Once upon a time, you went to the sweeteners aisle and next to the sugar you found pink, blue, and yellow packets artificial sweeteners. However, several studies found aspartame and other artificial sweeteners could, among other problems, trigger sugar cravings and weight gain.
As people became more wary of them, manufacturers became savvy to the fake-sugar backlash and offered a variety of healthy natural sweeteners they claimed didn't raise your blood sugar or create other problems that sugar did.
I looked at the science behind four of these popular sweeteners to determine which ones you can safely incorporate into your diet and which ones need to go the way of those nasty artificial sweeteners.
Monk Fruit
What is it? Alternately marketed as "lo han sweetener" (not to be confused with the troubled actress!), monk fruit has an extract 300 times sweeter than sugar. Besides its medicinal purposes, China has long used monk fruit as a sweetener.
What are its health benefits? In China, monk fruit sweetener has been used for nearly a thousand years to treat obesity and diabetes. Rich in antioxidants with anti-inflammatory benefits, one study indicated that monk fruit may offer anti-cancer and anti-diabetic benefits.
Is it safe? The U.S. Food and Drug Administration (FDA) classifies monk fruit as generally recognized as safe (GRAS) and there have been no reports of negative side effects.
How to buy monk fruit: Splenda has marketed their version of monk fruit sweetener as Nectresse. Although they claim it has "zero calories," they have added erythritol (good) but also sugar and molasses (not so good) to this monk fruit powder. Look instead for pure lo han sweetener with no additives.
My take: Monk fruit has become a popular sweetener in no-sugar-added coconut ice cream and other foods. Like with any sweetener, be cautious about over-using monk fruit. For some people, healthy sweeteners can trigger cravings for more sweet foods. If that's you, learn to appreciate the natural sweetness of, say, cinnamon or vanilla.
Erythritol
What is it? A sugar alcohol discovered in 1848 that naturally occurs in some fruits and fermented foods. (Note: Sugar alcohols got their name because their biochemical structure resembles a hybrid of a sugar and an alcohol.) Erythritol has 95 percent less calories than sugar, although the FDA does label it as having some calories.
What are its health benefits? Studies show that erythritol is tooth-friendly and does not contribute to dental problems like sugar does. Another study showed that erythritol (along with xylitol) inhibited caries formation.
Erythritol makes an ideal sweetener for people with diabetes. One study showed this sugar alcohol had no adverse effects on blood glucose levels.
Is it safe? A comprehensive review concluded "erythritol did not produce evidence of toxicity." Unlike other sugar alcohols, only about 10 percent of erythritol goes to your colon. (Going to your colon creates many of sugar alcohol's laxative effects.)
Instead, your small intestine absorbs most erythritol and excretes it in your urine. So you don't have the gas and bloating that other sugar alcohols can create. However, large doses (more than 50 grams) can create nausea and (very rarely) allergic urticaria. For the most part, however, erythritol is incredibly safe.
How to buy erythritol: You will often find erythritol blended with other sweeteners, or you can buy 100 percent erythritol powder at some health food stores.
My take: Erythritol makes a promising sweetener in small amounts since it does not seem to create the gastric distress other sugar alcohols can. (Although as with any sugar alcohol, a little bit goes a long way.) I recommend that you look for 100 percent erythritol or a erythritol/stevia blend.
Xylitol
What is it? A naturally-occurring sugar alcohol with a sweetness similar to sucrose. Xylitol, however, has 33 percent fewer calories than sugar. Manufacturers used to derive xylitol from birch trees, but now it more likely comes from either corn husks or as a blend of corn and birch. Scientists claim no molecular difference exists between sources.
What are its health benefits? Because it doesn't raise glucose like sugar does, Europeans have used xylitol for over a century as a sweetener for people with diabetes.
Whereas table sugar has a glycemic index of 100, xylitol ranks only a seven. (The glycemic index ranks how quickly a food raises your blood sugar levels.)
Xylitol has an impressive history of reducing occurrence of cavities. The FDA allows manufacturers to claim xylitol does not promote dental caries.
Other studies show xylitol can reduce risk for osteoporosis (at least in rats) and control oral infections of Candida.
Is it safe? Studies show you can ingest large amounts of xylitol with no toxic effects. The problem is xylitol's laxative effects, including diarrhea, gas, and bloating. Much like with fiber, starting low and gradually upping the amount of xylitol you use will help lessen these unpleasant effects.
Worth mentioning: Don't let your canine companions anywhere near xylitol. Studies show xylitol can be fatal to dogs.
How to buy xylitol: You can buy xylitol as a powder in most health food stores. Xylitol used to be found in many chewing gums, but sadly aspartame and other artificial sweeteners now give chewing gums their sweetness.
My take: I used to recommend xylitol. I've reconsidered because whereas once this sweetener was derived from birch trees, now most xylitol comes from corn and therefore carries this ubiquitous crop's problems. I also heard too many client complaints about gastric distress. If you can find birch tree-derived xylitol and it's your preferred sweetener, great; just remember too much at once can create an unpleasant aftermath!
Stevia
What is it? An herb that grows in North and South America that's 300 times sweeter than sugar.
What are its health benefits? Stevia has no known adverse effects on blood sugar. One study even found it can enhance glucose tolerance and improve metabolic syndrome, which makes stevia ideal for people with insulin resistance and diabetes. Most studies showing that stevia can improve insulin sensitivity and benefit diabetes have been conducted with rats, but human studies show similar promise.
Another study also showed stevia can reduce mild hypertension.
Is it safe? A 1985 study that showed stevia is a mutagen in rats and created potential liver problems was later debunked as flawed, and later determined limited amounts of stevia aren't dangerous. Regardless, stevia has a controversial history. In 1991, the FDA labeled stevia an "unsafe food additive," and manufacturers must classify stevia products as dietary supplements rather than sweeteners.
But wait, you say: how can manufacturers sell stevia-based sweeteners like Truvia and PureVia in the sugar aisle? Because these sweeteners use rebaudioside A, which is derived from the stevia plant but the FDA claims is not stevia but "a highly purified product."
My take: While some complain of a bitter aftertaste, stevia is the preferred sweetener for many people on low-carb and Paleo diets or with blood sugar issues. Because it has zero calories, stevia can create caloric dysregulation, where you can no longer calibrate the degree of sweetness to the caloric load, leading to cravings and overeating. If you use stevia, opt for pure, organic stevia. Many stevia "blends" contain maltodetrixin (corn) and other sweeteners.
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