Understanding Sugar and Sugar Substitutes

Sugar becoming an issue to our health is only because we have health issues such as diabetes, fatty liver disease, obesity, and so on, which only happened in the last 100 years and has high correlation with increasing consumption of sugar. Currently, to support our health but also our "sweet tooth", there are so many sugar and sugar substitutes that are out in the market. With marketing strategies and poorly designed research studies, it is difficult to learn what each of the sweeteners does and how they can affect our health.

In this article, there are information on what are some sweeteners are out in the market and how they are different. Information will also cover benefit towards weight and metabolic control.

Understanding Sugar, Refine Sugar, and Natural Sweetener

When we say sugar, we are referring to sucrose which is combination of glucose and fructose.  Fructose, in nature, is mainly found in fruits with some glucose.  In normal consumption level, fruits will not have any health problem due to fructose.  High fructose corn syrup is blending free fructose and glucose and generally higher in fructose than sucrose which makes high fructose corn syrup to be sweeter.

Although high consumption of fructose through eating fruits alone is rather challenging, however, in modern a high amount of fructose is easy through candies and beverages.  Excess fructose may lead to increase in appetite and cause metabolic dysregulation. 

Some of the known effects of fructose are ATP (adenosine triphosphate) or energy depletion.  Fructose, compared with glucose, consumes ATP faster which leading to “energy debt” that can be perceived by the body as starvation.  This effect is insignificant in small number of fruits, however, can be attained easily by candies, gummies and juices which have higher concentration of fructose.

Fructose also has effect on the brain and hormones and promotes food motivation.  Glucose on the other hand signals satiety.  This is why it is easy to consume fructose-based food and beverages in abundance compared with food with protein fat.

Affect of sugar on our body can be different when consumed in solid or liquid form.  This is due to absorption rate.  Faster the absorption rate is the stronger the appetite-driving effect.

Liquid form of sugar can be fruit juice, soda, and smoothies.  Along with faster absorption rate, they are usually packed with higher sugar concentration.  After the absorption rate in the gut can accelerate metabolic effects mentioned earlier.

Solid forms of sugar, such as candy bars, have slower absorption rate due to solidity and presence of fat.  Fat slows digestion which reduces rapid sugar spikes.

Refined sugars are extracted and concentrated from natural sources, but the end product is the same as glucose and fructose molecules.  Cane sugar or sucrose has glucose to fructose ratio of 50/50 and high fructose corn syrup is around 30/70.  This is why sweetness of high fructose corn syrup is stronger than the cane sugar. Terms like “natural sweetener” or “raw sugar” are just a marketing strategy and how they impact our body is the same.  Unless you are consuming sugar from whole food like eating apple or chewing on sugar cane, sugar you are using is refined.

Natural sweeteners, such as honey, maple syrup, agave are often higher in fructose compared to refined sugars, which may have impact on metabolic and appetite effects.

Sugar Consumption Timing

There are ideal and worst times to consume sugar.  Sugar (sucrose, glucose, fructose) aren’t bad.  Its health effects depend on amount you consume and capacity your body can metabolize and dispose of.  Metabolizing and disposal are influenced by insulin sensitivity and available glycogen storage space.

When looking at the best timing to consume sugar from above perspective, post-exercise will be the top choice.  After the exercise, glycogen (storage form of glucose) is depleted from muscles, which means there is room for glucose storage.  Insulin sensitivity is maximized, which will increase the efficiency of glucose uptake.

When looking at the worst time, on the other hand, to consume sugar is late at night or before going to bed.  Sleep slows down your insulin sensitivity.  Our body is more insulin-resistant at night.  Because of this, glucose spikes become larger, and clearance is slower.

Understanding Sugar Substitute

Sugar substitutes are classified by nutritive which provides calories and non-nutritive which provide almost no calories.  It can also be categorized by synthetic and natural source.

Low calorie synthetic sweeteners

• Saccharin - Sweet’N Low is the brand that uses saccharin, which has 0 Kcal/g and is 300 times sweeter than sucrose.

• Aspartame - NutraSweet is a brand, which has 4 Kcal/g and is about 200 times sweeter.

• Sucralose - Splenda is the name of the brand, which has 0 Kcal/g and 600 times sweeter than sucrose.

  
  

Low calories natural sweeteners

• Sorbitol - 0.6 time the sweetness of sucrose with 2.6 Kcal/g. May cause GI issues.

• Xylitol - About the same sweetness as sucrose with 2.4 Kcal/g.

• Erythritol - 0.7 times the sweetness of sucrose with 0.2 Kcal/g.

When comparing sugar and sugar substitutes in terms of it's effect towards metabolic health, including obesity, diabetes, and so on, it is somewhat challenging because of way the scientific studies has been done. This is true to majority of the nutrition studies. Studies or testing (animal or epidemiological studies) are done in perfectly controlled environment.

Nonetheless, majority of sugar substitutes studies have not shown significant amount of weight loss. So replacing 3 sodas/day to 3 diet sodas (usually aspartame)/day has little impact on body weight, where as replacing 3 sodas/day to 3 soda water/day (ex: sparkling water) lead to decent amount of weight loss.

Possible differences in outcome between diet sodas and soda water is that sugar substitute despite the calorie is low or none, it's sweetness may trigger the reward pathway that lead to compensatory eating, which leading to seeking extra calories from other sources.

Newer sugar replacements, such as Stevia, monk fruit, and sugar alcohol may have slightly more positive effect in weight and glycemic control.

Allulose is another natural sweetener that has shown positive outcome towards weight and glycemic control. Allulose has 0.2Kcal/g and 0.7 times the sweetness of sucrose and currently is the best choice for sugar substitute. Studies have found improvement in glucose tolerance, glycemic control, and weight control.

Summary

There is no good or bad in consuming sugar. Just like anything else, if consumed in moderation, negative impact towards health is minimal. Even drinking too much water can be harmful and may lead to hyponatremia.

Biggest challenge that people have is amount of sugar they consume and way they are consuming. In the U.S. average consumption of sugar is 50-80lb per year. That is over 145,000 Kcal just from sugar per year which is equivalent to weight gain of about 40lb.

However, sugar substitutes such as allulose, may help calm your sweet craving without harming your health. In addition, if you can practice resistance training for 2 times per week, then sugar consumption may not have much harm towards your weight or health.

Kota Shimada