Diabetes experts explain: Are sugar alternatives really healthy?

Honey, maple syrup, agave syrup or coconut blossom sugar are often considered healthy alternatives to granulated sugar, also known as table sugar or sucrose. However, if you compare the chemical structure of all these substances, you can see that the basis is the same. Both granulated sugar, honey, coconut blossom sugar, and maple syrup are composed of glucose (dextrose) and fructose (fruit sugar). “Even ‘natural’ sugar damages your teeth, causes blood sugar to rise and contains too many calories,” says German doctor Susanna Hofmann (42), who researches metabolic diseases. For example, the only difference between granulated sugar and honey is that honey contains additional minerals and their taste is different.

An advantage of so-called sugar alcohols is that the body processes them in the body without insulin, so they do not cause a rapid rise in blood sugar. They also contain fewer calories than granulated sugar and do not cause tooth decay. For this reason, they are often found in sugar-free gums. The following two sugar alcohols are particularly well known:

• Xylitol: Birch sugar is similar to granulated sugar and almost as sweet, but contains about 50 percent fewer calories than granulated sugar. When consumed in large amounts, xylitol can have a laxative effect.
• Erythritol: This sugar alcohol is similar to granulated sugar, but is only half as sweet. Erythritol is usually made from corn. It contains very few calories and has a laxative effect in large amounts.

Hofmann says scientists have discovered some risks associated with sugar alcohols. “New studies show that they can promote cardiovascular disease.” The expert says more research is needed to clearly confirm this, but the results should be taken seriously.

German nutritionist and diabetes specialist Matthias Riedl (60) says: “Other studies show that erythritol may have a negative effect on gut bacteria.” These are the first studies whose results should be viewed carefully. According to the expert, there is currently no evidence that xylitol has a negative effect on the intestinal flora. “Therefore, based on current knowledge, xylitol is a healthy alternative to granulated sugar.”

Aspartame, sucralose, saccharin and stevia are among those called sweeteners. “They taste very sweet and are found in many sugar-free drinks, cocktails or foods like ketchup,” Riedl says. They are low in calories and neither cause tooth decay nor cause insulin release. However, the World Health Organization (WHO) classifies sweeteners as “possibly carcinogenic to humans.”

These can also change the gut flora and therefore increase the risk of type 2 diabetes, says Riedl. “Therefore, it should be evaluated very carefully and anyone who wants to eat healthy should stay away from sweeteners.” According to experts, they are healthier when compared directly to granulated sugar. Using Coke as an example, the Zero version with sweetener is a better option than the regular Coke with granulated sugar.