponsored scientists at Harvard University to blame fat and not sugar for obesity and heart disease. For 50 years, millions of people suffered from morbid weight gain and disease progression due to the commonly prescribed low-fat diet and this misconception. (1,2,3)
Fortunately, now that we have the internet and accurate information at our fingertips, Americans are much more likely to receive accurate nutrition advice to achieve their wellness goals. Unfortunately, however, for millions of people around the world without access to this information, the food industry continues to shape the way that people eat.
For example, a New York Times article published in December 2017 highlighted the growing obesity epidemic in Malaysia, a direct result of the financial relationship between big companies like Nestle and General Mills, and scientists from the Nutrition Society of Malaysia. There are similar situations in many other developing nations like India and Cambodia as well (4)
If sugary cereals, beverages, and snacks continue to be recommended by “nutrition experts” to children as acceptable and healthy, this trend will only worsen. In order to be the change we want to see in the world, we can do our part by disseminating accurate and unbiased information to as many people as possible. That is what we strive to do at Parsley Health .
Here’s your guide to the most common sweeteners found in our food today, the types of sugar you should aim to avoid completely, and reccommendations on the types of sugar that are safe to consume in moderation.
Refined sugar is raw sugar (from sugarcane or sugar beets) which has undergone a refining process to remove molasses. The resulting white, granulated sugar that we know as table sugar, is sucrose, a disaccharide molecule of fructose and glucose.
Brown sugar is raw sugar which has not had the molasses removed, or is refined sugar which has had molasses added to it after the refining process (5).
At Parsley Health, we advise our patients to remove refined sugar from their diets for a multitude of reasons. Consuming refined sugar has been shown to worsen practically every disease under the sun including mood disorders, neurological conditions, gastrointestinal disease, hormonal and immune dysregulation, cardiovascular disease, obesity, and cancer.
Sucrose has the highest glycemic load than any of the other sweeteners that people commonly consume (6). Research has demonstrated that higher glycemic load foods correspond with higher levels of hsCRP (inflammation ) in the bloodstream (7, 8).
I probably don’t need to say much about HFCS, because everyone already knows to avoid it like the plague. Historically, HFCS entered the American food industry due to its cheap cost, stability in acidic environments and beverages, and accessibility.
Unlike raw sugar which comes from sugar cane grown near the equator, HFCS comes from corn, which is readily available and abundant in the US. In short, HFCS has been shown to behave in our bodies as a toxin, and increases the risk of diseases like heart disease, obesity, type 2 diabetes, nonalcoholic fatty liver disease, and hypertension, to name a few (8).
Equal and NutraSweet are two brands of aspartame, a calorie-free artificial sweetener. Since it’s FDA approval in 1974, it has been a hot topic of controversy. After its FDA approval, an investigation of the data showing that it was harm-free was accused of being falsified by its producers (9).
Additionally, numerous studies, including large meta-analyses of a multitude of scientific studies, have concluded that there is no cardio-metabolic benefit for patients to consume it over regular sugar, and actually worsen diseases like diabetes (10). Over the past decade, there have been various animal studies for and against its association with increased risk of cancer. Due to the above, I place this in the “do not consume” category.
Splenda, also known as sucralose, is another calorie-free artificial sweetener that entered the market in 1999, and gained lots of traction in the early 2000’s. A 2016 study on rats showed that it increased the risk of some blood cell cancers (11).
In order to make sucralose, regular sugar (sucrose) is treated with chlorine. The resulting sucralose molecule contains 3 chlorocarbon atoms, which act as insecticides because of the toxic effect of chlorine.
This is why ants are repelled by sucralose or Splenda. It’s actually a fun experiment to watch them run from it. Chlorine is also toxic to humans and can specifically negatively impact the thyroid gland. Needless to say, let’s put this on the “do not consume” list (12).
Just when you thought that you were never going to be able to taste something sweet again without guilt, you finally made it to the positive portion of this article. These are the types of sugars we recommend to consume in moderation.
Honey has a multitude of health benefits. Of course, too much of a good thing can be bad, and it can certainly raise your blood sugar given that its main components are glucose and fructose.
However, since it’s a whole food substance which also contains about 25 other nutrients, the effect on blood sugar (glycemic load) is dramatically better than refined sugar (6, 13). Our bodies recognize honey as a familiar friend, as humans have been consuming it for thousands of years, unlike refined sugar (13).
Consuming raw honey is particularly beneficial since it still contains the enzymes and probiotics that are eliminated through heating and processing. Raw honey has been shown in various studies to aid in wound healing, decrease the severity of environmental allergies , and prevent chronic sinusitis (14, 15).
In short, maple syrup, like honey, is healthy in small quantities and in its raw, unprocessed form.
Maple syrup contains numerous phytonutrients and antioxidants that can fight inflammation. Agave does not contain as many antioxidants as maple syrup and honey (16). Although all of their glycemic indexes are lower than sucrose (refined sugar), we still have to watch how much we eat, as their main components are fructose and glucose sugars.
The main sugar in fruit is fructose. A serving of fruit can contain anywhere from 2-40 grams of sugar, depending on which fruit we’re talking about (17).
Given the density of health-boosting phytonutrients, antioxidants, and vitamins that fruits contain, I give the sugars in whole fruits a free pass. In general, I recommend that people get 2-3 servings of whole fruit (organic as much as possible) every day, on average.
Stevia is a calorie-free sweetener which comes from the Stevia rebaudiana plant, and has been used by South Americans for thousands of years as a sweetener and plant medicine.
Although some petri dish studies have shown potential for stevia extract to be mutagenic (possibly cancer-inducing), those studies were not conducted on doses or routes of consumption used by people (18).
The majority of studies have shown it to be safe. Continual intake of extremely high doses might induce infertility, and stevia has historically been used in this manner as a form of birth control in South America (19). In my opinion, it is harmless in small, inconsistently consumed doses.
Monkfruit, or luo han guo, is a fruit from Southeast Asia. Through processing, an extremely low-calorie sweetener is created (2 calories per tsp) with no effect on blood sugar. It is 150-400x sweeter than regular sugar.
Although it is poorly studied in general, there are no studies to date that question its safety for consumption (20). There are actually numerous studies that show it acts as an anti-inflammatory and anti-oxidant, and has cancer, diabetes, and fatigue - fighting capabilities (21). Therefore, I think monkfruit can be safely consumed and is especially helpful when trying to avoid refined sugars.
Last, but certainly not least, sugar alcohols like erythritol, sorbitol, and xylitol are zero-calorie sweeteners with little to no effect on blood sugar.
Given their poor absorption in the intestines, many sugar alcohols cause gastrointestinal upset in some people. Since erythritol is better absorbed, it is much less likely to have this effect (22). It’s important to note that xylitol is toxic to dogs (23). Of the sugar alcohols, I think that erythritol is the safest to consume, especially when trying to avoid refined sugars.
As a rule of thumb: pure, raw, whole, and natural is the best way to go when deciding what to feed yourself and your family.
Paying attention to nutrition labels on everything you consume is key to avoiding excessive sugar. There are so many more types of sweeteners out there, so beware of how they are listed on nutrition labels. Ask your doctor or health coach for help if you’re not sure about what to consume or avoid. Sugar can be lurking in places you may expect, like sauces, bread, dressings, and snack bars. Even foods that claim to be “healthy” or “paleo ” can have excessive sugar , even if it’s coming from a natural source like raw honey, maple syrup, or coconut sugar.
I recommend trying to consume less than 5 grams of added sugar in any one sitting (with the exception of whole, raw fruits). Keep in mind that due to the sugar industry’s lobbying power, it is the only component on nutrition labels that does not have a “recommended daily allowance” associated with it (24). Of course, everyone has an individual tolerance to sugar, so please talk to your doctor about your specific situation.
If you’ve started 2018 with a new year’s resolution to get off of sugar, I applaud your positive intentions. If you’ve been struggling to get rid of excessive sugar in your diet for many years, I empathize with you, and I estimate that the majority of humans in the world can too.
Animals, including humans, love sugar. Animal studies have shown that it is more addictive than cocaine (25), and our brains are wired to search out calorie-dense foods specifically under times of physical and emotional stress. Understanding that it’s not you, and it’s just your human instinct to want sugar (especially when stressed) will hopefully take some of the guilt out of being drawn to it for you.
Know that you’re not alone in your struggle. Working with a health coach has proven to be immensely effective in helping our patients make difficult dietary changes like this, so I encourage you to book a visit if you are due to discuss how to remove excessive sugars from your diet.
Parsley Health is the doctor that helps you live healthier, longer, by treating the root cause of symptoms and conditions. Our medical teams—staffed by leading clinicians and health coaches—spend more time with you, order the right tests, and prescribe food, sleep and movement alongside medications so you can get better—and feel better.