What Is The Safest Sweetener For Diabetics

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The safest sweetener for diabetics is one that is zero calorie, doesn’t raise blood sugar levels, and is also non-poisonous. One such sweetener which fits all these criteria is Erythritol.

Erythritol is a sweetener which is found naturally in some fruits and fermented foods, such as grapes, wine, and cheese. It is also made by a process called partial enzymatic hydrogenation of dextrose which is, in turn, produced from cornstarch or from sucrose or from starch which has been obtained from corn.

The best sweeteners for people with diabetes

  • Stevia
  • Tagatose
  • Sucralose
  • Aspartame
  • Acesulfame potassium
  • Saccharin
  • Neotame
  • Monk fruit
  • Allulose
  • Agave nectar

Sweeteners are substances that add a sweet flavor to foods and drinks. Some sweeteners, such as table sugar, are harmful to people with diabetes. Others are low calorie and allow people with diabetes to occasionally enjoy sweet foods and drinks without affecting their blood sugar levels.

A variety of alternative sweeteners is available, each with different pros and cons.

However, according to the American Diabetes Association (ADA), while zero-calorie sweeteners might not produce an immediate spike in blood sugar, there is also no evidence that they help lower blood sugar long-term. It is best to use low calorie sweeteners in moderation as part of a varied, carbohydrate-conscious diet.

In this article, we look at nine of the best low calorie sweeteners for people with diabetes.

1. Stevia

A person mixing ingredients for baking in a mixing bowl, including an alternative sweetener.
Stefania Pelfini, La Waziya Photography/Getty Images

Stevia is a natural sweetener that comes from the Stevia rebaudiana plant. To make it, manufacturers extract chemical compounds called steviol glycosides from the leaves of the plant.

This highly processed and purified product is around 300 timesTrusted Source sweeter than table sugar, which means a person needs to use only a small amount to sweeten food.

Stevia has several pros and cons that people with diabetes need to consider. It is calorie-free and does not raise blood sugar levels. However, it is often more expensive than other sugar substitutes.

Stevia also has a bitter aftertaste that many people may find unpleasant. For this reason, some manufacturers add other sugars and ingredients to balance the taste. This can make stevia products less suitable for those with diabetes. Additionally, some people report nausea, bloating, and an upset stomach after consuming it.

The Food and Drug Administration (FDA) classifies sweeteners made from high purity steviol glycosides as “generally recognized as safe” (GRAS). But the FDA does not consider stevia leaf or crude stevia extracts safe. Therefore, it is illegal to sell these products or import them into the United States.

According to the FDA, the acceptable daily intake (ADI) of stevia is 4 milligrams per kilogram (mg/kg) of a person’s body weight. So, a person who weighs 60 kg, or 132 pounds (lb), can safely consume 9 packets of the tabletop sweetener version of stevia per day.

2. Tagatose

Tagatose is a form of fructose that is around 90% sweeter than sucrose. It exists in small amounts in some fruits, such as apples, oranges, and pineapples. However, manufacturers usually extract it from milk and may use it in food production as a low calorie sweetener, texturizer, or stabilizer.

The FDA classifies tagatose as GRAS, and scientists are interested in its potential to help manage type 2 diabetes.

Some studies indicate that tagatose has a low glycemic index (GI). GI is a ranking system that measures the speed at which foods increase a person’s blood sugar levels.

Tagatose may be particularly beneficial for people with diabetes who are following a low GI diet. However, this sugar substitute is more expensive than other low calorie sweeteners and may be harder to find in stores.

3. Sucralose

Sucralose is an artificial sweetener that is about 600 timesTrusted Source sweeter than table sugar but contains very few calories. It is one of the most popular artificial sweeteners and is widely available under the brand name Splenda.

Manufacturers add sucralose to sweeten a range of products, from chewing gum to baked goods. It is heat-stable and is a popular choice for sugar-free baking and for sweetening hot drinks. This is because, unlike other artificial sweeteners, sucralose retains its flavor at high temperatures.

The FDA has approved sucralose as a general-purpose sweetener and set an ADI of 5 mg/kg of body weight. For example, a person weighing 60 kg (132 lb) can safely consume up to 23 packets of the tabletop sweetener version of sucralose in a day.

However, some studies have raised health concerns. A 2016 studyTrusted Source found that male mice who consumed sucralose were more likely to develop malignant tumors.

Animal studies do not necessarily indicate that a substance poses a significant risk to humans, but nevertheless, more research on sucralose’s effect on humans is necessary to determine its safety.

4. Aspartame

Aspartame is a popular synthetic sweetener that is around 200 timesTrusted Source sweeter than sugar. It has been on the market in the U.S. since the 1980s and is available in grocery stores under the brand names Nutrasweet and Equal.

Manufacturers add aspartame to a wide variety of food products, including diet soda. However, unlike sucralose, aspartame is not a good sugar substitute for baking because it breaks down at high temperatures. People generally use it only as a tabletop sweetener.

The FDA considers aspartame safe at an ADI of 50 mg/kg of body weight. A person who weighs 60 kg (132 lb) could consume up to 75 packets of aspartame sweetener per day. However, aspartame is not safe for people with a rare genetic disorder called phenylketonuria.

5. Acesulfame potassium

Acesulfame potassium, also known as acesulfame K or Ace-K, is an artificial sweetener that is around 200 timesTrusted Source sweeter than table sugar. Manufacturers often combine it with other sweeteners to reduce its bitter aftertaste.

The FDA has approved acesulfame potassium as a low calorie sweetener and states that the results of more than 90 studies support its safety. According to the FDA, the ADI for acesulfame potassium is 15 mg/kg of body weight.

This is equivalent to a person weighing 60 kg (132 lb) consuming 23 packets of a tabletop sweetener version of this ingredient per day.

A 2017 studyTrusted Source in mice suggests a possible association between acesulfame potassium and weight gain, but further research in humans is necessary to explore this link.

6. Saccharin

Saccharin is widely available under brand names such as Sweet Twin, Sweet’N Low, and Necta Sweet. It contains zero calories and is 200–700 timesTrusted Source sweeter than table sugar.

According to the FDA, people expressed safety concerns about saccharin in the 1970s after research found a link between saccharin and bladder cancer in laboratory rats.

However, more than 30 human studies now support saccharin’s safety, and the National Institutes of Health no longer consider this sweetener to have the potential to cause cancer.

The FDA has determined the ADI of saccharin to be 15 mg/kg of body weight, which means that a person weighing 60 kg (132 lb) can consume up to 45 packets of a tabletop sweetener version per day.

7. Neotame

Neotame is a low calorie artificial sweetener that is about 7,000–13,000 timesTrusted Source sweeter than table sugar. It can tolerate high temperatures and is therefore suitable for baking.

The FDA approved neotame in 2002 as a general-purpose sweetener and flavor enhancer for all foods except meat and poultry. According to the FDA, more than 113 animal and human studies support neotame’s safety. The FDA has set an ADI for neotame of 0.3 mg/kg of body weight.

This is equivalent to a person weighing 60 kg (132 lb) consuming 23 packets of a tabletop sweetener version of neotame per day.

8. Monk fruit

Monk fruit, which is also known as Lo Han Guo or Swingle fruit, is a small, round fruit that grows in Southeast Asia. There, people have used it for centuries in traditional Chinese medicine as a digestive aid.

Some manufacturers make a zero-calorie, carbohydrate-free sweetener from dried monk fruit. It is around 250 timesTrusted Source sweeter than table sugar and does not affect a person’s blood sugar levels.

People can add monk fruit sweetener to many foods and drinks. It is stable at high temperatures but is not suitable as a sugar alternative in baked goods that need sugar for texture and structure.

The FDATrusted Source approved monk fruit extract as a food additive in 2010. It recognizes monk fruit as safe for everyone, including pregnant people and children, and has permitted the use of monk fruit in foods and beverages. However, it has not set an ADI for monk fruit.

9. Allulose

Allulose is a low calorie sugar that occurs naturally in some fruits and vegetables, such as figs, raisins, and jackfruit. It is around 70% as sweet as table sugar but has only 10% of the calories. It does not increase blood sugar or feed the dental bacteria that cause cavities.

The FDA has classified allulose as GRAS but has not set an ADI.

Unlike some other artificial sweeteners, allulose is suitable for baking and acts like sugar.

Is agave nectar OK for people with diabetes?

Agave nectar or syrup comes from agave plants. Although brands often market it as a healthy alternative to sugar, it is not suitable for people with diabetes because of its sugar content.

Agave nectar contains fructose, or fruit sugar. Fructose breaks down more slowly than sucrose, meaning that it is less likely to cause sudden spikes in blood sugar. For this reason, agave syrup has a low GITrusted Source rating.

However, GI is not the only consideration for people with diabetes. The ADA lists agave nectar as an example of an “added sugar” that people with diabetes need to watch for on food labels, along with corn syrup, honey, and table sugar. Consuming large amounts of added sugars may contribute to prediabetes, type 2 diabetes, and obesity.

Sweeteners Diabetics Should Avoid

Not all natural sweeteners are safe alternatives for people with diabetes. For example, while agave has a low glycemic index (meaning it’s less likely to cause spikes in blood glucose levels), it has more calories than granulated sugar and higher fructose content. Fructose (compared to the sucrose in table sugar) can cause the body to produce less insulin and put more strain on the liver as it breaks down the sugars.

In short, the side effects or effects of an alternative sweetener on insulin resistance may outweigh the benefits. Be careful when consuming artificial sweeteners and even more natural ones such as maple syrup, corn syrup and xylitol.

4 safe sugar substitutes for diabetics

Monk fruit extract

Monk fruit naturally contains mogrosides, a type of antioxidant responsible for the sweet taste of this treat. Researchers have found a way to extract this antioxidant to produce a sugar-free sweetener that does not contain calories and does not affect blood sugar levels.

Stevia

To make stevia sweetener, manufacturers collect the leaves of the Stevia rebaudiana plant and process them into fine crystals. Stevia is low in calories and retains its flavor when heated, making it an ideal sweetener for baking or hot drinks.

Erythritol

Erythritol is a sugar alcohol derived from the fermentation of cornstarch or wheat. It has very few calories and has no impact on blood sugar. While erythritol is less likely than others to do so, sugar alcohols can upset your stomach. Start with small amounts and discontinue use if it causes any discomfort. With that said, it is safe even in relatively large quantities.

Fresh fruit

Did you know that you can find the most natural sweetener in the aisle? Fresh fruit can be a great addition to your recipes, as fruits contain fiber that helps slow down sugar absorption and thus reduce the impact on your blood sugar levels. Try using mashed bananas, unsweetened applesauce or date paste in your next recipe.

According to Dr. Ho, “Most fresh fruits have a low to medium glycemic index, so they do not lead to a sharp rise in blood glucose level compared to other carbohydrate containing foods.” That means fruit is generally a safe way to add extra sweetness to your diet, as we cannot eat lots of fruits at the same time. “A portion of fresh fruit contains on average about 15 to 20 grams of carbohydrates, which is the equivalent of a slice of bread.”

“Most people with diabetes do not need to reduce the amount of fruit they eat,” says Dr. Ho. “However, dried fruits and fruit juices can be high in sugar and should therefore be better limited or avoided.”

Should you use artificial sweeteners?

With a low to no calorie sugar count, artificial sweeteners may seem like a treat for people with diabetes. But recent research indicates that artificial sweeteners may actually be counterintuitive, especially if you’re looking to manage or prevent diabetes.

In fact, the increased consumption of these sugar substitutes may correlate to the increase of obesity and diabetes cases.

The good news is that there are sugar alternatives you can choose from, including:

  • stevia or stevia products such as Truvia
  • tagatose
  • monk fruit extract
  • coconut palm sugar
  • date sugar
  • sugar alcohols, such as erythritol or xylitol

You’ll still want to watch your intake for glucose management, but these options are far better than the products marketed as “sugar-free.”

What is stevia?

Stevia is a low-calorie sweetener that has antioxidant and antidiabetic properties. It’s been approved by the U.S. Food and Drug Administration (FDA).

Unlike artificial sweeteners and sugar, stevia can suppress your plasma glucose levels and significantly increase glucose tolerance. It’s also not an artificial sweetener, technically speaking. That’s because it’s made from the leaves of the steviaplant.

Stevia alsohas the ability to:

  • increase insulin production
  • increase insulin’s effect on cell membranes
  • stabilize blood sugar levels
  • counter the mechanics of type 2 diabetes and its complications

You can find steviaunder brand names such as:

  • Pure Via
  • Sun Crystals
  • SweetLeaf
  • Truvia

While steviais natural, these brands are usually highly processed and may contain other ingredients. For example, Truvia goes through 40 processing steps before it’s ready to be sold. It also contains the sugar alcohol erythritol.

Future research may shed more light on the impact of consuming these processed stevia sweeteners.

The best way to consume stevia is to grow the plant yourself and use the whole leaves to sweeten foods.

What is tagatose?

Tagatose is another naturally occurring sugar that researchers are studying. Preliminary studies show that tagatose:

  • may be a potential antidiabetic and antiobesity medication
  • can lower your blood sugar and insulin response
  • interferes with the absorption of carbohydrates

A 2018 review of studies concluded tagatose is “promising as a sweetener without major adverse effects observed.”

But tagatose needs more studies for more definitive answers. Talk to your doctor before trying newer sweeteners such as tagatose.

What are some other sweet options?

Monk fruit extract is another alternative that is gaining popularity. But no processed sweetener can beat using fresh whole fruit to sweeten foods.

Another excellent option is date sugar, made of whole dates that are dried and ground. It doesn’t provide fewer calories, but date sugar is made of the whole fruit with the fiber still intact.

You can also subtract fiber from total grams of carbohydrates, if you count carbs for meal planning. This will give you net carbs consumed. The more fibrous a food, the lower impact it will have on your blood sugar.

Why are artificial sweeteners bad for people with diabetes?

Some artificial sweeteners say “sugar-free” or “diabetic-friendly,” but research suggests these sugars actually have the opposite of effect.

Your body responds to artificial sweeteners differently than it does regular sugar. Artificial sugar can interfere with your body’s learned taste. This can confuse your brain, which will send signals telling you to eat more, especially more sweet foods.

Artificial sweeteners can still raise your glucose levels

One 2016 study saw normal-weight individuals who ate more artificial sweeteners were more likely to have diabetes than people who were overweight or obese.

Another 2014 study found that these sugars, such as saccharin, can change your gut bacteria composition. This change can cause glucose intolerance, which is the first step towards metabolic syndrome and diabetes in adults.

For people who don’t develop a glucose intolerance, artificial sweeteners may help with weight-loss or diabetes control. But switching to this sugar replacement still requires long-term management and controlled intake.

if you’re thinking of replacing sugar regularly, talk to your doctor and dietitian about your concerns.

Artificial sweeteners may also contribute to weight gain

Obesity and being overweight is one of the top predictors for diabetes. While artificial sweeteners are FDA-approvedTrusted Source, it doesn’t mean they’re healthy.

Marketing for food products can lead you to think non-caloric artificial sweeteners help with weight loss, but studies show the opposite.

That’s because artificial sweeteners:

  • may lead to cravings, overeating and weight gain
  • alter gut bacteria which is important for weight management

For people with diabetes looking to manage their weight or sugar intake, artificial sweeteners may not be a good substitute.

Being overweight or obese can also increase your risk factors for several other health issues such as high blood pressure, body pain, and stroke.

Safety rating for artificial sweeteners

The Center for Science in the Public Interest currently deems artificial sweeteners a product to “avoid.” Avoid means the product is unsafe or poorly tested and not worth any risk.

What about sugar alcohols?

Sugar alcohols are naturally found in plants and berries. The types most often used in the food industry are synthetically created. You can find them in food products that are labeled as “sugar-free” or “no sugar added.”

Labels such as this are misleading because sugar alcohols are still carbohydrates. They can still raise your blood sugar, but not as much as regular sugar.

Common FDA-approved sugar alcohols are:

  • erythritol
  • xylitol
  • sorbitol
  • lactitol
  • isomalt
  • maltitol

Swerve is a newer consumer brand that contains erythritol. It’s available in many grocery stores. The brand Ideal contains both sucralose and xylitol.

Different from artificial sweeteners

Sugar alcohols are often synthetic, similar to artificial sweeteners. But these two classifications of sugar alternatives aren’t the same. Sugar alcohols are different because they:

  • can be metabolized without insulin
  • are less sweet than artificial sweeteners and sugar
  • can be partially digested in the intestine
  • don’t have the aftertaste of artificial sweeteners

Research suggests that sugar alcohols can be a sufficient replacement for sugar. But reports also say that it won’t play a significant role in weight loss. You should treat sugar alcohols the same as sugar and limit your intake.

Sugar alcohols are also known to produce side effects such as gas, bloating, and abdominal discomfort. However, erythritol is usually better tolerated, if you’re concerned about these side effects.

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