The good, the bad and the ugly

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Finding sugar substitutions that aren’t even worse for you than the original can be tricky, says nutritional therapist Karen Geary

The message about reducing our intake of sugar is finally getting through: a high dietary sugar load is frequently one of the drivers behind obesity, diabetes, high cholesterol, worsened menopause symptoms and cognitive decline. Going cold turkey is the straightforward way to quit sugar but for some that is not an option. So how do we navigate the increasingly complex world of alternative sweeteners?
Here is your guide:

Fix cravings
It’s not a sugar substitute, but cinnamon is a fantastic sweet spice that may help to manage blood sugar highs and lows. Various studies have demonstrated beneficial effects of the spice on glucose, insulin, lipids, blood pressure and lean body mass. It needs to be used liberally for benefit; try a whole teaspoon (my favourite is on stewed apples with Greek yogurt). Making sure you’re getting enough sleep, lots of fibre from veggies and plenty of protein in your diet are also all essential in fighting those sugar cravings.

Good PR sugar
Honey, maple syrup, coconut sugar, rice syrup, date syrup and molasses are all popular with the healthy eating brigade. The truth is, though, that the body still just sees and treats these as if they are sugar.
They may have slightly less fructose and some nice minerals – but you would have to eat a lot to get any actual benefit. If you are reducing sugar for health reasons, avoid these for now. Molasses is slightly lower on the glycemic index than the others and is probably the best of the bunch. It also has a huge amount of iron, among other things, so it’s great for those who need to increase their intake.
Oh, and demerara, turbinado, cane and dark brown sugar are still sugar. They just look fancy.

Possible substitutes
I say ‘possible’ because in studies, while lower in calories, nearly all alternative sweeteners have resulted in an increase in insulin and glucose levels. Additionally, a number of them contain FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols). These are short-chain carbohydrates (sugars) that the small intestine absorbs poorly. Some people experience digestive distress after eating them – bloating, gas and diarrhoea. Choose wisely.

Stevia – normally used in drops, it is touted as the best natural low-calorie sweetener. Studies have noted that stevia does not significantly contribute to increased glucose and insulin levels.
The downside is that it can have a bitter aftertaste so shop around for a good one. Low FODMAP.

Yacon syrup – a favourite with people who stick to a keto diet, it is harvested from the yacon plant and it tastes like molasses. It is high in fructo-oligosaccharides (FOS) which feed good bacteria in the gut and helps with constipation.
Likely high FODMAP.

Inulin – another FOS, a prebiotic fibre. Pretty good in tea and coffee but not as sweet as normal sugar.
High FODMAP.

Monk fruit – quite hard to get in the UK but, like cinnamon, there is some research suggesting it may help blood sugar management. It has a caramel taste and is safe to use. Just check it hasn’t been combined with other sweeteners.
Low FODMAP.

Erythritol (produced by fermentation from dextrose) and xylitol (wood sugar from birch). Both are sugar alcohols, and are about 70 per cent as sweet as sugar but without the big insulin spike. Both are fabulous in low carb baking. Avoid, or take particular care with, xylitol if you have dogs at home as it is highly toxic. Erythritol is a low FODMAP, xylitol a high FODMAP.

Allulose (watch this space) – not yet available in the UK, and relatively new to the market in the US.
It’s known as a ‘rare sugar’ and has the same chemical formula as fructose, but it is arranged differently, so it’s not processed in the body in the same way. It does not ferment in the gut so does not lead to digestive issues.

Avoid
Agave syrup. Diabetic friendly, this is a ‘natural’ sweetener but when processed it becomes 85 per cent fructose so it’s actually worse than sugar – it overloads the liver causing raised blood trigylcerides, bad (LDL) cholesterol and increased belly fat.

High Fructose Corn syrup. Used mostly in processed foods but thankfully not in the same quantities here compared with other countries. It is known as the key driver of obesity, poor metabolic health and non-alcoholic fatty liver damage.

Sorbitol and malitol. The sugar alcohols known for the most severe digestive distress and very high

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