I have a friend in my early 40s who was recently diagnosed with diabetes and was very anxious and felt that it was too painful to eat sweets in my life!
She asked me: If you have diabetes, do you really want to say goodbye to "sweets"?
My answer is: not necessarily!
The ADA diabetes diagnosis and treatment standards in the United States point out that for some diabetic patients who cannot quit sugary foods, non-nutritive sweeteners can be used as alternative products. They have little to no significant effect on glycemic management and can also reduce total calorie and carbohydrate intake [1].
However, there are so many products containing sugar substitutes on the market, not all of them are suitable for sugar lovers.
So, which sugar substitutes are more suitable for sugar lovers?
First of all, we need to make it clear that sugar substitutes, which are what we call "sweeteners", are currently found and used in two categories [2]:
| classify | subdivision | Example | Typical products |
| Synthetic class | Sucrose derivatives | Saccharin, acesulfame potassium, sucralose, etc., are hundreds or even tens of thousands of times sweeter than sucrose | Diet Coke |
| Amino acid derivatives | Aspartame, meringuese, is very sweet and has negligible calories | It is widely used in a wide range of food and beverages, including diet cola | |
| Natural kinds | Sugar alcohols | Xylitol, sorbitol, maltitol, etc | Chewing gum, sugar substitute pastries |
| Non-sugar alcohols | Steviol glycosides, mogrosides, etc., are extracted from plants, and the sweetness is hundreds of times that of sucrose | Various sugar substitute flavorings |
01
Synthetic sugar substitutes
They are widely used in a wide range of foods and beverages, but the effects of these sugar substitutes on humans depend on individual differences, including gut microbiomes, and may increase blood glucose levels, cardiovascular risk, and overall mortality [3].
In foreign studies on synthetic sugar substitutes, it has been found that it can induce changes in the composition and function of intestinal microorganisms, causing adverse effects [4].
Therefore, the synthetic sugar substitutes of sucrose derivatives and amino acid derivatives need to be carefully evaluated and used by diabetic patients and their families!
02
Natural sugar substitutes
Glycoside glycoside substitutes for sugar alcohols and non-sugar alcohols are found in various plants or some algae and microorganisms.
Sugar alcohols are sugar substitutes that do not raise blood sugar during digestion and metabolism [5].
In animal experiments with erythritol, mogrosides, and steviol glycosides, these sugar substitutes have been found to help control postprandial blood glucose or improve insulin resistance [6-8].
However, in studies in healthy adults, steviol glycosides and three other synthetic additives have been found to affect the human gut microbiota and make the body's glucose tolerance levels worse and blood sugar fluctuations greater [9].
Therefore, the natural sweeteners of sugar alcohols and glycosides are recommended to be appropriately replaced by diabetics who cannot quit desserts, but it is never recommended to consume them in large quantities for a long time!
In summary, in terms of the benefits of glycemic management: sugar-free> sugar substitutes> sugars.
There are 3 points to pay attention to when eating "sugar substitutes".
1. Pay attention to the amount and frequency of consumption:
Considering that there is still some controversy in the current research on the effects of sweeteners on human health, it is recommended to minimize the amount and frequency of consumption.
2. Don't believe in sugar substitutes/sugar-free foods:
Many high-carbohydrate foods, such as sugar substitute biscuits, sugar substitute moon cakes, sugar substitute cakes, etc., although sugar substitutes are used, but the starch content is extremely high.
In addition, 100 grams of food with less than 0.5 grams of sugar can be labeled as sugar-free, so sugar-free is not necessarily really sugar-free.
3. Pay attention to the body's reaction after consumption:
The effects of sugar substitutes on human health also need to be taken into account individual differences, especially the effects of synthetic sweeteners on human health are still debated and inconclusive, and some people will have adverse reactions such as diarrhea after consumption of natural sweeteners [11].
Overall, intake of small doses of sugar substitutes has less effect on glycemic control, but excessive intake of sugar substitutes may lead to an increased risk of disease [12].
For partners who can't quit desserts, you can choose natural sugar substitutes to add a little sweetness to your life once in a while.
Author: Liu Qiaozhen Registered Dietitian
bibliography
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