Sugar and artificial sweeteners’ health implications

16 MINUTES

Sugar is a ubiquitous ingredient in many of our favorite foods and beverages, from cakes and candies to sodas and sports drinks. However, overconsumption of sugar has been linked to a host of health problems, including obesity, type 2 diabetes, and heart disease. As a result, many people are now seeking ways to reduce their sugar intake and find healthier alternatives to satisfy their sweet tooth.

In this article, we will explore the effects of sugar on the body, the different types of sugar, and ways to reduce sugar consumption without sacrificing taste. Whether you’re looking to improve your health or simply want to learn more about this ubiquitous ingredient, this article will provide valuable insights into the world of sugar and artificial sweeteners.

What is sugar?

Sugar is a type of carbohydrate that is commonly used as a sweetener in foods and beverages. Chemically, sugar is a simple carbohydrate made up of carbon, hydrogen, and oxygen molecules.

Types of sugar

There are several types of sugar, both natural and processed, including:

  1. Glucose: A simple sugar that is the primary source of energy for the body and found naturally in fruits, vegetables, and honey.
  2. Fructose: A natural sugar found in fruits, vegetables, and honey that is often used as a sweetener in processed foods and beverages.
  3. Sucrose: Also known as table sugar, sucrose is made up of glucose and fructose and is often added to foods and beverages as a sweetener.
  4. High-fructose corn syrup (HFCS): A processed sweetener made from corn starch that is commonly used in processed foods and beverages.
  5. Lactose: A sugar found in milk and dairy products.
  6. Maltose: A sugar that is formed when starch is broken down during digestion and found in grains and malted foods.
  7. Galactose: A sugar found in dairy products and some fruits and vegetables.
  8. Brown sugar: A type of sugar that is made by mixing white granulated sugar with molasses, which gives it a brown color and slightly different flavor.
  9. Powdered sugar: Also known as confectioners’ sugar, this type of sugar is ground into a fine powder and often used in baking and frosting.
  10. Turbinado sugar: A type of raw sugar that is less processed than white granulated sugar, with larger crystals and a subtle molasses flavor.
  11. Muscovado sugar: A type of dark, unrefined sugar with a strong molasses flavor that is often used in baking.
  12. Honey: A natural sweetener made by bees from the nectar of flowers.
  13. Maple syrup: A natural sweetener made from the sap of maple trees.
  14. Agave nectar: A sweetener made from the agave plant, commonly used as a vegan and low-glycemic alternative to honey or sugar.
  15. Stevia: A sweetener made from the leaves of the Stevia rebaudiana plant, which is often used as a calorie-free alternative to sugar.
  16. Coconut sugar: A sweetener made from the sap of coconut palm trees, which has a caramel-like flavor and is often marketed as a healthier alternative to processed sugars.
  17. Date sugar: A sweetener made from dried dates that have been ground into a powder, often used as a natural sweetener in baking.
  18. Molasses: A byproduct of the sugar refining process, molasses is a thick, dark syrup that is often used as a sweetener in baking and cooking.
  19. Invert sugar: A liquid sweetener made by hydrolyzing sucrose into its component sugars, glucose and fructose. Invert sugar is often used in baked goods to retain moisture and extend shelf life.
  20. Treacle: A sweet, dark syrup that is a byproduct of sugar refining, similar to molasses. Treacle is commonly used in British cuisine in dishes like sticky toffee pudding.
  21. Corn syrup: A sweetener made from corn starch that is often used in processed foods, candy, and baked goods. It is available in light and dark varieties.
  22. Cane sugar: A type of sugar that is made from sugarcane, similar to beet sugar which is made from sugar beets. Cane sugar is often used in baking and sweetening beverages.
  23. Palm sugar: A sweetener made from the sap of certain palm trees, commonly used in Southeast Asian cuisine. Palm sugar has a caramel-like flavor and is often used in desserts and curries.

Types of artificial sweeteners

Artificial sweeteners are a type of sugar substitute that are often used as a calorie-free alternative to sugar. Here are some of the most common types of artificial sweeteners:

  1. Aspartame: A low-calorie sweetener made from two amino acids, aspartic acid and phenylalanine. It is often used in diet soda, chewing gum, and other low-calorie products.
  2. Saccharin: A zero-calorie sweetener that has been in use since the late 1800s. It is often used in tabletop sweeteners and other low-calorie products.
  3. Sucralose: A zero-calorie sweetener that is made from sugar but is modified so that the body cannot break it down. It is often used in diet soda, baked goods, and other low-calorie products.
  4. Acesulfame potassium (Ace-K): A calorie-free sweetener that is often used in baked goods and low-calorie products.
  5. Neotame: A calorie-free sweetener that is similar to aspartame but is 8,000 times sweeter. It is often used in low-calorie products and is not approved for use in some countries.
  6. Stevia: A zero-calorie sweetener made from the leaves of the Stevia rebaudiana plant. It is often used as a natural alternative to artificial sweeteners.
  7. Advantame: A high-intensity sweetener that is derived from aspartame, but is 20,000 times sweeter. It is used in a variety of food and beverage products.
  8. Cyclamate: A low-calorie sweetener that was first discovered in the 1930s. It is often used in tabletop sweeteners and other low-calorie products.
  9. Tagatose: A low-calorie sweetener that is derived from lactose, but has a glycemic index of only 3. It is often used in low-calorie products and as a sugar substitute in baking.
  10. Allulose: A low-calorie sweetener that is found naturally in small amounts in some fruits, such as figs and raisins. It is often used as a sugar substitute in baking and in low-calorie products.
  11. Glycyrrhizin: A natural sweetener that is extracted from licorice root. It is often used in food and beverage products as a natural alternative to sugar.
  12. Monk fruit extract: A zero-calorie sweetener that is derived from the monk fruit, which is native to China. It is often used as a natural alternative to artificial sweeteners.
  13. Erythritol: A low-calorie sugar alcohol that is often used as a sugar substitute in baking and in low-calorie products.
  14. Isomalt: A low-calorie sugar alcohol that is often used in sugar-free candies and gum.
  15. Lactitol: A low-calorie sugar alcohol that is often used in sugar-free candy and chocolate.
  16. Maltitol: A low-calorie sugar alcohol that is often used in sugar-free candies and baked goods.
  17. Xylitol: A low-calorie sugar alcohol that is often used as a sugar substitute in baking and in low-calorie products.
  18. Thaumatin: A natural sweetener that is derived from the fruit of the West African katemfe plant. It is often used in food and beverage products as a natural alternative to sugar.

How much sugar per day?

The amount of sugar a person should consume daily depends on various factors, such as age, gender, body weight, and activity level. However, the American Heart Association (AHA) recommends the following daily sugar limits:

  • Men: no more than 36 grams or 9 teaspoons of added sugar per day
  • Women: no more than 25 grams or 6 teaspoons of added sugar per day

The AHA’s recommendations refer to added sugar, which includes any sugar that is added to food during processing or preparation, as well as sugar that is naturally present in honey, syrups, and fruit juice concentrates. The AHA’s recommendations do not apply to the naturally occurring sugars found in fruits, vegetables, and dairy products, as these foods provide other essential nutrients.

How does sugar affect your health?

Consuming too much sugar, especially added sugars, can have negative effects on your health. Here are some potential negative effects of consuming too much sugar:

  1. Weight gain and obesity: Excessive sugar intake can lead to weight gain and obesity. This is because sugar contains empty calories and does not provide the essential nutrients needed for a healthy body.
  2. Type 2 diabetes: Consuming too much sugar can increase the risk of developing type 2 diabetes. This is because sugar can cause insulin resistance, which makes it difficult for the body to regulate blood sugar levels.
  3. Cardiovascular disease: Excessive sugar intake can increase the risk of developing cardiovascular disease. This is because sugar can contribute to high blood pressure, inflammation, and other risk factors for heart disease.
  4. Dental problems: Consuming too much sugar can increase the risk of dental problems such as cavities and tooth decay.
  5. Inflammation: Excessive sugar intake can contribute to inflammation in the body, which can lead to a variety of health problems, including autoimmune disorders, arthritis, and even cancer.
  6. Poor nutrition: Consuming too much sugar can displace more nutrient-dense foods from your diet, leading to poor nutrition and deficiencies in essential nutrients.

Too much sugar symptoms

Consuming too much sugar can lead to a range of negative symptoms and health effects, including:

  1. Weight gain: Consuming excess sugar can contribute to weight gain and obesity, as sugary foods and drinks are often high in calories but low in nutrients.
  2. Increased risk of type 2 diabetes: High sugar consumption can increase your risk of developing type 2 diabetes, as it can lead to insulin resistance and impaired glucose tolerance.
  3. Tooth decay: Sugar can contribute to tooth decay and cavities, as it feeds harmful bacteria in the mouth.
  4. Increased risk of heart disease: A diet high in sugar can contribute to high blood pressure, inflammation, and other factors that increase the risk of heart disease.
  5. Mood swings and energy crashes: Consuming sugary foods and drinks can cause a rapid spike in blood sugar levels, followed by a crash that can leave you feeling tired, irritable, and hungry.
  6. Skin problems: High sugar consumption can contribute to skin problems such as acne and premature aging.

Refined sugar versus artificial sweeteners: Which one is healthier?

Refined sugar is a natural product derived from sugar cane or sugar beets, but it is heavily processed and stripped of any nutrients during production. Consuming too much refined sugar has been linked to a range of negative health effects, including obesity, type 2 diabetes, heart disease, and tooth decay.

Artificial sweeteners, on the other hand, are synthetic substances that are designed to mimic the sweetness of sugar without the calories. While artificial sweeteners are often marketed as a healthier alternative to sugar, there is some evidence to suggest that they may have negative health effects, such as disrupting gut microbiota and increasing the risk of metabolic disorders.

White versus brown sugar: Is there any difference?

White sugar, also known as granulated sugar, is made from sugar cane or sugar beets. It is heavily processed to remove impurities and molasses, resulting in a fine, white crystal. White sugar has a neutral flavor and is commonly used in baking and cooking.

Brown sugar, on the other hand, is a mixture of white sugar and molasses. Molasses is a byproduct of the sugar refining process, and it is what gives brown sugar its distinctive color and flavor. Brown sugar comes in two varieties: light and dark. Light brown sugar contains about 3.5% molasses, while dark brown sugar contains about 6.5% molasses. Brown sugar has a slightly caramel-like flavor and is commonly used in baking, cooking, and making marinades and sauces.

In terms of nutrition, there is not a significant difference between white and brown sugar. Both types of sugar are high in calories and provide little to no essential nutrients. However, some people prefer brown sugar for its flavor and the fact that it is less processed than white sugar.

How to cut sugar?

Reducing your sugar intake can have many health benefits, such as maintaining a healthy weight, reducing the risk of chronic diseases, and improving overall energy levels. Here are some tips to help you cut your sugar intake:

  1. Read food labels: Sugar is added to many processed and packaged foods, including cereals, granola bars, yogurts, and salad dressings. Read the ingredient list and look for added sugars such as high fructose corn syrup, molasses, and cane sugar.
  2. Limit sugary drinks: Sugary drinks, such as soda, energy drinks, and sports drinks, are a major source of added sugar in the diet. Instead, choose water, unsweetened tea, or sparkling water with a squeeze of lemon or lime.
  3. Choose whole foods: Whole, nutrient-dense foods such as fruits, vegetables, lean protein, and whole grains can provide natural sweetness without added sugars.
  4. Use natural sweeteners: When cooking or baking, try using natural sweeteners such as honey, maple syrup, or stevia instead of refined sugar.
  5. Reduce processed foods: Processed foods are often high in added sugars, salt, and unhealthy fats. Choose whole, minimally processed foods as much as possible.
  6. Be mindful of portion sizes: Even natural sweeteners can be high in calories, so be mindful of portion sizes and moderation.
  7. Make gradual changes: Reducing your sugar intake can be challenging, so start small and make gradual changes to your diet. Over time, your taste buds will adjust to less sweetness.

What happens to your body when you quit sugar

Quitting sugar can have a range of positive effects on your body, including:

  1. Improved energy levels: Consuming too much sugar can lead to energy crashes and fatigue, but cutting back on sugar can help to stabilize your blood sugar levels and boost your energy.
  2. Weight loss: Reducing your sugar intake can help you lose weight, as sugary foods and drinks are often high in calories but low in nutrients.
  3. Reduced inflammation: Sugar consumption has been linked to increased inflammation in the body, which can contribute to a range of health problems. Cutting back on sugar may help to reduce inflammation and improve overall health.
  4. Improved dental health: Consuming too much sugar can contribute to tooth decay and cavities, but reducing your sugar intake can help to improve dental health.
  5. Better skin health: Sugar consumption has been linked to skin problems such as acne and premature aging, so reducing your sugar intake may help to improve your skin health.
  6. Reduced risk of chronic diseases: Consuming too much sugar has been linked to a range of chronic diseases, including type 2 diabetes, heart disease, and certain cancers. Cutting back on sugar may help to reduce your risk of these conditions.

Is sugar addictive?

There is ongoing debate among experts about whether sugar is addictive or not. Some studies suggest that sugar can activate reward centers in the brain and lead to cravings and overeating, similar to the way drugs of abuse can impact the brain. However, the degree to which sugar is addictive remains a topic of research and discussion.

That being said, some people may find themselves craving sugar or experiencing negative symptoms when they try to cut back on their sugar intake. This may be due to a variety of factors, including habit, cultural or social norms, emotional eating, or an imbalance in hormones related to appetite and satiety.

How can I tell if a food or drink has added sugars?

Food and beverage manufacturers may use different names for added sugars in their products, making it difficult to identify them on ingredient lists. Here are some common names for added sugars to look out for when reading food labels:

  1. High fructose corn syrup
  2. Cane sugar
  3. Brown sugar
  4. Corn syrup
  5. Dextrose
  6. Fructose
  7. Glucose
  8. Honey
  9. Invert sugar
  10. Malt syrup
  11. Molasses
  12. Raw sugar
  13. Sucrose
  14. Syrup
  • Beware of “low-fat” or “fat-free” products: These products often contain added sugars to make up for the loss of flavor and texture from the removed fat. Read the label carefully to ensure that the product doesn’t contain added sugars.
  • Check the ingredients list: Ingredients are listed in descending order by weight, so if sugar is one of the first few ingredients, the product likely contains a lot of added sugars.
  • Look for sugar aliases: Manufacturers may use different names for added sugars to make it harder to identify them on the ingredient list. Some examples include agave nectar, fruit juice concentrate, and evaporated cane juice.
  • Choose unsweetened or low-sugar alternatives: For example, choose plain yogurt instead of sweetened yogurt, and sparkling water instead of soda.
  • Use caution with condiments and sauces: Ketchup, barbecue sauce, and other condiments often contain added sugars. Look for low-sugar or sugar-free options, or use herbs and spices to flavor your food instead.

There are also many foods that are often considered “healthy” but can contain hidden sources of sugar. Here are a few examples:

  1. Yogurt: Some flavored yogurts can contain significant amounts of added sugar, sometimes as much as a candy bar. Choosing plain yogurt and adding your own fruit is a healthier option.
  2. Granola bars: Many granola bars marketed as healthy can contain large amounts of added sugars. Look for bars with less than 5 grams of sugar per serving or make your own at home.
  3. Salad dressings: Many store-bought salad dressings contain added sugar. Look for dressings made with whole food ingredients or make your own at home with olive oil and vinegar or lemon juice.
  4. Smoothies: Smoothies can be a healthy breakfast or snack option, but many store-bought smoothies contain added sugars, especially if they include juice or sweetened yogurt. Making your own smoothies at home with whole fruits and vegetables is a healthier option.
  5. Energy bars: Similar to granola bars, many energy bars marketed as healthy can contain significant amounts of added sugar. Look for bars made with whole food ingredients or make your own at home.
  6. Protein bars: Protein bars can be a convenient snack option, but many contain added sugars and other unhealthy ingredients. Look for bars with minimal added sugars and whole food ingredients.
  7. Tomato sauce: Many store-bought tomato sauces contain added sugar. Look for brands with no added sugar or make your own sauce at home with fresh tomatoes.
  8. Instant oatmeal: Some instant oatmeal packets contain added sugars and artificial flavors. Choosing plain oats and adding your own toppings, such as fruit and nuts, is a healthier option.
  9. Fruit juice: Fruit juice can be a good source of vitamins and minerals, but many varieties contain added sugars. Choosing whole fruit or making your own juice with a juicer or blender can help you avoid added sugars.
  10. Dried fruit: Dried fruit can be a healthy snack, but some varieties contain added sugars. Look for brands with no added sugars or make your own dried fruit at home.
  11. Condiments: Many condiments, such as ketchup and barbecue sauce, can contain added sugars. Look for brands with no added sugars or make your own condiments at home.
  12. Cereal: Many cereals marketed as healthy can contain large amounts of added sugars. Look for cereals with less than 5 grams of sugar per serving or make your own granola at home.
  13. Energy drinks: Energy drinks can be high in caffeine and sugar. Choosing water or unsweetened tea is a healthier option for staying hydrated and alert.
  14. Bread: Some types of bread can contain added sugars. Look for brands with whole grains and minimal added sugars or make your own bread at home.

Are sugar-free beverages healthy?

Sugar-free beverages can be a healthier alternative to regular sugary drinks, but it depends on the specific product and the context of your overall diet.

Many sugar-free beverages use artificial sweeteners to provide a sweet taste without the added calories of sugar. While artificial sweeteners have been approved as safe for consumption by regulatory agencies like the FDA, there is some evidence to suggest that they may have negative health effects, such as disrupting gut microbiota and increasing the risk of metabolic disorders.

Sugar-free beverages are not a replacement for water, which is the healthiest beverage choice. Drinking plenty of water throughout the day is essential for maintaining proper hydration and overall health.

What is the “added sugars” line on the Nutrition Facts panel?

The “added sugars” line on the Nutrition Facts panel is a new addition to food labels in the United States as of 2020. It is designed to help consumers easily identify the amount of added sugars in a food or beverage product.

The added sugars line shows the amount of added sugars in grams per serving, as well as the percent daily value (%DV) of added sugars based on a 2,000-calorie diet. The %DV represents the recommended daily limit of added sugars intake as a percentage of your daily caloric intake.

The added sugars line is separate from the total sugars line, which includes both natural sugars (such as those found in fruit or milk) and added sugars. The total sugars line may still be useful in determining the overall sugar content of a product, but the added sugars line can help you identify how much of the total sugars are coming from added sugars.

By paying attention to the added sugars line on the Nutrition Facts panel, you can make more informed choices about the foods and beverages you consume and work to reduce your overall sugar intake.

How can I contact gastroenterologist Dr. Zavos for an appointment?

Dr. Chris Zavos is a board-certified gastroenterologist and hepatologist, located in Thessaloniki Greece, and specifically in Kalamaria suburb, about 7 kilometres (4 miles) southeast of downtown Thessaloniki. His private office is at: Fanariou 8 street (near Aigaiou and Adrianoupoleos avenues), Kalamaria (Thessaloniki), Greece.

Thessaloniki International Airport is only 10 km away from his private office in Kalamaria and can be reached by taxi within 13 minutes from the airport.

Dr. Chris Zavos performs endoscopies at Bioclinic private hospital in downtown Thessaloniki (Mitropoleos 86 street).

You can contact Dr. Zavos at phone numbers: (+30)-6976596988 and (+30)-2311283833, or you can email him at czavos@ymail.com. Dr. Zavos responds to Greek and English languages.

Last update: 26 September 2023, 19:06

DR. CHRIS ZAVOS, MD, PHD, FEBGH

Gastroenterologist - Hepatologist, Thessaloniki

PhD at Medical School, Aristotle University of Thessaloniki, Greece

PGDip at Universitair Medisch Centrum Utrecht, The Netherlands

Ex President, Hellenic H. pylori & Microbiota Study Group