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If you want to optimize your type 2 diabetes or prediabetes health, understanding which sweeteners or sugar substitutes are safe and effective is crucial.
With over 50 different types of sugars and sweeteners available, navigating through the options can be confusing, especially with all the conflicting information out there.
By listening to this podcast or reading through the information below, your confusion will be put to an end.
We share research-backed benefits or downfalls to the sweeteners and sugar substitutes available, covering everything from traditional sugars like white sugar, brown sugar, honey, and syrups, through to modern substitutes such as stevia, monk fruit, erythritol, aspartame, and sucralose.
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PODCAST CHAPTERS
2:50 Sugar is as addictive and provides zero nutritional value
4:42 Carbs in natural sugars compared
8:06 Adverse effects of artificial sweeteners
11:13 Pros and cons of sugar alcohols
15:57 Research and benefits of naturally-derived sugar substitutes
22:52 Reading food labels and making a sweetener choice
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Why Cut Out Sugar?
Sugar provides zero nutrition
The main reason for cutting out sugar is that sugar provides zero nutritional value!
One reason why we eat is to provide fuel to our body in the way of nutrition, vitamins, minerals and so forth. Sugar doesn’t contain any of these things. So although we might like the taste of it, it’s deplete of anything valuable as far as nutrition goes.
Sugar negatively impacts our health
Here are a few more reasons to cut sugar out:
- Sugar is also easy to over consume
- Sugar is a refined product
- Sugar contains too many (empty) calories – no nutritional value = empty calories
- The fructose component of sugar is problematic – fructose gets metabolized entirely by the liver and converted directly into fat (not a pretty picture)
- Sugar does result in sharp rises to blood sugar levels
- We don’t really need sugar
To emphasize, cutting down on sugar is one key step to improving your health!
Sugar offers no vitamins, minerals, or beneficial nutrients – it’s just empty carbs and calories that contribute to weight gain, fatty liver, poor blood sugar control, and various health conditions.
Reducing sugar intake is not just about controlling blood sugar levels; it’s also about protecting your liver and overall metabolic health – that’s very important!
Sugar is highly addictive
Unfortunately the ‘white poison’ as some call it, is highly addictive.
In fact, Dr Eric Stice, neuro-scientist, has done studies on the brain showing that the same ‘addiction’ receptors are activated when we consume sugar as they are if we consume cocaine.
Quite shocking but true!
So you know, you could try to limit sugar but that’s hard to do, and there’s a reason why – those parts of the brain Dr Eric Stice discovered – they get stimulated, along with various hormones. And when that stimulation occurs, we want more of the sweet stuff.
Then, we might find ourselves in a viscous sugar cycle!
The Hidden Names of Sugar
When it comes to choices, white sugar is definitely the worst type of sugar. This includes castor sugar and icing sugar as these are all highly refined. The whiter it is, the worse it is.
Following closely behind white sugar is brown sugar and raw sugar. Though they are brown or ‘raw’ they are still processed and refined, although containing a little more molasses that changes the flavor.
Sugar is what we find in most processed and packaged food products. But it’s not always labelled as sugar, as there are over 50 names for sugars and sugar substitutes.
Sugar Nutrition Facts Compared
Let’s take a closer look at the nutrition facts of all the sugar and sugar substitute choices.
For 1 Tablespoon of each item
White sugar – 48 cal, 12.6 g carbs/sugar, 0 nutrients, GI: 54-84.
Brown sugar – 51 cal, 13.5 g carbs/sugar, 3 mg sodium, 18 mg potassium, 0 nutrients, GI: 54-84 .
Raw sugar – 45 cal, 12 g carbs/sugar, 0 nutrients, GI: 54-84.
Coconut sugar – 45 cal, 12 g carbs/sugar, 0 nutrients, GI: 35.
Rapadura sugar – 45 cal, 12 g carb/sugar, 5.7 g iron, 3.6 g vitamin C, GI: 65.
Molasses – 58 cal, 15 g carb/sugar, 7 mg sodium, 41 mg calcium, 0.94 mg iron, 293 mg potassium, 0.134 mg niacin, GI: 55.
Blackstrap molasses – 47 cal, 12 g carb/sugar, 172 mg calcium, 3.5 mg iron, 43 mg magnesium, 8 mg phosphorus, 498 mg potassium, 11 mg sodium, 3.6 mcg selenium, 0.216 mg niacin, GI: 55.
Raw honey – 70 cal, 17 g carb/sugar, 11 mg potassium, antibacterial and antiviral, GI: 50.
Brown rice syrup – 21 cal, 15 g carb/sugar, 4.8 mg calcium, 49.4 mg magnesium, 1.9 mg manganese, 14.8 mg phosphorus, 2.8 mg Vit B6, GI: 25.
Maple syrup – 52 cal, 13-14 g carb/sugar, 4 mg phosphorus, 42 mg potassium, 2 mg sodium, 1 g calcium, GI: 54.
As you can see from the list above, most forms of sugar have roughly the same amount of carbs/sugar per serving. The only real difference is the amount of nutrients that can be found in them.
Sugar Substitutes Nutrition Facts Compared
Allulose – 0 cal, 16 carbs/sugar, 0 nutrients, GI: 0.
Sucralose (Splenda) – (1 g packet) 3 cal, 1 g carbs/sugar, 0 nutrients. GI: 0.
Artificial sweeteners – 0 cal, 0 carbs/sugar, 0 nutrients. Artifical sweeteners include aspartame (aka Equal and Nutrasweet), saccharin (aka Sweet N Low), and acesulfame K (aka Sweet One), GI: 0.
Sugar Alcohols – erythritol and xylitol -‘tols’ – 0 cal, 0 carbs/sugar, 0 nutrients, GI: 1.
Stevia – 0 cal, 0 carbs/sugar, 0 nutrients, GI: 0.
Monk fruit – 0 cal, 0 carbs/sugar, 0 nutrients, GI: 0.
So What Is The Best Sweetener For Diabetics?
Natural Sugars
White sugar, brown sugar, honey, maple syrup, and more. These sugars, although different in appearance and flavor, generally have similar effects on your blood sugar levels and overall health and will lead to a blood sugar spike.
KEY POINT: If you are going to choose a “natural” form of sugar, it is better to choose something like rice syrup, molasses, honey or maple syrup, which at least provide some nutrients and are lower glycemic index.
Although manuka honey is the best form of honey in the world (with medicinal properties), it is still honey – high in fructose/sugar that can increase blood glucose and A1c, not help it.
In small doses, manuka honey is definitely a better option. But avoiding sugar and syrups (most of the time), even natural ones – honey, molasses, maple syrup – is going to be better for your health overall.
What About Agave Syrup?
This question comes up a bit so we better add agave to the list.
Agave was hyped up for several years as a safe option for people with diabetes because it’s “low GI.” While that may be the case, it doesn’t make it good.
Interestingly, when researchers discovered high fructose corn syrup, they also thought they’d found the halo for an obesity and a possible diabetes cure (because fructose gets processed by the liver and does not require much insulin).
Well, it turns out they didn’t have their handle on the whole story because fructose is said to be the CAUSE of much of our obesity and diabetes issues – many researchers agree.
How does this relate to agave? Agave is 80-90% fructose, which is a lot!
Fructose is 100% metabolized by the liver, this then leads to fatty liver, which then leads to insulin resistance and contributes to the development of diabetes. Not to mention fructose gets stored as fat at 3 times the rate of sucrose – talk about bring on obesity!
And, like most other “natural” sugars, agave still contains approximately the same amount of carbs – 20 grams per tablespoon.
KEY POINT: Overall, agave syrup is not a recommended choice.
Artificial Sweeteners: Aspartame, Saccharin, and Sucralose
- Saccharin – Brand names: Sweet’N Low, Sugar Twin, Necta Sweet.
- Aspartame – Brand names: Equal, Nutrasweet, Natra Taste.
- Acesulfame-K – Brands: Sunette, Sweet One, Swiss Sweet.
- Sucralose – Brand name: Splenda
Interestingly, aspartame and many of the ‘old hat’ artificial sweeteners were first implemented to help the obesity problem. In came diet coke and Coke Zero a whole range of ‘diet’ products and foods. Years later, research now shows that these may contribute to weight gain in many people – not weight loss as you’d expect.
So, although artificial sweeteners have been used for decades, they come with potential risks.
Aspartame has been linked to headaches, depression, and even more severe health issues in some studies. The International Agency for Research on Cancer (IARC) recently classified it as a potential carcinogen.
Saccharin, once banned due to cancer concerns, remains controversial despite being deemed safe for consumption.
Sucralose, while considered safer, has more recently been found to negatively affect gut bacteria and disrupt glucose metabolism.
KEY POINT: If you need to use an artificial sweetener, sucralose is the better choice over aspartame, Ace-K or saccharin.
Sugar Alcohols: Erythritol and Xylitol
- Erythritol
- Xylitol
- Mannitol
- Sorbitol
The ‘tols’ are sugar alcohols – not really sugar or alcohol but named that way, provide sweetness with fewer calories and less impact on blood sugar.
The ‘tols’ are claimed to be natural because sugar alcohols are naturally occurring in lots of fruits and veggies. However, these ‘tols’ are usually processed from pure glucose and sucrose taken from wheat and/or cornstarch. The end result is a zero calorie sweetener that does not affect blood sugar levels (in most people).
Erythritol, is the most frequently used and available of the ‘tols’, as it does not cause the digestive issues that other sugar alcohols might. Erythritol is absorbed into the bloodstream and excreted unchanged in the urine, making it a safe option.
Xylitol, while similar to erythritol, can cause digestive discomfort in higher doses and can be toxic to pets. Therefore, it should be used with caution if you have animals around the house.
KEY POINT: The ‘tols’ are generally a safe option for people with diabetes and prediabetes to choose. Erythritol is the most frequently used and best tolerated sugar alcohol, and is safe to use.
Natural Sweeteners: Stevia and Monk Fruit
Stevia, derived from a South American herb, is available in both liquid and powder forms. It has no calories, no carbs, and does not raise blood sugar levels. Research has shown that stevia can help regulate appetite and improve insulin sensitivity. It’s also known for its potential anti-inflammatory and antioxidant properties.
Monk fruit, another great option, is 300 to 400 times sweeter than sugar and also has zero calories and carbs. It contains mogrosides, which have been shown to inhibit the formation of harmful compounds in the body. Though there’s less research on monk fruit compared to stevia, it appears to be a safe and effective sweetener.
KEY POINT: Stevia and monk fruit are excellent choices.
Allulose: A Newer Contender
Allulose is a newer sweetener that shows promising benefits for people with diabetes.
It’s a rare sugar with almost zero calories and has been found to lower postprandial (after meal) blood sugar levels. Studies have shown that allulose may even improve insulin resistance and liver inflammation.
KEY POINT: Allulose is an excellent choice.
Conclusion: Best Sweetener for Diabetes?
Certainly minimize sugars, as these will impact blood sugar directly.
As for the sweeteners that have little, if any impact on blood sugar, we prefer using stevia, monk fruit, erythritol and allulose over all other sweeteners and it’s what we generally recommend to most people.
These recommendations are grounded in research that supports the benefits of these sweeteners for diabetes health.
In saying that, at the end of the day it’s going to be a personal choice. Some people hate the taste of stevia, for example. So move up the ladder and try the ‘tols’ or a stevia/allulose combo.
If anything, try to avoid the nasty ones mentioned first – Aspartame, Saccharin, and Acesulfame-K, the artificial sweeteners.
It’s also good practice to try to move away from eating too many sweets overall and focus on eating more vegetables because they are much better for your health and help to reduce cravings too!
What sweetener do you use? Or maybe now you’ve read this you’ll change it?
TRANSCRIPT
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Dr. Jedha, Host
Hello there, and welcome to episode 49. There are numerous types of sugars and sugar substitutes used in food products, including natural sugars like white sugar, brown sugar, and honey; different syrups like maple syrup, corn syrup, agave and rice syrup; other types of sugar like coconut sugar, or palm sugar; natural sweeteners like stevia, monk fruit extract, and erythritol; and artificial sweeteners like aspartame, saccharin, and sucralose. Yes, it can all get a bit confusing when there are over 50 different types of sugars and sugar substitutes available. Of course, some we see more in food products like maltodextrin or high fructose corn syrup, others are readily available to us such as white or brown sugar or stevia and erythritol.
So today, we’re tackling this topic that’s on lots of people’s minds: safe diabetes sweeteners and sugar substitutes. And in our usual fashion, it’s evidence over opinion here. We’ll be investigating what the research has to say on all these sugars and sweeteners.
You can head down to our website at Type2DiabetesTalk.com to review some of the info we cover today. And if you’re one of our members, you can find a newly updated and detailed sugar substitutes guide inside the members site. Find that in the ‘Food Guides’ or alongside episode 46.
2:50
You know, we all love sweets from time to time; it’s just human nature. Unfortunately though, sugar is easy to over consume and in today’s modern world, sugar is found in the majority of food products. That doesn’t help with sugars’ highly addictive appeal. In fact, Dr. Eric Stice, a neuro-scientist, has done studies showing that the same addiction receptors are activated when we consume sugar as when we consume cocaine. It’s shocking but true, which explains why it’s so hard to moderate sugar intake.
Although we might like sugar, for the most part, sugar is best to cut out of our diet as much as possible. Why? The main reason is that sugar provides zero nutritional value. Sugar has no vitamins, minerals, or beneficial nutrients. It’s just empty calories, and lots of evidence shows us that added sugar contributes to weight gain, fatty liver and the development of various health conditions. Obviously with any of us, sugar leads to sharp rises in blood sugar levels, and in diabetes, this is clearly an issue. But sugar also triggers systemic inflammation, changes gut bacteria, among other things. Again, sugar provides zero nutritional value. So, reducing sugar intake isn’t just about controlling blood sugar levels; it’s also about protecting your liver and overall metabolic health.
4:42
When we compare different sugars, white sugar is obviously the worst, being highly refined. But brown or raw sugar are still made up of the same, they just maintain some of the natural molasses that gives them the brown coloring and a different flavor. Whether it’s white, raw or brown, these all contain roughly 12 to 13 grams carbs per tablespoon and 45-50 calories. Honey, molasses and maple syrup, although natural, all contain roughly 13-17 grams carbs per tablespoon and 45-70 calories. Similarly, manuka honey, although known for its medicinal properties, still contains 17 grams carbs per tablespoon and around 50 calories.
These days we have many sweeteners available that are substitutes for sugar, and many of them have zero carbs and zero calories. So, what’s the best option for blood sugar levels and health?
Let’s start with whether it might be okay to have small amounts of natural sugars like raw sugar, honey, coconut sugar, brown rice syrup, etc. You might also consider certain factors like coconut sugar has a lower glycemic index than regular sugar, however, it still contains the same amount of carbs, 12g and calories, 45. Brown rice syrup may seem like better option because again, it has a lower glycemic index and less calories, around 25 per tablespoon, but again, the carbs are around 15g per tablespoon.
If you were to choose foods or include these natural sugars or sweeteners, moderation is certainly key as you’d have to be aware of their impact on blood sugar levels, that’s really going to be your biggest concern. And clearly, it’s going to be little benefit for your health if you’re eating too many sweet treats containing sugar, honey or maple syrup. Does that make them completely off limits?
Well, no. We don’t like to say you ‘can’t’ have anything or ‘should’ take one pathway only, because it’s always a matter of choices. And also consistency is more important than perfection, so if you were at a birthday celebration and you wanted to enjoy a piece of cake with your grandson, then go for it.
So if the option isn’t sugar itself, you might be basing your decision on the wide range of sweeteners available – artificial sweeteners, stevia, monk fruit or sugar alcohols, these may seem ideal because they provide zero calories and zero carbs. But, there’s a bit more to the story here too, so let’s dive in and explore them in more detail.
8:06
Let’s look closer at some of the artificial sweeteners like aspartame, saccharin, and ace-K. These were the only types of sugar substitutes that used to be available. They were initially brought onto the market as a zero carb, zero calorie with the thought they would help consumers deal with obesity. Fast forward until now and unfortunately, some research shows they may contribute to weight gain and other health issues. Aspartame, for instance, has had lots of FDA complaints and has been linked to headaches, depression, and even more severe health issues in some studies. In 2023 there were reviews done over aspartame safety and overall the conclusion was there is limited data, there just haven’t been enough studies to show the health effects. Being that these products have been on the market so long we’d expect more safety data would have been explored, but that’s not the case. However, the International Agency for Research on Cancer (IARC) has more recently classified aspartame as a potential carcinogen to humans, meaning a potential for cancer, so clearly that’s not a good thing.
Saccharin was once banned due to cancer concerns, and it is still controversial despite being deemed safe for consumption. Ace-K has also been associated with potential health risks, including disruptions in metabolic processes. Sucralose is another artificial sweetener used in many products. It was once considered safer to eat than aspartame and other artificial sweeteners, however, more recent research has shown it can negatively affect gut bacteria and might have cumulative effects that disrupt glucose metabolism. And for all these artificial sweeteners, there is some research showing they may increase blood glucose levels, promote atherosclerosis, and increase risk for heart disease. From the research we’ve looked at over the years, we don’t generally recommend artificial sweeteners. If you can avoid them altogether that’s probably a good idea, although if you’re somewhere with sugar free foods available, some of them may contain these artificial sweeteners. And if you had a choice, sucralose would be a much better option that aspartame, Ace-K or saccharin.
11:13
So far we’ve talked about natural sugars and syrups, and artificial sweeteners, so what other options are there?
Well, the next type of sweetener we have are the ‘tols’ – xylitol, erythritol, maltitol and several others. These are all sugar alcohols, also known as polyols, and they are a type of carbohydrate that chemically have characteristics of both sugars and alcohols. Despite their name – sugar alcohol, they do not contain ethanol and are not actually alcohol. Sugar alcohols can naturally be found in small amounts in fruits and vegetables, but for commercial production they are most commonly produced by chemically converting sugars, which allows them to be widely used in sugar-free and reduced-sugar products. Two of the most common sugar alcohols are xylitol and erythritol. Sugar alcohols like erythritol and xylitol do not significantly impact blood sugar levels. However, be aware that they can cause digestive issues in some people, xylitol being worse. And just be aware that xylitol can be toxic to pets, especially dogs, so it should be used with caution if you have animals around the house. Erythritol is often found in combination with other sweeteners like stevia, which can make it easier to use in baking and other recipes.
I want to highlight that there were some sensational headlines and controversial reports around erythritol increasing risk of heart disease and stroke, but the headlines were not based on strong or founded evidence but instead have misrepresented erythritol safety and led to confusion. I’ve since heard all sorts of things, with some people even saying they’ve read research that it’s a neurotoxin, which based on my knowledge there certainly is no evidence to suggest that at all. Backtracking to those headlines, the controversial study that led to all this mess suggested that high blood levels of erythritol were associated with an increased risk of cardiovascular events. However, this study did not account for dietary intake of erythritol and only measured endogenous erythritol levels, which are produced naturally in the body. Therefore, it’s important not to jump to conclusions based on this study alone. The large body of evidence available suggests that erythritol is perfectly safe to consume. Studies have shown that erythritol is absorbed into the bloodstream and then excreted in the urine without being metabolized, some studies have shown it to have antioxidant properties, which can help reduce oxidative stress and inflammation. Anyway, at this stage there is no data to say erythritol isn’t safe.
Another thing to keep in mind as well is that some sugar alcohols can still spike blood sugar, not in everyone, but this is more common with maltitol, polyglycitol, isomalt, sorbitol and xylitol.
15:57
Beyond the sugar alcohols we have monk fruit and stevia, with stevia being used more frequently than monk fruit. Stevia comes in both powder and liquid form. Monk fruit is mainly powder. There’s been a lot of research on stevia, being it has grown in popularity. Overall the evidence suggests it’s safe, with no carcinogenic or genotoxic effects. When stevia was compared with sugar it has been shown to regulate appetite with less food being consumed throughout the day as opposed to sugar. Stevia causes no glycemic response and has also been shown to reduce blood sugar levels at 20 and 30 minutes post meal compared to sugar. stevia has been shown to increase insulin sensitivity. According to research stevia possesses interesting medicinal activities, including antidiabetic, antihypertensive, anti-inflammatory, antioxidant, anticancer, and antidiarrheal activity. According to research some of the benefits of stevia are that it stimulates Glucagon-like peptide 1 (GLP-1), reduces oxidative stress, can help to regulate lipid metabolism, which can be beneficial for cholesterol, and stevia doesn’t affect gut bacteria negatively. Overall, stevia has the strongest evidence for safety and benefits.
While we might not have heard of it until recently, immigration brought monk fruit to the U.S. in the 1940’s, so it’s been around for a long time. Research on monk fruit shows it may help regulate blood sugar, and it has antioxidant and anti-inflammatory properties. There certainly isn’t as much research on monk fruit as there is stevia but there doesn’t seem to be any negative impacts out of all the research we’ve read, so it’s certainly another suitable option.
One last sweetener, one that is newer on the market is allulose. Allulose is a rare sugar with almost zero calories, and in recent years researchers found a new way to manufacture it and subsequently allulose has been investigated for its potential benefits for T2 and prediabetes. This one is a very interesting one. Studies have actually shown it lowers postprandial blood sugar levels, that’s your after-meal blood sugar levels. What’s interesting about that, is there are not many foods that actually lower postprandial blood sugar levels when the same meals are consumed. Let’s take a closed look at these study outcomes.
A systematic review looked at the effects of postprandial glucose when healthy adults added 5 or 10 grams of allulose to a carbohydrate-containing meal. They found that those taking the allulose had lower after-meal glucose levels. In another small study with type 2 diabetes, the allulose meal reduced after meal glucose by 18 mg/dL or 1 mmol/L. Another single arm trial found a reduction of 32 mg/dL or 1.8 mmol/L for fasting blood sugar when people had allulose each morning for 8 weeks, along with improvements in A1c and insulin resistance. But the results are mixed, as another, more rigorous randomized controlled trial found that allulose had no effect on glucose levels in healthy people. There have been various studies in animals showing allulose reduced liver inflammation, lower insulin resistance, and slowing down the progression of diabetic nephropathy. Overall, the research here is very interesting and we’ll be keeping an eye on developments. Allulose certainly had the extensive research that something like stevia has, but with the potential benefits of lowering postprandial levels and it is considered safe, it’s definitely a sweetener worth considering. It is now readily available in grocery stores like Walmart and on Amazon etc. And it’s often used in combination products with other sweeteners like stevia and erythritol.
22:52
So with all that said, what is the best and safest sweetener?
Considering the evidence, the most suitable sugar substitutes are stevia and monk fruit, sugar alcohols like erythritol and the newly available allulose. These are unlikely to have any impact on blood sugar levels and at least stevia and monk fruit may offer several health benefits. Allulose may also help to lower postprandial levels. There are also some suitable syrups and sugar-free honeys available that use monk fruit, stevia and allulose and natural flavors, herbs and spices. Consuming natural sugars in very small quantities on occasion is also a suitable option, just keeping in mind they will have an impact on blood sugar levels, raising them by a certain degree. If you need to use an artificial sweetener, or you’re choosing a product with an artificial sweetener, sucralose is the better choice over others like aspartame or saccharin. However, it’s still better to opt for more natural alternatives when possible, the stevia and monk fruit for example. Overall, it may also come down to your personal taste preferences – the ones you prefer the taste of compared to others. Always remember to read the nutrition facts labels and consider the ingredients in a product, so you can make the best choice for you.
If you’re a sweet-tooth kind of person, overall, if you can focus on reducing your intake of sweets for other food options, this will have multiple benefits for your health and reduce your intake of added sugars and sugar substitutes as well. If sugar cravings are an issue, listen to episode 8 where we covered 7 effective ways to tame sugar cravings.
I hope you’ve found this information useful. Remember, you can head down to our website at Type2DiabetesTalk.com to review some of the info we cover today. And if you’re one of our members, you can find a newly updated and detailed sugar substitutes guide inside the members site. Find that in the ‘Food Guides’ or alongside episode 49.
Thank you for joining me today. If you did find this episode helpful, please share it with others and take time to leave a rating and review to help the podcast reach more people who can benefit from this valuable info.
That’s all from me today. Stay healthy and sweeten your life wisely!
Dr. Jedha over and out.
References
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Noya-Leal F, van der Wielen N, Behrens M, Rouschop S, van Arkel J, Jongsma M, Witkamp R, Mes JJ, Bastiaan-Net S, Meijerink J. Rebaudioside A from Stevia rebaudiana stimulates GLP-1 release by enteroendocrine cells via bitter taste signalling pathways. Food Funct. 2023 Jul 31;14(15):6914-6928. doi: 10.1039/d3fo00818e. PMID: 37431625.
Patel S, Navale A. The Natural Sweetener Stevia: An Updated Review on its Phytochemistry, Health Benefits, and Anti-diabetic Study. Curr Diabetes Rev. 2024;20(2):e010523216398. doi: 10.2174/1573399819666230501210803. PMID: 37138480.
Kurek JM, Mikołajczyk-Stecyna J, Krejpcio Z. Steviol glycosides from Stevia rebaudiana Bertoni mitigate lipid metabolism abnormalities in diabetes by modulating selected gene expression – An in vivo study. Biomed Pharmacother. 2023 Oct;166:115424. doi: 10.1016/j.biopha.2023.115424. Epub 2023 Sep 5. PMID: 37677968.
Singh G, McBain AJ, McLaughlin JT, Stamataki NS. Consumption of the Non-Nutritive Sweetener Stevia for 12 Weeks Does Not Alter the Composition of the Human Gut Microbiota. Nutrients. 2024 Jan 18;16(2):296. doi: 10.3390/nu16020296. PMID: 38257188; PMCID: PMC10821022.
Tey SL, Salleh NB, Henry CJ, Forde CG. Effects of non-nutritive (artificial vs natural) sweeteners on 24-h glucose profiles. Eur J Clin Nutr. 2017 Sep;71(9):1129-1132. doi: 10.1038/ejcn.2017.37. Epub 2017 Apr 5. PMID: 28378852.
Braunstein, C.R.; Noronha, J.C.; Glenn, A.J.; Viguiliouk, E.; Noseworthy, R.; Khan, T.A.; Au-Yeung, F.; Blanco Mejia, S.; Wolever, T.M.S.; Josse, R.G.; et al. A Double-Blind, Randomized Controlled, Acute Feeding Equivalence Trial of Small, Catalytic Doses of Fructose and Allulose on Postprandial Blood Glucose Metabolism in Healthy Participants: The Fructose and Allulose Catalytic Effects (FACE) Trial. Nutrients 2018, 10, 750. https://doi.org/10.3390/nu10060750.
Yuma T, Tokuda M, Nishimoto N, Yokoi H, Izumori K. Allulose for the attenuation of postprandial blood glucose levels in healthy humans: A systematic review and meta-analysis. PLoS One. 2023 Apr 6;18(4):e0281150. doi: 10.1371/journal.pone.0281150. PMID: 37023000; PMCID: PMC10079081.
Fukunaga, K.; Yoshimura, T.; Imachi, H.; Kobayashi, T.; Saheki, T.; Sato, S.; Saheki, N.; Jiang, W.; Murao, K. A Pilot Study on the Efficacy of a Diabetic Diet Containing the Rare Sugar D-Allulose in Patients with Type 2 Diabetes Mellitus: A Prospective, Randomized, Single-Blind, Crossover Study. Nutrients 2023, 15, 2802. https://doi.org/10.3390/nu15122802.
Tak, J., Bok, M., Rho, H., Park, J., Lim, Y., Chon, S., & Lim, H. (2022). Effect of diabetes-specific oral nutritional supplements with allulose on weight and glycemic profiles in overweight or obese type 2 diabetic patients. Nutrition Research and Practice, 17, 241 – 256. https://doi.org/10.4162/nrp.2023.17.2.241.
Bae, H., Shin, S., Han, Y., Yoo, J., Kim, S., Young, H., & Kwon, E. (2023). D-Allulose Ameliorates Dysregulated Macrophage Function and Mitochondrial NADH Homeostasis, Mitigating Obesity-Induced Insulin Resistance. Nutrients, 15. https://doi.org/10.3390/nu15194218.
Niibo, M., Kanasaki, A., Iida, T., Ohnishi, K., Ozaki, T., Akimitsu, K., & Minamino, T. (2022). d-allulose protects against diabetic nephropathy progression in Otsuka Long-Evans Tokushima Fatty rats with type 2 diabetes. PLoS ONE, 17. https://doi.org/10.1371/journal.pone.0263300.
Additional references can be found in all the posts and research linked to throughout this ultimate guide.
Jeffrey Lowenthal
Glycine powder is an amino acid that is a building block for glutathione and has a mildly sweet taste. I use it in coffee (half teaspoon) or plain Greek yogurt
George E Kann
Hello:
All those “restaurant” sweetener packets, I believe, contain several things and maltodextrin-type ingredients. I’ve heard maltodextrin is the highest glycemic index of anything. It’s the first ingredient with stevia and silica in a powder
sweetener I’ve been getting. It’s only as a “flowing agent.” Good grief!! Wonder how bad that is? Supposed to be Keto…???? Buy at a health food store. Brand name NuNaturals.
MaryAnne
Do you suggest or recommend monk fruit as as a sugar substitute?
Jedha: Nutritionist (MNutr)
Monk fruit is a suitable natural sugar substitute. Find more info here.
Kay
Allulose is a new sweetener found in Stop and Shop stores on east coast—- better than stevia or any other diabetic sweetener. Read about it online.
Emily - Dietitian (MS, RD)
Allulose is proving to be a promising sugar choice for diabetics! It is a naturally occurring sugar, yet not metabolized by the body so it does not impact your blood sugar levels.
John
What about Monk Fruit? My wife has been using a product that is a combo of Erythritol and Monk fruit extract. 4 carbs per tsp 0 calories. This sweetener works well for both of us, our friends can not tell the difference. I am a type 2 diabetic that has had the disease in remission for over 2 years. It has become second nature now to read labels and test, test, test! Diet and exercise keeps the beast sleeping. My doc is very pleased. “Whatever it is you are doing is working, and you need to continue doing it.” he tells me. This website too, has contributed to the proper nutrition and understanding of how it all works. Thank you!
Jedha: Nutritionist (MNutr)
Hi John, great results well done! YES, monk fruit and erythritol are both good forms of natural sugar substitutes.
Candi
What about agave?
Jedha: Nutritionist (MNutr)
You can find info on agave here Candi.