Sugar and sugar substitutes

Sugar and sugar substitutes

Bailey Koch, RD, CSP, LD

Is a Registered Dietitian, board certified as a Specialist in Pediatric Nutrition. She founded Atlanta Pediatric Nutrition and joined the GI Care for Kids team, providing nutrition counseling to patients and families.

Most children (and adults) love sweets. Not just candies, but sweet desserts, sweet cereals and sweet drinks. But the problem is that sugar adds a lots of calories to what children eat and drink. Regular sodas have as many as 10 teaspoons of sugar in a single 12 ounce can. Fruit juices, like apple juice, have the same amount of sugar as sugary sodas. Grape juice has even more. It's no wonder dentists and doctors warn parents that juice in bottles is unhealthy. 

Many parents are looking for alternative sweeteners for their children and themselves. There are lots of different sugar alternatives.  

In the table below, sweeteners are divided into 2 categories. Nutritive sweeteners are those, like sugar and honey, that the body can use for energy and the body's metabolic needs. The non-nutritive sweeteners provide the sweet taste, but they can't be used by the body in the same way. 

The concern for the nutritive sweeteners is that too much can contribute to the problems of weight gain and obesity. And the real concern is that diet drinks (with various sweeteners) still doesn't make them into healthy choices. Especially when compared to the original diet drink – water.


Common Names


De rived From

Found in

SucroseTable Sugar50% glucose + 50% fructose 4 kcals/gm;40 kcals/Tbspsugar cane or sugar beethoney, fruits, most root vegetablesTooth Decay;  Increased intake leads to obesity, high blood sugars, Type 2 Diabetes, Gout
FructoseFruit Sugarlowest GI of all sugars  sweetest of all sugars 4 kcals/gm;                    40 kcals/Tbspsugar cane, sugar beet or corntable sugar, High Fructose Corn Syrup (HFCS), agave, honey, molasses, maple syrup, fruit, root vegetablesIncreased intake leads to obesity, insulin resistance + hyperlipidemia;  May not regulate satiety, leading to overeating; may contribute to liver disease, Gout
HFCSHigh Fructose Corn syrup50% glucose + 50% fructose as "free sugars";  in sucrose these are "bound" but when digested it quickly turns into "free sugars" as well  4 kcals/gm;40 kcals/Tbspproduced by changing corn into corn starch into corn syrup and then adding enzymes processed foodsIncreased intake leads to obesity, insulin resistance + hyperlipidemia
Honeyhoneymixture of sugars including glucose + fructose; 1-1.5x sweeter than sugar;  3 kcals/gm; ~64 kcals/Tbspproduced by honey bees from the nectar of plants or secretions of living parts of plants Increased intake leads to obesity, insulin resistance + hyperlipidemia;  risk of infant botulism so avoid in babies <1 yo
Agaveagave nectarnutritionally and functionally similar to other sugars, including HFCS depending on how it is processes1.5x sweeter than sugar;  ~60 kcals/TbspBlue Agave plant which is same plant from which tequila comes fromin a syrup or in processed foodsIncreased intake leads to obesity, insulin resistance + hyperlipidemia; processed just like other sugars
SucraloseSplenda600x sweeter than sugar; poorly absorbed by body and excreted unchanged in urine; heat stableprocess that replaces 3 hydrogen-oxygen groups on sucrose with chlorine atomstabletop sweetener and as an ingredient in variety of processed goods100+ scientific studies over 20 yrs looking at variety of health issues demonstrated safety
AspartameEqual, NutraSweet180x sweeter than sugar;  not heat stablemolecule consisting of phenylalanine + aspartic acidtabletop sweetener and as an ingredient in variety of processed goodsvast majority of research over 30+ yrs concludes that it does not cause cancer.  2 studies that say otherwise were done in rats and were poorly designed studies; contains phenylalanine- must be avoided by people with PKU
SaccharinSweet'N Low300x sweeter than sugar; heat stable; not broken down by body and eliminated in same form chemical processtabletop sweetener and as an ingredient in variety of processed goodsstudies in 70's in rats linked it to bladder cancer.  However, the bladder tumors were due to how the substance worked in rats and is not relevant to humans.  12/2000- warning label no longer required
SteviaTruvia, PureVia, Sun Crystals200x sweeter than sugarstevia planttabletop sweetener and as an ingredient in variety of processed goodsmultiple studies have shown they are not associated with cancer
Monk FruitPurefruit, Nectresse200x sweeter than sugarfruit grows on vines in sub-tropical Asia;  processors extract the natural sweetener by crushing it and infusing with hot watertabletop sweetener and as an ingredient in variety of processed goodsmultiple studies have shown they are safe for human consumption

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