Which Are The Healthiest Sugar Substitutes

Sugar is an inseparable part of our diets but consuming too much sugar is not good for our teeth and waistline. A sugar substitute, on the other hand, is something that is artificially sweetened and duplicates the effect of sugar in taste and usually has less food energy. In spite of its benefits, some studies on animals have proven that artificial sweeteners cause health hazards such as brain tumors, bladder cancer and weight gain.1  

Artificial sweeteners, also known as non-nutritive sweeteners or low-calorie sweeteners, are food additives that are used to sweeten foods and beverages without adding calories. They are often used as an alternative to sugar in order to reduce the calorie and carbohydrate content of a product, particularly for people who are trying to lose weight or manage diabetes. 

People suffering from diabetes mellitus usually have difficulty in regulating their blood sugar levels. Substituting sugar with artificial sweeteners can help them enjoy a diverse diet, at the same time sugar substitutes are metabolized slowly thus allowing blood sugar levels to remain more stable over time.1

It is important to use artificial sweeteners with caution, especially in high-risk individuals such as pregnant and lactating women, diabetics, and people with migraines or epilepsy. Children are also a high-risk group due to their higher intake of food and beverages relative to their body weight.2 Instead of relying on artificial sweeteners, it is generally recommended to incorporate nutrient-dense, low-calorie foods into the diet, such as fiber-rich grains, vegetables, fruits, and low/no fat dairy products. It is also important to note that artificial sweeteners may be less useful when used to replace nutrient-dense foods like milk and fruits.2

About sugar

Types of sugar

There are many types of sugar that are used for cooking and baking. Some common types of sugar include:3

  1. Granulated sugar: This is the most common type of sugar, and it is made from sugar beet or sugar cane. It is a fine, white, crystalline powder that is used for sweetening drinks and for baking
  2. Brown sugar: This type of sugar is made by adding molasses to refined white sugar. It has a moist, soft texture and a slightly caramelized flavor. It is commonly used in baking and in sauces and marinades
  3. Powdered sugar: Also known as confectioners' sugar or icing sugar, this type of sugar is made by grinding granulated sugar into a fine powder. It is commonly used to make frostings and icings, and it can also be used to dust cakes and pastries
  4. Raw sugar: This type of sugar is made from sugar cane and is less refined than granulated sugar. It has a golden-brown color and a slightly caramelized flavor. It is often used in baking and for sweetening drinks
  5. Honey: Honey is a sweet, thick liquid that is made by bees from the nectar of flowers. It has a unique flavor and is often used as a natural sweetener in cooking and baking
  6. Maple syrup: This is a sweet, amber-colored liquid that is made from the sap of maple trees. It has a unique, slightly nutty flavor and is often used as a natural sweetener in cooking and baking
  7. Agave nectar: This is a sweet, syrupy liquid that is made from the agave plant. It is often used as a natural sweetener and has a lower glycemic index than sugar, which means it does not cause a rapid rise in blood sugar levels3

 Health benefits of sugar to our body

Sugar, also known as sucrose, is a type of carbohydrate that is found naturally in many fruits and vegetables, and is also added to many processed foods and drinks. While sugar can provide a quick source of energy, it is not considered a necessary nutrient and consuming too much can lead to health problems.

One potential benefit of sugar is that it can be used to increase the palatability of foods and drinks, making them more enjoyable to consume. This can be especially useful for people who have difficulty eating or drinking due to illness or other medical conditions.

Sugar can also be used as a natural preservative and can help to inhibit the growth of harmful bacteria in certain types of foods.

That being said, it is important to consume sugar in moderation as excessive intake has been linked to a variety of health problems, including obesity, type 2 diabetes, and heart disease. The World Health Organization (WHO) recommends that adults and children limit their intake of added sugars to less than 10% of their daily caloric intake, and ideally, less than 5% to prevent chronic disease.

The best way to consume sugar is through natural sources such as fruits, because sugar in fruits is accompanied by other nutrients which are beneficial.

Harmful effects of sugar

Eating too much sugar can have a variety of negative effects on health. Some potential health problems associated with excessive sugar intake include:

  • Weight gain and obesity: Consuming too much sugar can lead to weight gain, as it is high in calories.
  • Tooth decay: Sugar can cause plaque to build up on teeth, which can lead to cavities
  • Type 2 diabetes: Consuming too much sugar can increase the risk of developing type 2 diabetes, a condition characterized by high blood sugar levels4
  • Heart disease: A diet high in added sugars has been linked to an increased risk of heart disease.
  • Non-alcoholic fatty liver disease: Consuming too much added sugar can lead to an accumulation of fat in the liver, which can lead to non-alcoholic fatty liver disease5
  • Poor nutrition: Eating too much sugar can displace more nutritious foods in the diet, which can lead to nutrient deficiencies

It's worth noting that the risks associated with sugar consumption are related to consuming added sugars, which are sugars that are added to food and beverages during processing.

Sources of sugar

Are sugar substitutes healthier than sugar?

Sugar substitutes, also known as artificial sweeteners, are alternative sweeteners that can be used in place of sugar. Some sugar substitutes may be healthier than sugar for people with certain health conditions, such as diabetes because they don't affect blood sugar levels in the same way as sugar.6  However, more research is needed to understand the long-term health effects of consuming artificial sweeteners. Additionally, while they may be lower in calories, it can still lead to weight gain as they may cause increased appetite. In general, it is recommended to consume sugar or sugar substitutes in moderation.

Which are the healthiest sugar substitutes

There are many different sugar substitutes available, and the healthiness of each one can vary depending on the individual and the context in which it is consumed. Some of the most commonly used sugar substitutes include:

  • Stevia
  • Erythritol
  • Xylitol
  • Monk Fruit Extract

Again, it's important to note that more research is needed to understand the long-term health effects of consuming artificial sweeteners. 

Reducing sugar in your diet: Tips

Here are a few tips for reducing sugar in your diet:

  1. Read nutrition labels: Pay attention to the number of added sugars in packaged foods and drinks
  2. Choose whole foods: opt for fruits, vegetables, and whole grains, which contain natural sugars, over-processed foods and snacks, which often have added sugars
  3. Limit sweet drinks: Cut back on soda, juice, and sweetened coffee and tea, which can be major sources of added sugars
  4. Use natural sweeteners: Try using natural sweeteners like honey, maple syrup, and dates instead of refined white sugar
  5. Experiment with spices: Try using spices like cinnamon, nutmeg, and vanilla to add sweetness to food and drinks without added sugars6
  6. Be mindful of your sugar intake: Be aware of how much sugar you consume, and try to gradually reduce your intake over time
  7. Make a homemade version: Make your own version of common store-bought foods that are high in sugar such as yogurt, granola, and salad dressing
  8. Try not to eat too much processed food and try to prepare your food by yourself
  9. Don’t buy pre-packaged meals, snacks, etc. that have high sugar content
  10. Get enough sleep and exercise regularly, these can also affect your cravings for sugar


What sugar substitutes should you avoid?

There are several sugar substitutes that some people may choose to avoid due to potential health risks or other concerns. These include:7

  • Aspartame: This artificial sweetener has been the subject of controversy and safety concerns for many years. Some studies have suggested that aspartame may be linked to cancer, headaches, and other health problems, but the evidence is not clear
  • Sucralose: Known as Splenda, is a commonly used artificial sweetener, but some studies have suggested that it may have negative effects on gut health and blood sugar control
  • Saccharin: This artificial sweetener is a derivative of coal tar, which gives it a distinct bitter aftertaste. Studies have suggested that it may increase the risk of bladder cancer

What is the most harmful sugar substitute?

Aspartame is considered to be one of the most harmful sugar substitutes. It is an artificial sweetener that is commonly found in diet sodas and other low-calorie foods. Many of the studies have been conducted on the high dosage which is not close to the recommended daily intake for humans. Therefore, more research is needed to fully understand the potential risks associated with aspartame.4

 What is the best and safest sugar substitute for diabetics?

For diabetics, the best and safest sugar substitutes are those that do not raise blood sugar levels. Some popular options include Stevia, Erythritol, Xylitol, and monk fruit sweetener.

It's important to note that these sweeteners are not calorie-free, even though they don't raise blood sugar levels. Therefore, it's important for diabetics to monitor their overall calorie intake and to consult with their healthcare provider before making any major changes to their diet.


While some artificial sweeteners have been approved for use in the United States and other countries, there has been some controversy surrounding their safety and potential health effects.

It is important to note that while some studies have suggested that artificial sweeteners may have negative health effects, the majority of research has found them to be safe when consumed in moderation.

It is also important to consider the context in which these sweeteners are used. For example, using artificial sweeteners as a way to reduce sugar intake and lower the risk of obesity, diabetes, and other related health conditions may have overall health benefits. However, using artificial sweeteners as a way to "cheat" on a diet or consume more sweet-tasting foods and beverages without regard for overall calorie and nutrient intake may not be beneficial.


  1. Tandel KR. Sugar substitutes: Health controversy over perceived benefits. Journal of Pharmacology and Pharmacotherapeutics. 2011 Dec;2(4):236-43.
  2. Sharma A, Amarnath S, Thulasimani M, Ramaswamy S. Artificial sweeteners as a sugar substitute: Are they really safe?. Indian journal of pharmacology. 2016 May;48(3):237.
  3. Zaitoun M, Ghanem M, Harphoush S. Sugars: Types and their functional properties in food and human health. International J. Pub Health Res. 2018;6:93-.
  4. Lustig RH, Schmidt LA, Brindis CD. The toxic truth about sugar. Nature. 2012 Feb;482(7383):27-9.
  5. Ali S. Harmful Effects of Sugar in American Foods.
  6. You A. Dietary guidelines for Americans. US Department of Health and Human Services and US Department of Agriculture. 2015;7.
  7. Alfin-Slater RB, Pi-Sunyer FX. Sugar and sugar substitutes: comparisons and indications. Postgraduate Medicine. 1987 Aug 1;82(2):46-56.
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Tasneem Kaderi


Tasneem is a dental practitioner since 5 years in India. She is also a Medicolegal consultant plus Hospital and Healthcare Administrator since 2 years. She has a diploma in Clinical Research and Pharmacovigilance and is working as a Data Analyst for Medical Devices at 3Analytics, California. An avid reader and optimist at heart, loves to scribble here and there.

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