Sweet facts: Real and fake sugars

From raw cane sugar to honey to agave syrup, there are dozens of ways to sweeten food and drinks. They all taste sweet, but are they the same?

Gurvinder Kaur, MD, a board-certified family medicine physician at Crystal Run Healthcare, says that what we sweeten food and drinks with matters more than the taste.

“How you consume sugar has a big impact on your health and that goes for artificial sweeteners as well,” said Dr. Kaur. “The types of sweeteners you use matter.”

Non-sugar sweeteners, or NSS, are a type of artificial food sweetener made using chemicals that taste sweet but don’t contain the same calories as sugar. NSS were developed as an alternative to sugars and are widely used both in pre-packaged foods and beverages and added to food and beverages directly by individuals. People who use NSS products to sweeten foods and drinks typically want to reduce the number of calories they consume, limit their sugar intake, or manage health issues. However, studies show that switching sugar with NSS substitutes has little impact on glucose metabolism, which is how the body breaks down sugar for energy, or long-term weight loss.

“There is misinformation about artificial sweeteners decreasing morbidity and obesity, or even helping people live longer,” said Dr. Kaur. “They don’t. They can actually be harmful to your overall health.”

The World Health Organization does not recommend using non-sugar sweeteners to control body weight or reduce risk of non-communicable diseases like heart disease, cancer or diabetes. Consuming too much NSS can lead to other health complications, such as increased risk of type 2 diabetes, tumors, cardiovascular diseases and mortality in adults.

A recent study also reviewed the health benefits and risks of the most popular kinds of NSS. Tracking the NSS intake from over 100,000 people from 2009 to 2021, this large cohort study found that high consumption of the three most-used artificial sweeteners, which are found in many food and beverage brands worldwide, was associated with increased cancer risk. Those who consumed only artificial sweeteners had a notably higher risk of breast and obesity-related cancers compared to those who had a moderate amount of sugar and NSS in their diet.

What can people trying to reduce their sugar intake do?

According to Dr. Kaur, it’s all about getting creative with food. “Be creative with your sugar. If you like sweet drinks, use honey,” said Dr. Kaur. “Moderate the amount of sugar you add to all your food and be mindful of the sugar in any pre-made foods too.”

Processed snack foods can have artificial sweeteners or added sugars that make it more difficult to track how much sugar a person consumes in a day. Bottled salad dressings make salads taste delicious but often have a lot of sugar, artificial or otherwise. Juice has a high concentration of sugar even when no additional sugars are added. Diet and zero-calorie drinks may sound like easy ways to decrease the amount of sugar in your diet, but in reality, they contain artificial sweeteners.

“Many people don’t realize how calorie and sugar-dense juice is. I ask my patients who drink multiple glasses of orange juice a day if they would eat eight oranges in the same amount of time,” said Dr. Kaur. “Usually, they wouldn’t, and it helps them rethink how much sugar they consume in a day.”

Small changes can also help people ditch sugar while avoiding artificial sweeteners. There are ways to avoid sugar in daily eating and drinking habits, such as adding seeds to salads instead of heavy dressings, swapping juice for homemade fruit-infused water, or exchanging dessert-like yogurt for simpler varieties.

When in doubt, talk to your primary care physician about making positive changes to your diet. Whether you choose a family practitioner, an internist, or a geriatric specialist, your primary care provider at Crystal Run Healthcare will help you manage and coordinate all your healthcare needs, including how to help get you on the best path to healthy eating. They offer integrated, coordinated care for all patients, including those with common medical conditions like obesity, diabetes and more.

Gurvinder Kaur, MD, is a board-certified Family Medicine physician at Crystal Run Healthcare. She earned her medical degree at the Medical University of Silesia in Katowice, Poland and completed her residency in Family Medicine at The Institute for Family Health, Mid-Hudson Family Medicine Residency Program in Kingston, New York. Dr. Kaur has clinical interests in type 2 diabetes, hypertension, diet/lifestyle modification, morbid obesity and its treatments. She is seeing patients in Middletown, New York.