The Skinny on Sweets

Xylitol is metabolized much more slowly than regular sugar. On the glycemic index, which is a measurement of how quickly a carbohydrate changes blood sugar, xylitol is a 7 while ordinary sugar is rated a 100. And xylitol doesn’t raise insulin levels. And while it’s more costly than ordinary sugar, considering all of it’s health benefits, it’s relatively cheap.

By Ben Fuchs | Pharmacist Ben

Disciplining and controlling the human “sweet tooth” and subsequently stabilizing blood sugar is one of the most important things a person can do to maintain good health. Elevations in blood sugar and associated elevations in insulin are behind many, if not most of the health issues we confront today. High blood pressure, cardiovascular disease, obesity, and of course diabetes have clear associations to unstable blood sugar and blood insulin. And while the connections to cancer, accelerated aging, osteoporosis, arthritis and autoimmune issues are less definitive, a case could certainly be made that the likelihood of confronting these health challenges (among others) would almost certainly be reduced by reducing sugar intake. Now while it is important to recognize that simply fighting sugar cravings is a futile strategy.

In other words will power is not a great weapon in the battle against sugar because the drive for sugar is built-in, it is hardwired into our brains from millions of years of evolution; and in the battle between hard wiring and will power, hard-wiring usually wins. What we want to be able to do is understand the “habituation” mechanism. “Taste anesthesia” must be confronted. Our taste buds become numb to sweetness and gradually it takes more and more sweet for us to be satisfied. And, there is some literature that suggests that even the sweet taste can raise blood sugar and insulin levels, even without sugar! Ideally, we want to take a “sweet holiday”, one or two days off from sweetness, from the sweet flavor so that our sweet receptors can become re-sensitized. Sort of a sweet “re-set”. That’s ideally. However for some of us, who are addicted to sugar that may be easier said than done. And, after our “sweet holiday” we’re going to want to reintroduce the sweet flavor back into our lives albeit to lesser degree than it was before our break. And that’s where alternative sweeteners come in.Mainstream alternative sweeteners have been out for decades. I remember when I was a little kid the big one was cyclamate. Then some studies showed that it may be associated with bladder cancer and in 1969 it was banned for sale in the United States, although you can still get it in other countries.

Then there’s the old standby saccharin, which is a lot sweeter than sugar, but is a simple chemical, “benzoic sulfilamine” that has not energy or calories. It’s also is free of aftertaste which makes it ideal for drinks and candies and manufactured food products. It was the first really big artificial sweetener and was branded as sweet n’ lo which is still a familiar site in restaurants and diners and coffee shops around the country. Sweet n Low account for 100 million dollars a year in sales and according to the manufacturer 30 million people use it every day. It’s unstable to heat, so you can’t really cook with saccharin, which is why it’s most often used in a blend with other artificial sweeteners (Sweet n’ Low is made with dextrose) in the 1970’s some studies linked saccharin to bladder cancer and warning labels were mandated. These have since been removed and it has now been declared by the FDA as safe for consumption. It is currently the third most popular artificial sweetener in the United states right behind Aspartame which goes by the name NutraSweet or Equal.

Aspartame, which is now being called “AminoSweet” is probably the most controversial of the artificial sweeteners. It’s a derivative of amino acids and it breaks down to form phenylalanine, which is why it has a warning label on it for people who can’t process phenylalanine . It’s 200 times sweeter than sugar and has no calories and doesn’t directly affect blood glucose or insulin (although recent literature indicates that the sweet taste alone may cause changes in blood glucose and insulin). Because it doesn’t taste exactly like sugar sometimes it’s blended with another artificial sweetener, called acesulfame, which goes by the brand names Sunett or Sweet One. The big problem with Aminosweet or Nutrasweet or whatever you want to call it is it’s link to neurotoxicity. It is classified as an excitotoxin by dr. Russell Blaylock who has researched and written extensively on aspartame. He claims it is associated with brain and nerve problems and cancers like leukemia and brain lymphomas. What’s worse, dr. Blaylock says that Searle, the company that developed aspartame knew about this. According to Dr. Blaylock “the original studies done by the G.D. Searle company “…found lymphomas as well as primary brain tumors and tumors of multiple organs” at the time of the approval by the United states government Donald Rumsfeld was the chairman of the Searle corporation. That may or may not have had anything to do with it getting it through the regulatory process.

Then there’s the whole formaldehyde issue. Aspartame consumption is associated with the production of high levels of formaldehyde and according to the EPA, formaldehyde causes cancer in animals and likely cause cancer in humans as well. Aspartame can also covert to methanol under certain conditions and this can also create biochemical toxicity. According to the aspartame toxicity center long and short term use can cause 39 different toxic reactions including tremors, convulsions chronic fatigue, nausea, vomiting diarrhea and even death. And it can exacerbate or mimic 16 different medical conditions including panic attacks, ADD, lupus, Alzheimer’s Disease and even diabetes. Now in fairness to the stuff Searle and the government say it all much ado about nothing, but with all the alternative sweeteners out there, its probably a good idea to stay away from “Nutra-Amino Sweet”. Then there’s the best selling artificial sweetener on the market sucralose, which is basically sucrose, table sugar plus chlorine. Marketed as Splenda, it’s 500-700 times sweeter than sugar, and twice as sweet as saccharin. Sucralose is used in foods in very small quantities because of it’s high sweetness and while it doesn’t directly affect blood sugar or insulin, although once again it’s sweetness may cause these markers to rise.

The big problem with Splenda are those chlorine molecules. The company that makes Splenda says that the chlorine is what keeps Splenda from being absorbed and accounts for its zero calorie status as well as it’s safety, but a lot of chemists aren’t so sure. The chlorines put sucralose into a classification called organochlorines, and this is a chemical family that is clearly associated with cancers. More recently, concerns have been raised about Sucralose’s affects on the thymus gland which has implications for the immune system. According to the Sucralose Toxicity Information Center, ingestion of sucralose was related to thymus shrinkage in laboratory animals. The company that makes sucralose not unexpectedly denies the allegations. The biggest problem that I see with sucralose, is the fact that it’s so new. According to the Sucralose Toxicity Information Center, of the manufacturer’s hundred’s of studies, not all of which are indicative of sucralose safety, many “were clearly inadequate and do not demonstrate safety in long-term use”. Basically sucralose, aspartame acesulfame and saccharin are artificial sweeteners that are processed by the body as drugs. They are “pharmasweeteners” toxins and handled by the body’s drug detoxification system, and that’s the real problem. Do you really want to add to your body’s toxic load? Do you really want to use a sweetener that is processed as a poison?

Thankfully there are some kinder, less industrial sugar alternatives that are available and while not all of them are great, they’re not toxic and some of them can be helpful sugar replacements and allow us to indulge our sweet tooths (or teeth?) with little or no health associated problems. My favorite alternative sweetener is probably xylitol. Now first of all I should tell you that the suffix, the ending “–ol” when associated with a sugar, indicates the biochemical structure of something called a sugar alcohol. Thus you have sweeteners, sugar alcohols, like mannit-ol, sorbit-ol and erythrit-ol which have been used for decades.

These sugar alcohols, some people call them “poly-ols”, are not sugar and they’re not alcohol, but they are sweet carbohydrates. The important thing to understand about all the sugar alcohols is while they’re tasty and sugar-like, they are not absorbed into the body the way regular sugar is. That accounts for their benefits, namely they will not affect blood glucose and insulin the way sugar does, but it also accounts for their drawback. You see, because they are NOT absorbed into the blood they get into the intestine and they can affect bacterial balance and water balance. This can lead to gas, bloating, and they may even have a laxative effect and may exacerbate symptoms of Irritable Bowel Syndrome or other digestive conditions. They’re all officially low carb and some nutritionists actually consider them zero carb. If you can handle them they’re great and xylitol is probably the best of them and I’ll tell you why: while none of the sugar alcohols will promote cavities, xylitol has actually been shown to reduce them! According to an article in The Journal of the American Dental Association from 1998, xylitol is “…an effective preventive agent against dental caries”. In addition it has been shown to reduce the incidence of gum disease, which can lead to tooth loss and destroy the tissues that support the teeth. The Journal of Dental Research calls gum disease a significant public health problem that may have been underestimated by up to 50%. And gum disease doesn’t just affect the mouth. Several studies have linked it diabetes, cardiovascular issues and rheumatoid arthritis. Recently, a study published in the Journal of Periodentology, linked gum disease to lung health. The study showed that bacteria from the upper throat can be inhaled into the lungs leading to pulmonary disease and pneumonia. So, using xylitol as a sweetener may help reduce the likelihood of inflammatory diseases, cardiovascular issues. and enhance respiratory health too. Xylitol increases the amounts protective factors in the mouth and it helps keep saliva minerals absorbable. It also helps improve saliva secretion, so it may have benefits for folks who suffer from dry mouth. According to a paper published in the Journal of the American Geriatrics Society, patients who chewed xylitol containing gum substantially lowered their risk oral fungal infections (“thrush”). And it reduced the risk of chelitis which shows up as rashy sores on the sides of the mouth. The study concludes that xylitol can provide “real clinical benefit” for elderly patients. Take 1 teaspoonful or so and dissolve it in a half a cup of water and use it as a mouth rinse. It will kill bacteria and fungus, keep the acid level in the mouth down (bacteria thrive in a medium acid environment). Use it after brushing and flossing and you don’t have to worry about leaving xylitol in the mouth like you would with other sweeteners. You will actually be suppressing tooth decay. And, xylitol will improve mineral absorption into the teeth making for stronger enamel. You’ll notice small decay spots will improve and even larger cavities will become less sensitive.

And xylitol doesn’t just improve mineral absorption into the teeth. It can do the same thing for bones. Xylitol has been shown to improve osteoporosis! It can actually increase bone density! According to research done in Finland, it hardens bones and helps improve calcium absorption. How do you like that a sweetener that’s good for your bones and your teeth! Another interesting benefit of xylitol is it’s ability to slow down the growth of bacteria that can cause ear infections in children. In two studies of over 1000 children xylitol reduced the incidence of ear infections by 40%. Somehow xylitol interferes with the ability of bacteria’s ability to attach themselves to sinus and nasal tissue. And not only that, but unlike other sugars (even other poly-ols) xylitol can’t be used by bacteria as an energy source. In fact not only can’t bacteria use xylitol for energy, it actually costs microorganisms energy to break down xylitol making it difficult for them to thrive. You can actually take a little xylitol, maybe a teaspoonful or so dissolve it in a couple of ounces of water (4 or 5 tablespoonsful) , put it in a nasal spray bottle and make an allergy or infection protected spray for your sinuses. Dr. Lon Jones, a physician in Texas says that by using a xylitol nasal spray he prevented 93% of ear infections and had comparable reductions in sinus infections, allergies and asthma! You want more? OK…xylitol has also been shown to reduce Candida yeast and harmful digestive bacteria like h pylori that can be the cause of bad breath, ulcers, and gum disease. It looks and tastes like sugar, you can cook with it, it’s totally natural; it’s found in fruits and vegetables and corn cobs and tree bark and it’s made by the human body itself as a normal part of sugar metabolism. And while sugar is acid-forming xylitol is not. In fact, it actually enhances alkalinity. Xylitol has the same sweetness as sugar but with 40% less calories and 75% less carbohydrates.

Xylitol is metabolized much more slowly than regular sugar. On the glycemic index, which is a measurement of how quickly a carbohydrate changes blood sugar, xylitol is a 7 while ordinary sugar is rated a 100. And xylitol doesn’t raise insulin levels. And while it’s more costly than ordinary sugar, considering all of it’s health benefits, it’s relatively cheap. A 2 and a half pound bag of it costs less than 20 dollars.

Another interesting sweetener is one that I fhear about recently from Dr. Sharon Livingston. It’s called Yacon and it’s got some interesting properties. It comes as a powder or syrup and it’s derived from a tuber, much like a potato or turnip. It’s a good source of anti oxidants, and the amino acid tryptophan which can be helpful for mood and brain health but its most important benefit is as a source of something called inulin, which is technically refer to as an FOS (fructo-oligo-saccharide). Now FOSs are technically a type of sugar but usually they’re not usually very sweet. They are however, very important for colon health. That’s because, while humans can’t use it as energy source the way it can ordinary, bacteria can. Especially bacteria, that live in the colon, so-called probiotics. Now, we talk about probiotics all the time on this program, but we don’t often talk about nourishment for probiotics, food and energy sources for the good bacteria. Well FOS is just that. An energy source that can feed and sustain good bacteria in the colon, allowing them to proliferate. Sort of a nutritional supplement for probiotics. Some nutritionists refer to FOS as a prebiotic and while it is found in smaller quantities in many fruits and vegetable, like artichoke and garlic and onions, asparagus, wheat and barley, Yacon stands out because it’s almost 50% FOS. That makes it a sweetener that’s a wonderful dietary supplement that supports colon health. And not only that, but because FOS supports the health of bacteria that fight fungus, it can be helpful for fighting yeast infections. FOS has been shown to improve calcium absorption so it may have benefits for improving or delaying the onset of osteoporosis. And FOS contributes to the fiber fraction of the diet so it can improve digestive health, relieve constipation issues speeding up the movement of food through the colon as well as the elimination of toxins. It can also improve hunger satisfaction making it an ideal sweetener for people who are trying to lose weight. A study published in April, 2009 in the European Journal clinical nutrition found that using Yacon syrup daily produced a “significant decrease in body weight, waist circumference and body mass index”. The study went on to say that decreases in serum insulin, increases in defecation and satiety were also observed. And all of these benefits were achieved without affecting blood sugar or blood fats.

Yacon is great for diabetics, it won’t affect blood glucose or insulin and while FOSs are typically not very sweet, the ones in Yacon give it a molasses like flavor that taste great. The syrup goes for around 12 or 13 dollars for 13 oz and Yacon powder is around $10 or 11 dollars for a half pound. Its got about 10 calories in a teaspoon and you can use it in recipes like you would honey. It’s got a thick and sticky texture and it can impart some moisture to recipes, much like honey would. If you mix 2 tablespoonsful of the syrup in with a cup of xylitol it makes a great low calorie diabetic-safe brown sugar substitute.

Another little know sugar substitute is stevia, sometimes called “honey leaf”, which is becoming more and more popular these days. When I first heard of stevia 15 years ago, the only place you could find it was in herb stores. Today it’s available pretty much everywhere. And, in a way, stevia has pretty much become officially mainstream as you can find processed versions in grocery stores as brand names like “Truvia” which is made by Coca Cola and “PureVia” which is made by Pepsi. Technically stevia is over 300 times sweeter than sugar, but that might not be such a good thing as that much sweetness can come across with a slightly bitter aftertaste. It’s got zero calories and it sweetening power is completely safe for diabetics and anyone whose concerned about blood sugar or insulin. My favorite factoid about stevia, is that the FDA considers it an illegal sweetener and allows it sale only as a dietary supplement. It’s been the subject of searches and seizures and import alerts, trade complaints and embargoes and generally been treated as if it were a illegal drug. Even books about stevia have been considered illegal. In a famous letter from an FDA compliance officer, the president of the Texas-based Stevita company, a stevia distributor was warned that the FDA would quote ““be available to witness the destruction of the cookbooks, literature and other publications for the purpose of verifying compliance.” Sweetness is big business and big bucks and clearly the FDA does not like stevia. The do however approve of the supermarket versions like Truvia and PureVia which are made with something called rebiana, which is extracted from the stevia plant and requires a lot of processing. That’s why it involves the participation of huge multinational food processing companies like Cargill and Coca Cola and Pepsi. Oh by the way, the FDA allows for a 97% purity standard on these processed stevia products. I’m not sure what the other 3% is but it probably has something to do with the erythritol that is used to spike the processed stevia products. That’s right, a sugar alcohol is added to the stevia, for whatever reason. As if 300 times sweeter than sugar isn’t enough sweetness. The erythritol accounts for the digestive side effects some people suffer when they use these products. Remember sugar alcohols, or poly-ols can have a negative effect on digestive bacteria and can cause bloating, constipation and other digestive symptoms. If you’re going to use stevia, my advice is to stay away from the Coca Cola and Pepsi versions and go to a health food store and get the real stuff. It can only be labeled as a dietary supplement, but you can use it any way you like, There are literally hundreds of studies that attest to the safety of stevia and aside from the slightly bitter after taste that you get when you use to much , it’s pretty much a perfect sugar substitute. It won’t lose its sweetness at high temperatures so it can be uses for baking and cooking but because it doesn’t have the properties of sugar, you can’t use it to add texture, help soften batter, caramelize, browning or ferment yeast. My favorite way to use stevia is with lemons and a little strawberry blended together, maybe one or two teaspoonfuls of stevia powder to 4 cups of water and 2 or 3 lemons with one or two strawberries. And for those with a green thumb, is easy to grow in a little garden. It does require a warmer climate so plant it after frost unless you’re in Florida or California. And it grows in pretty much in Any well-drained soil that is good for your typical garden vegetables.

Another interesting sweetener is something called “Whey Low”. I call it the “Whole Foods” low calorie sweetener, because the only place I’ve ever seen it is at Whole Foods, although according to the Whey Low website it’s available at other health food stores as well. It’s got 75% less calories than table sugar and it’s much lower on the glycemic index, which as we’ve said is a measurement of how fast a carbohydrate changes blood sugar. A teaspoon has 5 calories (a teaspoonful of ordinary sugar has about 20) You can substitute it one to one with sugar in recipes. It tastes like sugar, basically because it is sugar. It’s a blend of fructose, lactose and sucrose which are all sugars. Supposedly the sugar blend serves as a barrier in the intestine interferes with the absorption accounting for the low glycemic index. I’m not sure I’m buying that and fructose and sucrose are clearly problematic sweeteners. And even though they call it Whey Low, there’s no whey in the product. The name is derived from the lactose which comes from whey. Whey Low, is basically a nutritionally void processed sweetener, and doesn’t have any advantages over xylitol or Yacon or even stevia.

Then there’s straight fructose which is available as a sweetener in powder form. I’d be extremely careful of it as there’s a ton of literature that’s come out over the last few years implicating it in numerous health problems. Yes it’s fruit sugar and most of us have warm, fuzzy feelings about fruit, and for many years it’s been considered a safe alternative to regular sugar and for diabetics but recently ingestion of fructose has been linked to elevated triglycerides, uric acid, insulin, blood glucose. Fructose reacts with proteins more easily than regular sugar too. The reaction is called the browning reaction because it literally browns proteins and that means accelerated aging and greater susceptibility to organ failure and disease. It increase blood acidity which can be a prelude to cancer and it can have a negative on mineral balances involving calcium, magnesium, iron, phosphorus and zinc. It can also throw off copper metabolism which can cause a weakening in blood vessels. That means strokes aneurysms and defects in connective tissue. It’s processed by the liver so it can exacerbate detoxification issues and it converts to fat more readily than regular sugar. And last but not least there are fructose malabsorbtion issues which affect 30% of Americans. That’s when you have a problem absorbing fructose into cells and it builds up in the intestine. Fructose malabsorbtion is common in folks who already have bowel problems like irritable bowel syndrome or celiac disease although anyone can have it. If you get bloating or diarrhea or gas or any digestive discomfort after you eat fruit or high fructose syrup or even honey, which is around 50% fructose chances are you’ve got an absorption problem.

Another sweetener that’s become popular in last few years is Agave Nectar. Now while Agave nectar sounds like its some kin of natural syrup or honey, it’s really a highly processed chemical sweetener that’s anywhere from 55 to 90% fructose, depending on whose information you’re reading. It has about ¾ of the calories of sucrose and while it does have a low glycemic index, if you’re a diabetic, it’s probably not a good choice given all the problems associated with fructose and what’s worse, most of it is produced in Mexico, which is known for less than rigorous regulatory standards, and some evidence suggests that it’s being cut with corn syrup. On top of that, the FDA has actually refused some shipments of agave nectar because of excessive pesticide residues. Agave is basically non-nutritional fructose, and if you want fructose, you’re probably better off using honey, which is about half fructose, and has a higher glycemic index and more calories than agave but contains a mother lode of nutrition including minerals, vitamins amino acids and enzymes, as long as it’s raw and unprocessed.