Simplifying Sugar Substitutes

November 02, 2017

By Saba Zahid, RD, LDN
Patient Experience Manager, Unidine

For a long time, our only choices for sugar substitutes were the type you see in sugar caddies at a restaurant – the familiar pink, blue and yellow packets of super-sweet substitutes. Today, however, products seem to be coming out left and right that claim to be a better or healthier substitute for regular or table sugars and even artificial sweeteners. If you’re looking to reduce your sugar intake, it’s important to understand the types of sugar substitutes, how they work and what they’re made from.

Sugar substitutes can be classified into four major groups: artificial sweeteners, sugar alcohols, novel sweeteners, and natural sweeteners. Each type of substitute works differently and has its own set of pros and cons, and not all of them are sugar- or calorie-free. Let’s take a look:

  1. Artificial sweeteners: Artificial sweeteners are the sugar substitutes that most people are familiar with. This group includes Equal, Splenda, and Sweet ‘n’ Low. Artificial sweeteners are synthetic but can be derived from natural substances such as herbs or sugar itself. Artificial sweeteners are regulated by the Food and Drug Administration and are given a “generally recognized as safe” (GRAS) designation. There has been a lot of discussion regarding the safety of artificial sweeteners and whether long-term use has negative health effects. After years of research, though, there is no strong evidence that long-term, moderate use of artificial sweeteners is associated with cancer or other health concerns. There is continued research regarding the use of artificial sweeteners and how our bodies react to them. Despite all of the hype around the potential health concerns of using artificial sweeteners, they continue to be a go-to sugar substitute. Artificial sweeteners do not add calories and are much sweeter than sugar, so less is needed. Many people turn to artificial sweeteners to help manage diabetes or weight loss because they do not raise blood sugars or contain calories. If you are still concerned about artificial sweeteners, regulatory agencies have set Acceptable Daily Intake (ADI) levels for this type of sugar substitute. According to, ADIs indicate “the maximum amount of a food additive that can be safely consumed on a daily basis over a person's lifetime without any adverse effects.” To learn more about those guidelines, click here.
  2. Sugar alcohols: Sugar alcohols are carbohydrates that can be found naturally in fruits and vegetables, but they are also manufactured. Unlike artificial sweeteners, sugar alcohols can raise blood sugars and they do contain calories, although it is less than regular sugar. Sugar alcohols are generally used in processed foods and manufactured products rather than at home. This type of sugar substitute can generally be identified by an –ol at the end of the word and include xylitol, malitol, erythritol, and sorbitol, just to name a few.  One of the downsides of sugar alcohols is that large amounts can have a laxative effect on your body, so you want to make sure you don’t consume too much.
  3. Novel sweeteners: Novel sweeteners are a group of various types of sweeteners, not necessarily made in the same way, but they are considered processed sugar substitutes. Stevia falls into this group of sugar substitutes. Tagatose is another type of novel sweetener; it is a low carbohydrate sweetener that occurs naturally but can be manufactured from lactose, the milk sugar.
  4. Natural sweeteners: Lastly, there are natural sweeteners. This group includes agave nectar, molasses, honey, and maple syrup. It is important to remember that these sweeteners typically do undergo some type of processing before being sold. These natural sweeteners are also considered to be added sugars because they tend to be added to foods during processing. It is also important to remember that natural sweeteners do contain calories and sugars, so consuming too much can lead to weight gain, cavities, and even increased triglycerides.

At the end of the day, regardless of which sugar substitute you choose to use (or not use), moderation is key. Everyone has their own preference for which sugar substitute they prefer based on taste, use, and even how their body processes the sugar substitute. Sugar substitutes are not going to be the magic answer for weight loss, diabetes, or any other concern. Sugar and sugar substitutes are one component of the overall picture. For help navigating a sugar substitutes, schedule an outpatient nutrition counseling appointment with one of our registered dietitians at Shore Medical Center. For more information, contact us at 609-653-4600, opt 5 or visit our website at