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Thursday, February 25, 2016


What sugar can I have?  How can I get sweetness into me and still be healthy?  Common questions that I ask myself, because, hey, I HAVE A SWEET TOOTH (or two).

First, below are listed many of the more common types of sweeteners.

Artificial sweeteners: Acesulfame potassium (Sunett, Sweet One), Aspartame (Equal, NutraSweet), Neotame, Saccharin (SugarTwin, Sweet’N Low), Sucralose (Splenda), Advantame.

Sugar alcohol sweeteners: Erythritol, Hydrogenated starch hydrolysate, Isomalt, Lactitol, Maltitol, Mannitol, Sorbitol, Xylitol.

Natural sweeteners: Agave, Date sugar, Fruit juice concentrate, Honey, Maple syrup, Molasses, Cane Sugar.

Herbal sweetener: Stevia.

So which ones are healthy?!  That’s what I want to know.  NOW.

Few or no calories is good, right?

A few thoughts regarding types of sweeteners…

Artificial sweeteners were once upon a time believed to be metabolically inactive but have more recently come under as much fire as sugar itself. A few recent studies suggest that consumption of these allegedly “healthier” sugar substitutes actually increases rather than decreases abdominal fat (Fowler SP, et al. Am J Geriatr Soc. 2015; 63(4): 708–715), and can boost incidence of cardiovascular disease (Vyas et al. J Am Coll Cardiol. 2014) and diabetes (Fagherazzi et al. AJCN. 2013)

Artificial sweeteners also disrupt the gut flora balance (microbiome) per multiple studies which can have a multitude of negative effects on our body (ie way too many to list here).

Sugar alcohols generally have slightly few calories than regular table sugar and are about as sweet as table sugar.

It’s not all about simple blood sugar and insulin.  Leptin matters too!

  • Leptin is a hormone that suppresses the appetite and increases energy metabolism. Typically that’s great! 
  • That said, chronically elevated leptin can lead to leptin resistance.
  • So, over time, with constant exposure, the brain blocks the leptin receptors to compensate, diminishing satiety (increasing appetite) and causing cravings, and potentially decreasing metabolism (causing weight gain).

Allulose.  This is a naturally occurring sugar found in small quantities in jackfruit, figs, and raisins, that was recently introduced into the world of food manufacturing.  So, it technically fits into the category of “Natural Sweeteners”.

  • In 2015, Anderson Global Group and Tate & Lyle both announced the launch of allulose in the US, under the brand names ‘AllSweet’ (AGG) and ‘Dolcia Prima’ (Tate & Lyle).
  • Allulose has the taste and texture of regular table sugar and performs similarly in baked goods, but with 90% fewer calories, potentially marking it as the holy grail of sweeteners.
  • However, there is evidence of fatty degeneration and fibrosis in the liver with allulose consumption (Yagi & Matsuo, 2009; J Clin Biochem Nutr. 2009 Nov; 45(3): 271–277).
The bottom line is that the taste of sweetness on the tongue triggers leptin release, no matter which sweetener type is used and regardless of whether the sweetener has caloric value. This response essentially "tricks the brain" into thinking that it is receiving glucose.

I would NOT recommend allulose loaded products as they come on the market.  It is natural, so a tiny bit probably is just fine, but in the doses that are in manufactured foods now and will be in the near future, NOT GOOD.

Based on my expertise in nutrition and medicine, I believe that sugars contained in the whole fruit and vegetables are WAY, WAY, WAY better than anything else because it comes in a healthy relationship to so many other nutrients.  Yes, there is such thing as eating too much fruit.  General rule is, eat more veggies than fruit.  Eat more fruit when it’s in season and less when it’s out of season.  Stay away from dried fruit as it has metabolized itself almost completely pure sugar.  After fruit comes stevia.  I even grow a stevia plant in my garden and during the right season will throw a leaf in the blender to sweeten a smoothie on occasion.

These are all general guidelines and it helps if you know your fasting glucose, A1c, insulin and/or leptin levels to make a truly informed decision on how much sweetness your body can thrive with.

Another consideration, which is often left undiscussed when it comes to low calorie sweeteners, is the adaptation of our society to sweet. At no point in human history have people consumed so many foods with a flavor profile so sweet. All these added sweeteners (whether natural or artificial) are acclimating our taste buds to a flavor profile that reduces the enjoyably of other naturally occurring flavors. Oranges and apples are sweet, but have an apple after a cup of soda and it won’t taste as amazing.

Enjoy the video and, as always, feel free to pass it along!

Medical Disclaimer: Information provided in this article is for informational purposes only. The information is a result of years of practice and experience by Yoshi Rahm, DO. However, this information is NOT intended as a substitute for the advice provided by your physician or other health care professional, or any information contained on or in any product label or packaging.

Do not use the information provided in this article for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other health care professional before taking any medication or nutritional, herbal or homeopathic supplement, or using any treatment for a health problem. If you have or suspect that you have a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read in this article.

Information provided in this article and the use of any products or services related to this article by you DOES NOT create a doctor-patient relationship between you and Yoshi Rahm, DO or any other physician featured in this article. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

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