ZOE Science & Nutrition - What’s the best natural sugar substitute?
Episode Date: July 13, 2023Get science-based nutrition advice delivered straight to your inbox. https://bit.ly/46BPTYz Are you trying to eat less sugar? If you are, you might have tried a natural sugar alternative. Stevia, ro...binia honey, coconut sugar, agave… the list of these table sugar replacements seems to be growing day by day. But what even are these alternatives? Are they really natural? And do they offer us a healthier way of getting that sweet taste? In today’s short episode of ZOE Science & Nutrition, Jonathan and Dr. Sarah ask: What are natural sugar alternatives, and are they healthier than table sugar? Follow ZOE on Instagram. https://www.instagram.com/zoe/ Download our FREE guide — Top 10 Tips to Live Healthier: https://zoe.com/freeguide Mentioned in today’s episode: The artificial sweetener erythritol and cardiovascular event risk from Nature Medicine Effects of D-allulose on glucose tolerance and insulin response from BMJ Open Diabetes Research & Care Effects of stevia on glycemic and lipid profile of type 2 diabetic patients from the Avicenna Journal of Phytomedicine Agave syrup: Chemical analysis and nutritional profile from the International Journal of Environmental Research and Public Health Are natural sugar alternatives healthier? from Harvard Health Publishing Alternative sugars - agave nectar from British Dental Journal  Episode transcripts are available here. Is there a nutrition topic you’d like us to explore? Email us at podcast@joinzoe.com and we’ll do our best to cover it.
 Transcript
 Discussion  (0)
    
                                         Hello, and welcome to Zoe Shorts, the Bite Size podcast where we discuss one topic around
                                         
                                         science and nutrition. I'm Jonathan Wolfe, and today I'm joined by Dr. Sarah Berry. And
                                         
                                         today's subject is natural sugar alternatives.
                                         
                                         That's right, Jonathan. Today we're discussing foods such as honey, maple syrup, stevia,
                                         
                                         and agave that people use instead of table sugar.
                                         
                                         And some believe these natural options are healthier than regular table sugar.
                                         
                                         But are these natural alternatives actually better for us than table sugar?
                                         
                                         Well, as always, the answer is not straightforward.
                                         
    
                                         And I think the facts will surprise you, Jonathan.
                                         
                                         Amazing. Let's dive in. So Sarah, take me inside your house on a Saturday
                                         
                                         morning. Does your family use any natural sugar alternatives? Yeah, on weekends, I might have
                                         
                                         pancakes with the kids with honey or maple syrup on them. Well, it seems actually, Sarah, that
                                         
                                         you've picked two household favourites because we did some research and it turns out that honey is the most popular spread in the UK, more popular than jam or jelly, as our colleagues in the States would say. And in the US, more than five million gallons of maple syrup are produced each year. Other popular natural sugar alternatives as well as honey and maple syrup include pureed
                                         
                                         fruit like bananas, dates, agave syrup and coconut sugar, which is made from the sap of coconut palm
                                         
                                         and is essentially the same as palm sugar. And I've heard of stevia, I feel like more often
                                         
                                         recently as well. Is that a natural alternative to sugar? So technically it is. And this is because stevia
                                         
    
                                         is derived from a very sweet tasting South American plant. It's actually more than 200
                                         
                                         times sweeter than sugar. It's not something that we've historically eaten. And it goes through many,
                                         
                                         many steps to process the final stevia extract. Crude stevia, which is the processed product before it is purified,
                                         
                                         often carries quite a bitter taste and also a foul smell until it's bleached or decoloured.
                                         
                                         It's also worth noting that the stevia products that you buy in the store often contain other
                                         
                                         ingredients like the artificial sweetener erythritol. And you may remember, Jonathan,
                                         
                                         we actually discussed artificial sweeteners in a previous podcast episode. So if we're talking about these naturally occurring alternatives to
                                         
                                         sugar, some more processed than others, and I guess honey is the least processed because you
                                         
    
                                         just dip it out of the hive. Why, Sarah, are some people switching from table sugar to these
                                         
                                         alternatives? So Jonathan, this is because most people know
                                         
                                         that eating a lot of sugar isn't great for their health. And there's a perception that
                                         
                                         natural sugar alternatives like honey are healthier than table sugar because they're
                                         
                                         less processed and because simply they're considered to be more natural. And a question
                                         
                                         I hear really frequently is, if I use honey or maple syrup or any of these other natural sugar
                                         
                                         alternatives in my cooking or my baking, does it mean it's healthier? So before we talk about those
                                         
                                         alternatives, can we actually maybe start with the beginning of that question, which is,
                                         
    
                                         isn't table sugar itself natural? Well, it depends what you term natural. Yes, it's made from sugar
                                         
                                         cane, which is a plant. And once the cane is
                                         
                                         harvested, it's crushed to extract its juice and the sugar cane juice is boiled until the water
                                         
                                         evaporates, leaving behind these sugar crystals. Could you just explain a bit how exactly natural
                                         
                                         sugar alternatives are different from table sugar and explain a bit what's going on there? Yeah. So let's first look at what table sugar is. So table sugar is sucrose and this is a
                                         
                                         disaccharide, which means it's made up of two sugars bound together. Hence where the word
                                         
                                         di-saccharide comes from, di meaning two and saccharide meaning sugar. And the two sugars
                                         
                                         that are bound together in sucrose are glucose and fructose.
                                         
    
                                         So are natural alternatives to sugar also made up of glucose and fructose stuck together to make sucrose?
                                         
                                         Yeah, so typically most natural alternatives to sugar are made up of fructose and glucose.
                                         
                                         Sometimes the ratios of the fructose to glucose in these natural sugars might be different.
                                         
                                         So for example, in Rabinia honey, it contains more fructose and glucose.
                                         
                                         And there's also other more complex sugars found in honey, but actually in quite low
                                         
                                         concentrations.
                                         
                                         So to make sure I've got this right, Sarah, you're saying the basic contents of sugar
                                         
                                         and these natural sugar alternatives are essentially almost the same.
                                         
    
                                         They've got glucose and fructose inside them. But in fact, I think that they can taste quite
                                         
                                         different to us. What's going on there? Yeah. So many of the natural sugar alternatives
                                         
                                         sometimes taste sweeter, but they're also slightly different from table sugar in that they often
                                         
                                         contain extra micronutrients. So for example, honey contains some vitamins, minerals, and
                                         
                                         polyphenols, although it's important to say these are quite small amounts.
                                         
                                         So Sarah, could you just explain very simply what happens when I eat a spoonful of sugar
                                         
                                         or dissolved in my coffee? What happens to my body and how does
                                         
                                         that affect my health? So firstly, what happens is you have sweet taste receptors in your mouth
                                         
    
                                         that say, Jonathan, this tastes super yummy. I want more. And then secondly, what happens is
                                         
                                         the sugar enters your intestine and it enters your bloodstream and it's broken into fructose and into glucose. Now the fructose
                                         
                                         is transported directly to your liver where it's either converted into glucose or if it's a very
                                         
                                         high amount might be converted into fat. So the glucose is transported in your blood and we often refer to this as blood sugar so when we talk about
                                         
                                         blood sugar we often mean the glucose that's circulating in your blood now what happens is
                                         
                                         when you consume sugar then you have this quite rapid peak in circulating blood sugar or circulating
                                         
                                         blood glucose that peaks at around 15 minutes after consuming the
                                         
                                         sugar and returns to baseline around two hours. And where this becomes a problem is we know that
                                         
    
                                         if it's excessive in terms of the size of the peak, then you can actually have unfavorable
                                         
                                         downstream effects. So it can initiate inflammation, for example. Now, this is a normal physiological
                                         
                                         response to consuming sugar, but it's when it's excessive and repeated over a long period of time
                                         
                                         that we believe it has an unfavorable effect on health. But what we've also found that's really
                                         
                                         interesting from our work, Jonathan, is that some people have dips after they have too much sugar.
                                         
                                         And so what happens is, is they have a dip in the circulating level of blood glucose, blood
                                         
                                         sugar.
                                         
                                         And this is unfavorable because people that have these dips tend to feel really hungry
                                         
    
                                         quite quickly.
                                         
                                         They tend to feel less alert and they actually consume a lot more energy at their next meal.
                                         
                                         So nearly about 300 calories more
                                         
                                         over a day compared to if they don't experience dips.
                                         
                                         You eat one thing, right? There's sucrose and very rapidly your body is breaking it down into those
                                         
                                         component parts, the glucose and the fructose as you said. Is that similar as we go and think about
                                         
                                         honey, for example? so people are asking like is
                                         
                                         honey better than me it certainly seems more natural in the sense that there wasn't any of
                                         
    
                                         that processing our ancestors have probably been eating it for millions of years is honey
                                         
                                         therefore going to be better for my health so honey contains fructose it contains glucose just
                                         
                                         like table sugar does so So it's metabolized
                                         
                                         in just the same way. So it causes just the same metabolic effects in our body.
                                         
                                         And so if honey is going to have a pretty similar effect to table sugar, so it sounds like you're
                                         
                                         not saying it's a dramatically better alternative with very different health outcomes. What about
                                         
                                         the stevia that you were talking about earlier?
                                         
                                         Stevia is really much more like an artificial sweetener. So as I said earlier, though,
                                         
    
                                         a lot of stevia products also contain erythritol, which is a sugar alcohol. And there was a recent study in Nature Medicine that found links between erythritol and a higher risk of cardiovascular
                                         
                                         disease and stroke and heart attack. But this study did have really
                                         
                                         lots of limitations. So we need to study this a lot more before we draw any conclusions about
                                         
                                         the health effects of erythritol. We do know from what research has been published around
                                         
                                         artificial sweeteners that they seem to unfavorably impact our overall blood sugar control,
                                         
                                         and they seem to unfavorably impact our gut microbiome.
                                         
                                         But I do think it's an area that we need more research before we can say it's safe to swap
                                         
                                         sugar for sweeteners, or we shouldn't consume sweeteners at all.
                                         
    
                                         And so what about agave syrup? That's something else that I feel I see all the time in sort of healthy recipes where
                                         
                                         that's been used as an alternative to table sugar within the recipe.
                                         
                                         Yeah. And again, I think that's because people say it's natural. They say it's a good source
                                         
                                         of minerals, vitamins, and polyphenols compared to some other natural sugar alternatives or
                                         
                                         compared to table sugar. But the type of agave syrup that
                                         
                                         most of us are now likely to buy in the store is typically really quite highly refined. And so this
                                         
                                         is more likely to have less of these healthy polyphenols than the unrefined agave syrup or
                                         
                                         even maybe than maple syrup. And what about the effect of agave on our blood sugar levels?
                                         
    
                                         Well, the body processes agave slightly differently to table sugar. And this is because agave is made up mostly of fructose. And like I mentioned earlier, fructose is metabolized
                                         
                                         slightly differently to glucose. So it doesn't directly raise blood sugar levels, but also on the flip side, if we consume it in excess,
                                         
                                         the liver can start making fat in the form of triglycerides from the fructose. But this would
                                         
                                         have to actually be in quite large amounts of fructose intake that I don't think many of us
                                         
                                         would typically consume. I feel like the writing is sort of on the wall here for this whole area am I right?
                                         
                                         We're kind of splitting hairs if we go through each of these natural sweeteners yes one might
                                         
                                         have a tiny amount more of this polyphenol or a tiny amount more of this vitamin or this mineral
                                         
                                         but at the end of the day they're really really similar in terms of the sugars that they contain, the fructose and the glucose and how we metabolize them. It's quite clear the majority of us are consuming too much sugar. The majority of the sugar that we consume is not added at the table or added during home cooking. It's hidden in our foods. And it's this sugar that's hidden in our foods that I think we should be worrying about far
                                         
    
                                         more than whether we're adding a teaspoon of sugar to something at the table versus
                                         
                                         a teaspoon of honey versus a teaspoon of maple syrup.
                                         
                                         There are some people that are so fearful of sugar because of this sugar scaremongering
                                         
                                         that's kind of gone on on the last 10 to 15 years,
                                         
                                         that they avoid fruit. They're like, oh my God, it's full of fructose. It's going to cause this
                                         
                                         to my liver. It's also got some glucose. It's going to cause this. Actually, sugar that's
                                         
                                         packaged within the original food that it came from behaves very, very differently.
                                         
                                         And it's really important to remember this we
                                         
    
                                         know that people that consume higher levels of fruits which obviously delivers more sugar
                                         
                                         in their diet actually have improved health outcomes improved risk of cardiovascular disease
                                         
                                         etc and this is because the magical properties of whole foods and And so for example, if we take an orange or we take orange juice,
                                         
                                         they could have similar amounts of sugar, but the whole orange also has lots of fiber.
                                         
                                         It also therefore slows down the rate at which we absorb the sugar. So it slows down the rate at which our stomach empties.
                                         
                                         It causes a slower increase in blood sugar that is sustained for longer. And you don't seem to
                                         
                                         get this kind of rebound effect that you have like with the dips that we talked about earlier.
                                         
                                         Amazing. Thank you, Sarah. Well, if you found this episode interesting,
                                         
    
                                         and perhaps you'd like
                                         
                                         to understand more about how your body responds to sugar, maybe get your own blood sugar sensor
                                         
                                         and see it in real time, you might want to try Zoe's personalized nutrition program
                                         
                                         to improve your health. You can get 10% off by going to joinzoe.com slash podcast.
                                         
                                         I'm Jonathan Wolfe.
                                         
                                         And I'm Sarah Berry.
                                         
                                         Join us next week for another ZOE podcast
                                         
