Blue Cross Blue Shield Vermont
This article is republished from our Fall 1999 issue of Vigor.

How Sweet It Is

In the “olden days,” folks had maybe one or two choices of sweeteners to put on their porridge. Nowadays, after we nuke the instant oatmeal, we face a bunch of decisions. Calories or no-cal? Natural or artificial? Processed or plain? And then what was that thing the newspaper article said? Does this one cause cancer? Did that one actually claim to deliver health benefits?

We’re going to try and boil down the facts for you (no maple reference intended). We’ll leave the decisions up to you.

Refined Sugar
Americans consume about 65 pounds of sucrose per year. Everyone deserves — maybe needs — something sweet now and then. Some theories hold that we are predisposed at birth to like sweet tastes because of the sweetness of mothers' milk.
Still, most people eat way too much sugar. Sugar, corn syrup, and other refined sweeteners make up 16 percent of the average U.S. diet, but provide no vitamins, minerals, or protein. That means that we have to get 100% of our nutrients from the remaining 84% of our food.
White sugar may pose particular risks. Sugar must be processed in order to be safe. (Raw sugar may contain contaminants, such as molds and fibers. Even so-called “sugar in the raw” is actually processed, though it maintains the “raw” look.) But the processing of the sugar strips its nutrients and (some insist) may leave harmful residues.

Refined sugars can promote obesity, tooth decay, and, in some people, even heart disease. Also, refined sugar is mostly sucrose. Digesting this substance requires insulin production by the pancreas. It also causes significant fluctuation in blood-sugar levels (giving “sugar highs” and “sugar lows”).

Is brown sugar better than white sugar? Sorry. While some brown products (like brown rice and whole wheat flour) retain their brown color because they are less refined, brown sugar is just regular sugar coated with molasses.

Honey
Honey doesn’t need much processing, since the bees do most of that. Most honey is treated with heat to reduce unwanted bacteria, but this processing doesn’t generate the problems involved in sugar processing.

Your body digests honey differently, too. Because honey contains more fructose than sugar, it has less of an impact on your blood glucose and insulin levels. Hence, you get less of a sugar “high” and the accompanying sugar “low” with honey than with sugar.

Because honey is sweeter than sugar, you need less to do the job. So, though honey contains a few more calories per tablespoon, you can use fewer tablespoons. (Make sure that when you’re substituting honey for sugar in a recipe, you reduce the amount of one of your liquid ingredients to compensate for the liquid nature of the honey.)

Not only does honey do less harm than most sweeteners; it can actually do you some good. Honey contains antioxidants, thought to ward off cancer. It also gives you a smattering of vitamins and minerals. Some scientists claim that eating local honey can desensitize hay fever sufferers to local flora and ease their condition.

And get this — you might want to keep some honey in your first aid kit. No, not to eat (although it will soothe a sore throat), but to rub on a wound. It’s a natural “anti-microbial agent” — that is, it kills germs. It also pulls moisture from the air and helps to promote healing and prevent scarring.

Two cons on picking honey as a sweetener: It rots teeth faster than sucrose, and it can’t be given to children under one year of age because it may contain a form of botulism that could be dangerous to infants.

Maple Syrup
Couldn’t write an article in this state without singing the praises of maple! Really, maple syrup looks a little better than white sugar in a few ways. Like honey, maple syrup can be processed using only heat, so you get more nutrients and have less risk of toxins.

A 50 ml serving of maple syrup can contain as much as 6% of the daily recommended intake of calcium and thiamin, 3% of the recommended potassium, and 2% of the recommended intake of magnesium and riboflavin. (Please don’t try to get all your riboflavin from maple syrup, but it’s something, right?)

Maple syrup does contain about 65 percent sucrose. Compared to white sugar, however, it produces less of a negative impact upon blood-sugar levels.

Fructose
This sugar, found in fruit, causes less of a rise in blood-sugar levels than sucrose. Fructose sugars don't require insulin to be digested. You metabolize them in your liver rather than in your small intestine, where you digest sucrose. They are also absorbed more slowly into your bloodstream than sucrose. Usually, you find fructose in other food products, like fruit drinks, but you can buy fructose for table use. For example, several companies market ground-up dates. The sugar in dates is predominantly fructose.

Molasses
Molasses is the liquid that remains after sucrose is refined from sugar cane or sugar beets. Some researchers complain that it can contain concentrated amounts of the stuff that was on the sugar cane or beets, like pesticides, environmental toxins or sulfur, if that substance was involved in processing out the sucrose.

Despite those cons, some nutritionists recommend molasses as a “best of the worst“ sweetener. It does contain nutrients (B vitamins, vitamin E, iron, calcium, magnesium, potassium, chromium, manganese and zinc) that have been refined out of white sugar. The darker the molasses, the more nutritious. (Blackstrap is supposedly the best.)

Sweet Substitutes

Aspartame (Nutra-Sweet)
Aspartame contains no calories, so it should follow that you won’t gain unwanted weight from eating it. (Interestingly, Americans have put on pounds at an even faster rate since Aspartame’s introduction, so its role as a “sweet substitute” might be false.) Granted, you won’t fill up on it and forgo eating healthier foods the way you might with sugar. Still, Aspartame, made up primarily of two amino acids, is a very new sweetener and some claim that it should undergo more testing to determine if it causes cancer in when consumed in large quantities. Some consumers have reported adverse side effects like dizziness, hallucinations and headache after drinking Aspartame in soda, but these reports have not been confirmed in controlled studies. If you think you've experienced adverse effects due to aspartame, avoid it. Also, people with the rare disease PKU (phenylketonuria) need to avoid it.


Sorbitol
Sorbitol is a sweet-tasting sugar alcohol used in many candies, and other foods, as well as in some medicines. It occurs naturally in fruits and berries and is a close relative of sugars, but is only half as sweet. Like artificial sweeteners, it provides fewer calories than regular sugars, because the human body absorbs it poorly. It won’t cause tooth decay when you chew it in gum because your oral bacteria do not metabolize it well. Some diabetics use sorbitol-sweetened foods because it absorbs slowly and does not cause blood sugar to increase rapidly.

Moderate amounts of sorbitol may have a laxative effect. The FDA requires a laxative notice on the few products that may lead to consumption of 50 grams or more of sorbitol daily. (Some nutritionists worry that children may experience these side effects from smaller amounts of the substance.) Otherwise it appears safe.


Saccharine
Saccharin (contained in the brand name Sweet'N'Low) is 350 times as sweet as sugar. Like aspartame, saccharin may help people lose weight. Many studies on animals have shown that saccharin can cause cancer in various organs of rodents and other animal subjects. Other studies have shown that saccharin increases the potency of other cancer-causing chemicals. A study done by the National Cancer Institute found that the use of artificial sweeteners (saccharin and cyclamates, which are now illegal additives) was associated with a higher incidence of bladder cancer. The food industry acknowledges that saccharin causes bladder cancer in male rats, but argues that those tumors are caused by a mechanism that would not occur in humans. Others disagree, noting that more studies are needed. If you do use saccharine, you may want to limit the quantity you consume.

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