Added sugar substitutes for diabetic patients and health conscious - people, go naturally??

Arvind Kumar
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Introduction: -

  • We get carbohydrates (sugar and other nutrients) from natural products like fruits, vegetables, grains etc. It is natural sugar and gives our body fuel and energy to run the body properly. It is not a good choice to cut this natural sugar for normal people. 

  • Natural sugar is available in different forms, but our body converts the different forms of sugar (other than glucose) into glucose. 

  • However, we require the sugar to be added in items which are prepared by us like hot and cold drinks, desserts, sweet dishes, confectionary items, sauces, donnets, medicines, sugary beverages, candy, ice cream, cakes, pies, cookies, doughnuts, colas, fruit drinks, energy drinks, etc. it is called Added sugar, table sugar, etc.

  • Different types of added sugar are generally Sucrose and made from sugarcane plants or sugar beet etc.  with slight changes in the process of cleaning, boiling, crystallizing, drying, etc. Color of sugar depends upon the percentage of molasses present in the sugar. Pure white sugar does not contain molasses and dark brown sugar has a good amount of molasses. Different types of added sugar have slight changes in the properties, taste, uses etc.

  • Added sugar is available broadly in two forms i.e. Refined and Unrefined. Refined sugar is having only calories without nutrients and Unrefined sugar is having calories with little amount of nutrients (vitamins, minerals etc.)

  • Added sugar must be used in limited quantities, else it may be injurious to health. Therefore, alternate forms of sugar, called Sweeteners (substitute sugar) are developed and easily available in the market.

  • Sweeteners (substitute sugar) are of two types: Natural sweeteners and Artificial sweeteners. Natural sweeteners are derived from natural plants etc. However, Artificial sweeteners are derived/processed from chemicals.

  • Some Natural Sweeteners may have little calories, and some may have high calories like added sugar. May have nutrients and other benefits also.

  • Artificial sweeteners have sweetness only and provide zero (or negligible) number of calories, nutrients, etc.

  • In this article, we will read about different types of sugars such as Natural Sugar, Added sugar (Refined and unrefined), Sugar substitute (Natural sweeteners and Artificial Sweeteners), their pros and cons and some brand names available in the market. 

  • Finally, we will conclude with some views regarding consumption of different types of sugar for different types of people.


1. Natural Sugar

Various types of Natural sugar found in vegetables, plants, fruits, grains etc. are summarized below:



Types of Natural Sugar (chemical name - Saccharide)

Monosaccharide

(Mainly 03 types)

Disaccharide

(mainly 03 types)

Combination of any two monosaccharides

Glucose

Fructose

Galactose

Sucrose

Lactose

Maltose

Similar to Glucose

It is a combination of Glucose and Fructose

Generally, combination of Glucose and Galactose

Generally, combination of Glucose molecules

Naturally found in plants


Available in root vegetables, fruits etc.

Mostly found in peas etc.

Naturally found in plants

Naturally found in Milk and its product

Naturally found in Sprouts


2. Added Sugar:

Added sugar is generally Sucrose and made from sugarcane or sugar beets, Coconut plant etc. 

It contains high calories as Natural sugar. 

There are mainly two types (Refined and Unrefined) of added sugar. Refined sugar does not contain nutrients, however Unrefined sugar has some nutrients.

  Its properties are described below:


Added Sugar

Types of added sugar 

Calories

(Energy)

Nutrients

Fiber

Remarks

Refined Sugar-

also called table sugar, white sugar, granulated sugar etc.


Derived from sugarcane, sugar beets, corn, etc. 

High

Nil

Nil

If used in overdose:

1. harmful for diabetic patients and health-conscious people.

2. may increase body weight (Body Mass Index=BMI)


3. may develop other health issues.

Unrefined Sugar-

Example - brown sugar

High

contains nutrients, vitamins, minerals, antioxidants etc.

Nil

Almost similar effect as normal (added) sugar but contains nutrients for some benefits. 


Vegans should consider unrefined or organic sugar.


3. Sugar Substitutes or Sweeteners:


Sugar Substitutes (sweeteners) are mainly two types (Natural sweeteners and Artificial sweeteners).

Their properties, benefits and side effects are summarized below:


Types of sweeteners and its properties

Natural Sweeteners

Artificial Sweeteners

Origin

Derived from plants or natural products.

Derived from chemicals in the laboratories.

Sugar (calories)

Some have high calories like added sugar and some may have little calories.

All have zero or little calories.

Nutrients, vitamins, minerals, antioxidants etc,

May have these properties.

Do not have these good properties.

Benefits and side effects

Natural sweeteners having little calories are Good for diabetic patients and health-conscious people.

Natural sweeteners having high calories are not suitable for diabetic patients and health-conscious people.

Provides some good nutrients and medicinal uses.

may have various side effects.

More research is needed to verify the facts.

Good for diabetic patients and health-conscious people.

Do not provide any nutrients.

may have various side effects.

More research is needed to verify the facts.


4. Natural Sweeteners:

The word “Natural” may be confusing here. The fruits, vegetables, Grains, sprouts etc. are natural sources of sugar and when consumed by us, they provide us Natural Sugar.  

However, Natural Sweeteners are derived from natural products like plants etc.          and are available in the form of powder, granules, syrup, liquid, tablet etc.

Here we will discuss the various types of Natural sweeteners along with their properties, brand name available in the market as summarized below:



Natural Sweeteners 

Name

Brand name

Benefits

Side effects

Stevia

(Rebaudioside)

extracted from the Leaves of plant Stevia.

Sweet Leaf

Sun Crystals

Stevia

Truvia

PureVIA



Low or zero calories


may reduce high blood pressure but does not affect normal blood pressure.

 

Controls sugar spikes, so helpful to maintain blood sugar level.


Dissolves in water.


Suitable for baking.

Some may dislike the taste, depending on the brand.


May affect gut health.


May cause bloating or gas.


If mixed with erythritol, it may increase the risk of heart attack and stroke.


More study is needed to verify the facts.



Monk fruit

(Luo Han Guo) -

extracted from the fruit in the powdered form.

Lakanto Monk fruit sweetener


Low calories.


may reduce high blood pressure.


Helpful to maintain blood sugar level.

 

may be helpful to control inflammation.


Dissolve in water.


Suitable for baking. 

If mixed with erythritol, it may increase the risk of heart attack and stroke.



More study is needed to verify the facts and safety.

Yacon syrup - derived from Yacon plant.


Low calories.


may be helpful to improve intestine health.

 

Due to high fiber, it may control constipation.


may be helpful to control body weight.

Only moderate consumption is recommended.

Allulose

extracted from some fruits.


Low calories.


Helpful to maintain blood sugar level.

Not popular.

 

High doses may develop digestive problems.


More research is needed.

Sugar alcohols

(polyols) -


Xylitol,

Mannitol,

Sorbitol,

Erythritol,

Lactitol,

Maltitol

Swerve Erythritol

Low calories.


Control blood sugar spikes.


Prevent tooth problems.

May develop digestive problems.


Bitter aftertaste.


May be toxic for dogs.


More study is needed to verify the facts.

Honey

Wedderspoon Manuka honey from New Zealand)


Same or more calories as white sugar.


Contains vitamins, minerals and antioxidants.


May be used for medicinal purposes.

May develop digestive problems.


Thicker liquid.

Syrup

(Maple, Dates, Agave etc.) - 

extracted from fruit or plant.

Coombs family farms maple syrup


Similar or little less calories as normal sugar.


Contains vitamins, minerals and antioxidants.

Not very useful to maintain the blood sugar level.

Blackstrap molasses

Derived from sugarcane.

Wholesome’s Blackstrap molasses.

Similar calories as natural sugar



Contains vitamins and minerals.


May be used for medicinal purposes.

Not useful to maintain the blood sugar level.

Jaggery

derived from juice of sugarcane.


Similar calories as normal sugar.


Contains vitamins and minerals.


May be used for medicinal purposes.

Not useful to maintain the blood sugar level.

Coconut sugar

extracted from coconut tree.

Terrasoul superfoods

Similar calories as natural sugar.


May contain vitamins, minerals and antioxidants.


May be used for medicinal purposes.

Not useful to maintain the blood sugar level.


It is considered as added sugar.

Apple sauce

derived from apple.


little less calories than added sugar.


Contains fiber, vitamins and minerals.

Not very useful to maintain the blood sugar level.


5. Artificial sweetener (Intense sweetener or artificial sugar substitute): -

 These are chemicals which are hundreds or thousands of times sweeter than refined/normal sugar but used in very small quantities, so calorie content is almost zero. Its taste is similar to added sugar.

Different types of artificial sweetener available in the market are summarized below:


Artificial Sweetener

Property

Brand name

Remarks

Aspartame

Hundred times sweeter than added sugar.

  1. Nutrasweet

  2. Equal

  3. Sugartwin


Acesulfame Potassium (acesulfame K)

Hundred times sweeter than added sugar.


Used for cooking and baking.

  1. Sunnet 

  2. Sweetone



Aspartame (Acesulfame salt)

Hundred times sweeter than added sugar.


  1. Twinsweet


Advantame 

Many thousand times sweeter than added sugar.


Used for cooking and baking.



Cyclamate

Used for Cooking and baking.



It is learnt that it is banned in some countries.

Neotame

Thousands of times sweeter than added sugar.


Used for baking and cooking.

  1. Newtame


Neohesperidin

Hundreds of times sweeter than added sugar.


Used for baking, cooking and mixing with some specific food.



It is not approved in some countries.

Saccharin

Hundreds of times sweeter than added sugar.


  1. Sweet’N Low

  2. Sweet Twin

  3. Necta Sweet

  4. Sugar Twin

Unpleasant aftertaste

Sucralose

Hundreds of times sweeter than added sugar.


Used for baking, cooking and mixing with some specific food.

  1. Splenda


  • Note: - Some facts regarding consumption of artificial sweetener:

  • Low calories or nil calorie contents.

  • may reduce the body weight, however it may vary from individual to individual depending on various factors.

  • may reduce tooth decay.

  • may disturb digestive health etc.

  • Generally, considered safe for most people, however some side effects may develop in some people.

  • Link with cancer, heart attack, stroke, dementia, type-2 diabetes  etc. not permanently established.

  • However, more research is needed to elaborate the above facts, etc.

  • It is advisable to consult a specialist to give proper advice.



  •        Conclusion:

  •           What should we do? Should we stick to consuming added sugar or shift to Natural           sweeteners or Artificial sweeteners??
  • We should consume sufficient quantities of fresh vegetables, fruits etc. to get natural sugar, nutrients, fiber and other benefits to fight the diseases. 

  • It may be very difficult to completely stop the consumption of added sugar. 

  • Limited use of added sugar does not affect (or little affect) the health of normal people.

  • However, use of added sugar for diabetic patients or health-conscious people is discouraged. Diabetic patients and health-conscious people may consume fresh vegetables, fruits, etc. which have low calories and avoid regular/frequent use of  high calories natural products like mango, pomegranate, banana, grapes, corn, potato, sweet potato, melon, chikoo and other high calories contents. Zero (or negligible) calories sweeteners are better than added sugar for diabetic patients. 

  • Overdose of added sugar may increase the risk of various health issues like diabetes, obesity, heart attack, stroke, tooth decay etc. Definitions of limited use vary as per the health condition and need of individuals. Alternatively, we can also add the intake of sweeteners (Artificial or Natural). 

  • Every form of sugar has some benefits and some negative impacts. 

  • Which one is the best option of the sugar and how much should be consumed by  the individuals?  It will be decided by the doctor/specialist/dieticians as per the health conditions of the individuals. 

  • All types of sweeteners are easily available at online platforms like Amazon, Walmart, Thrive Market, Vitacost, IHerb, flipcart etc. Their ingredients, derived source, certifications etc. may be verified on the label as well as from trusted sources.

  • Disclaimer: The best efforts are made to provide you a good  information and credit goes to the following references:

  • https://www.healthline.com

  • https://www.goodrx.com/health

  • https://www.amazon.in

  • https://www.finedininglovers.com

  • https://www.sugar.org

  • https://www.webmd.com

  • https://www.healthline.com

  • https://www.hopkinsmedicine.org

  • Other similar websites on the internet

  • The article is written for educational purposes only. I am not a certified doctor/specialist and do not take any responsibility/guarantee of its correctness & consequences. Before consuming any types of sugar/sweeteners, it is advised to take the recommendation of a doctor/dietician/specialist etc.

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