Try This: The Good, the Bad, and the Ugly around Popular Sugar Alternatives

Before we get started, I have a few questions for you!

Do you regularly have Splenda or Sweet’N Low with your coffee or latte?

Do you eat a lot of protein bars, keto products, or sugar-free candy that contains sugar alcohols like xylitol or erythritol?

What about the occasional diet soda sweetened with aspartame? No judgment 🙂

If you answered yes to any of these questions, this newsletter is for you!

Before we jump in to today’s topic we want to acknowledge our very first Try This sponsor, Pendulum.

I’ve been pretty open about my experience with leaky gut and how building up my good gut bacteria was key for fixing it. But there’s one bacteria strain in particular I was excited to learn about on my health journey because it specializes in keeping our gut barrier strong—it’s called Akkermansia.

Akkermansia feeds on our intestinal mucosal layer and modulates its thickness. As a byproduct, it produces short-chain fatty acids (SCFA) that allow other good bacteria strains to make butyrate—another SCFA that’s critical for healing a leaky gut, supporting the immune system, and promoting optimal health.

Akkermansia has been linked to everything from managing a healthy weight and blood sugar levels to supporting a healthy inflammatory response. Pendulum is the first company to figure out how to harness the amazing benefits of Akkermansia in a probiotic capsule. 

Pendulum is offering the Try This community 20% off their first purchase or first-month subscription of their Akkermansia probiotic supplement. Click here for the link and use the promo code TRYTHIS at checkout to redeem this amazing offer!

Now let’s get to this week’s newsletter…

Try This: The Good, the Bad, and the Ugly around Popular Sugar Alternatives

Did you know that your gut can sense the difference between real sugar and artificial sweeteners?

Those gut bugs of ours are smart. They know fake sweeteners when they see them—and they don’t like being tricked!

That’s why calorie-free sweeteners are associated with weight gain: they leave our bodies craving more food—especially carbs and sugar—that will provide real energy!

Some alternative sweeteners are better than others, however. As we learned last week, there are plenty of natural sweeteners out there that are a better choice than having sugar all the time.

But besides artificial sweeteners, which of those other alternative sweeteners are most troublesome?

That’s what we’re going to dive into today. I’m sharing the pros and cons of sugar alcohols, the nuances associated with them, and why artificial sweeteners are such a problem. We’re also going to cover a bonus sweetener that’s had its reputation tarnished by recent literature, although it’s still thought to be a better alternative.

The goal of this newsletter is to provide some context around the sugar alternatives that are problematic for some people and the ones you’ll want to avoid entirely.

Ready? Let’s dive in!

Alternative Sweeteners

I. Sugar Alcohols

Sugar alcohols are a class of sweeteners naturally found in fruits, vegetables, and mushrooms. They are also found in sugar-free chewing gum, candy, and low-carb foods. Sorbitol, mannitol, xylitol, and erythritol are a few of the main ones.

Sugar alcohols are not calorie-free like artificial sweeteners, but they do contain significantly fewer calories than table sugar, making them a popular sugar substitute for weight loss. Additionally, sugar alcohols have a low blood sugar and insulin impact, which makes them a better alternative for diabetics (1)(2). But there are some people who might not benefit from them.

Functional Medicine practitioners often tell their patients who struggle with gastrointestinal conditions or general gastrointestinal upset to avoid sugar alcohols while their gut is healing (1)(2)(3). Gut microbes feed on fiber and sugar alcohols and cause gas and bloating that may worsen their symptoms. Sugar alcohols also have an osmotic effect (3). In other words, they can pull water into your large intestine and cause diarrhea if you have too much at one time.

Even if you don’t have underlying gut issues, sugar alcohols can cause problems if you’re not used to them. The biggest culprits are packaged foods and beverages that contain crazy high amounts in even just one serving.

Because sugar alcohols behave similarly to fiber in the gut, they have a prebiotic effect and can benefit our gut microbiome. Some sugar alcohols can promote the growth of good gut bugs like bifidobacteria, which helps strengthen the gut barrier. As a bonus, gradually increasing your intake of sugar alcohols can promote the growth of bacteria species that are effective at metabolizing them and can therefore help increase our tolerance (3).

Another notable benefit of sugar alcohols is that they are not fermented by our oral microbiome, which means they can prevent tooth decay when used in place of sugars (4)(5).

Sugar alcohol can be problematic for some people, especially those who are dealing with gastrointestinal conditions. However, they can also beneficially modulate the gut microbiome and lower the risk of tooth decay if consumed in place of sugar. Just make sure to not overdo it and have too much at once to avoid having any GI pain or discomfort. If you do think you are reacting negatively to sugar alcohols, you can try removing them from your diet completely for three weeks and see if you notice a change in your body.

II. Artificial Sweeteners

Artificial sweeteners are a double-edged sword. They don’t spike our blood sugar, but they do affect our metabolic health in a different way—by modulating our gut microbiome, tricking our brain chemistry, and triggering our pancreas to release insulin even though they don’t contain any actual sugar.

The main artificial sweeteners out there include aspartame, saccharin, sucralose, and acesulfame-K. Some of the commercial names of products with these sweeteners in them include Equal, Sweet ‘N Low, Splenda, and Sunett, respectively.

These sweeteners are primarily used in diet foods and soft drinks. Just because artificial sweeteners have zero calories, though, it doesn’t mean they don’t have an impact on our biology—quite the opposite, actually.

The longer these sweeteners have been on the market, the more research has shown us that they alter the brain’s response to sweetness. They produce a greater reward response in our brains than sugar, which makes them highly addictive. Furthermore, they cause us to overeat by impairing our brain’s ability to regulate calorie intake (6).

As far as weight loss goes, there’s a reason why people who consume diet foods and beverages sweetened with artificial sweeteners tend to have a harder time losing weight. A meta-analysis of randomized controlled trials looked at the effects of sugar alcohols in over 400,000 people and found that artificial sweeteners were associated with weight gain, waist circumference, and incidence of obesity (7).

In addition to hacking our brain chemistry, they make us glucose intolerant by wreaking havoc on our gut microbiome (8) and make us insulin-resistant by tricking our pancreas into making insulin even though there’s no glucose around. Frequent use of artificial sweeteners can cause increased circulating insulin levels which can eventually reduce the sensitivity of insulin receptors (9).

As a result, they actually increase our risk of developing metabolic syndrome, type 2 diabetes, cardiovascular disease, and obesity when consumed long-term (10).

There are also some concerns about artificial sweeteners increasing the risk of cancer. So far, the research is weak and doesn’t point toward a definitive correlation (11). Most human studies that report an association are observational and have limitations, but there is sufficient evidence in mice to warrant caution against them. This is a good example of where we can apply the precautionary principle to be on the safe side.

With the growing concern around artificial sweeteners, it’s no wonder that more and more practitioners and scientists are encouraging the public to greatly minimize or completely avoid any products that contain them.

Further reading:

III. Agave

About a decade ago, agave was the hottest natural sweetener on the market—people couldn’t get enough of it! I myself was on the agave bandwagon until newer research came out showing it to be as disruptive to our metabolic health as high fructose corn syrup (12)!

But I’m getting ahead of myself. Let me back up a little…

Agave is a type of plant native to Mexico and the southern United States. Its roots, sap, and juice were traditionally used in Latin America for medicinal purposes due to its anti-inflammatory properties. Agave nectar is made by extracting the sap from the agave plant and turning it into a syrup, which requires heating it at extremely high temperatures.

The glycemic index of agave is very low (about 19) and it used to be considered diabetes friendly because it doesn’t spike blood glucose or insulin. But that’s only because it contains very little glucose and is made up of 75-to-90 percent fructose (13). And as we’ve discussed previously, concentrated fructose can lead to metabolic dysfunction, insulin resistance, high blood pressure, type 2 diabetes, and obesity through a different mechanism—turning on our liver’s fat storage switch and increasing uric acid.

So even though agave is a natural sweetener, it causes more trouble than it’s worth metabolically. If I had to choose between honey and agave, I would pick honey every time based on the list of health benefits we discussed last week.

Final Thoughts

Have you ever heard the saying, “sugar is sugar is sugar is sugar”? While that might be true in the context of refined sugar, carbohydrates, and flour, the same cannot be said when talking about the different types of sugar and alternative sweeteners that are out there.

It’s important to be wary of the consequences associated with the sweeteners mentioned above. There may be a place for sugar alcohols for some, but artificial sweeteners have consequences for our brain and gut that are likely very risky when consumed long-term.

If you want to learn more about sweeteners, my good friend Chris Kresser has a comprehensive e-book that summarizes all of the natural and alternative sweeteners on the market today. You can access it here.

Here’s to your health,
Dhru Purohit

  3. Lenhart A, Chey WD. A Systematic Review of the Effects of Polyols on Gastrointestinal Health and Irritable Bowel Syndrome. Adv Nutr. 2017;8(4):587-596. Published 2017 Jul 14. doi:10.3945/an.117.015560
  4. Moriconi E, Feraco A, Marzolla V, et al. Neuroendocrine and Metabolic Effects of Low-Calorie and Non-Calorie Sweeteners. Front Endocrinol (Lausanne). 2020;11:444. Published 2020 Jul 16. doi:10.3389/fendo.2020.00444
  5. Mäkinen KK. Sugar alcohol sweeteners as alternatives to sugar with special consideration of xylitol. Med Princ Pract. 2011;20(4):303-320. doi:10.1159/000324534
  8. Suez, J., Korem, T., Zeevi, D. et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature 514, 181–186 (2014).
  9. Mathur K, Agrawal RK, Nagpure S, Deshpande D. Effect of artificial sweeteners on insulin resistance among type-2 diabetes mellitus patients. J Family Med Prim Care. 2020;9(1):69-71. Published 2020 Jan 28. doi:10.4103/jfmpc.jfmpc_329_19
  10. Ruiz-Ojeda FJ, Plaza-Díaz J, Sáez-Lara MJ, Gil A. Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials [published correction appears in Adv Nutr. 2020 Mar 1;11(2):468]. Adv Nutr. 2019;10(suppl_1):S31-S48. doi:10.1093/advances/nmy037
  11. Liu L, Zhang P, Wang Y, Cui W, Li D. The relationship between the use of artificial sweeteners and cancer: A meta-analysis of case-control studies. Food Sci Nutr. 2021;9(8):4589-4597. Published 2021 Jun 23. doi:10.1002/fsn3.2395
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