What is Healthier: Natural Sugar, Table Sugar, Artificial Sweeteners or Sugar Alcohols?

“Natural” sugars: what does that mean?

Natural sugar goes way beyond traditional table sugar. There’s sugar in the raw varieties, coconut sugar, agave nectar, honey, and the oft-demonized high-fructose corn syrup. Honey and molasses are often turned to instead of table sugar because of their natural properties, but they have the exact same glycemic index as sugar.

Agave nectar is sometimes lauded as a healthier alternative to table sugar because it has a lower glycemic load — which basically means it’s kicks up blood sugar levels more slowly — but it’s still very refined and processed, according to gastroenterologist and obesity medicine specialist, Dr. Nitin Kumar. It also has a high fructose content, which means it has similar properties to high-fructose corn syrup; they both convert sugar into fat more easily than table sugar. So more or less whether a fancy name for sugar or not, they’re all the same. Except high-fructose corn syrup, which should still be avoided like the plague.

Artificial sweetener: what are the differences?

With artificial sweeteners, things get complicated because there are so many different FDA-approved types:

Saccharin

Also known as Sweet’N Low, is a little more controversial; saccharin was deemed unsafe after a study in 1978 found a connection between the sweetener and bladder cancer in rats. But subsequent studies have found no clear correlation between saccharin and cancer in humans, since we process it differently than rats do. Go figure. More recent research suggests it could even help inhibit cancer cell growth… wait, what? Even though the National Cancer Institute says it’s safe for consumption, the 300-times-sweeter-than-sugar sweetener hasn’t been as popular since the whole late-’70s debacle. We’d say this is your WORST choice.

Aspartame

Is the most common ingredient you’ll find in sugar-free processed foods, like diet soda. It’s also sold in little packets under the brand names Equal and NutraSweet, and is 200 times sweeter than sugar. Unlike other sweeteners, which generally just pass through your body, aspartame is metabolized into compounds found in natural food. It’s considered safe in small amounts, except for people with phenylketonuria, a genetic disease. We’d say this is your NEXT WORST choice.

Sucralose

Also known as Splenda, passes through the body easily and does not build up in body fat. It’s also 600 times sweeter than sugar, so a little goes a long way. A bad choice but so far not as harmful.

Stevia

Is about 300 times sweeter than sugar, has been touted as the latest, healthiest artificial sweetener because it comes from the Stevia rebaudiana plant. A plant, that must be good! It has zero calories, and Dr. Kumar says it can result in lower glucose and insulin levels after meals than sugar. But overall, the hype could be more marketing than scientific fact; while Rebaudioside A, also known as stevia extract, has been deemed generally recognized as safe by the FDA, pure stevia has not been given the same stamp of approval. Overall, artificial sweeteners are generally all on the same playing field anyway. The best of these four choices.

“As far as the long-term health effects of using artificial sweeteners, the FDA has recognized some artificial sweeteners (saccharin, aspartame, sucralose, stevia extract) as ‘generally recognized as safe,'” Dr. Kumar explains. “Because they generally pass through you without being digested (except aspartame), and because they have been studied extensively in labs, they are accepted as safe for long-term use (other than aspartame in people with phenylketonuria).”

“Safe” is one thing, but most people turn to artificial sweeteners as a way to reduce calorie consumption. That’s where things get a bit trickier. The verdict is still out on whether sugar-free sweeteners cause people to consume fewer calories overall. Although they would appear to (diet soda is calorie-free!), some studies claim that artificial sweeteners give you an increased appetite. But most of the research on it is conflicted, so doctors can’t really say for sure either way.