By Tara Bannow

The Bulletin

Like most people, Mary Cluskey hears a lot about so-called “natural” sweeteners. You know the ones: agave nectar, stevia, monk fruit, et cetera.

“People seem to think that if you don’t consume something fresh and raw and in its natural state then it’s not healthy for you,” she said.

Cluskey, an associate professor in the Moore Family Center for Whole Grain Foods, Nutrition and Preventive Health at Oregon State University, said the line most people draw between “natural” foods and processed foods is, for the most part, an arbitrary one.

Nutrition experts agree that choosing a sweetener is a confusing task. Given all the different sources of information on the subject — many of them conflicting — it’s sometimes hard to know who to trust, especially with marketers throwing around words like “natural” and featuring leaves on their packaging.

Even stevia, a calorie-free sweetener adored by many, a natural foods enthusiast for its origins in the Stevia rebaudiana Bertoni plant, is thoroughly processed to become the powder form in which it’s consumed.

“If all we did was squeeze an agave leaf into our glass of iced tea or something, yeah, that would be more natural,” Cluskey said. “But the reality is, we don’t. It has to be isolated and concentrated.”

When it comes to sweeteners, a little processing is a good thing, Cluskey said. Truly raw sugar, for example, cannot even be sold in the U.S. because it contains naturally occurring environmental contaminants, she said.

‘Just keeps showing up’

Often just the perception that a food is natural can blind consumers to its potentially harmful properties.

Lori Zanini, a registered dietitian in Los Angeles and spokeswoman for the Academy of Nutrition and Dietetics, said her diabetic clients often tell her they can add honey to anything and it’ll still be good for them.

“It sounds funny, but people do that all the time,” she said.

Just because sweeteners like agave nectar — which is really more of a syrup than anything — honey and molasses are believed to be naturally occurring, people somehow don’t believe they’ll raise their blood sugar or cause them to gain weight like table sugar will, Zanini said.

Honey, in particular, is often touted for containing beneficial nutrients like iron. But that’s a lot like the anti-oxidizing effects of dark chocolate: You’d have to eat so much of it to derive that benefit, it wouldn’t be worth it, Cluskey said.

Likewise, agave nectar is touted for having a low glycemic index, meaning the sugars flow slowly into the bloodstream, releasing insulin gradually and keeping a person fuller longer. Plus, it’s sweeter than sugar, so people will use less of it. That said, agave nectar has the same amount of calories and carbohydrates as sugar, according to the American Diabetes Association.

Recognizing sugar’s contribution to the growing ranks who suffer from chronic conditions such as Type 2 diabetes and obesity, a number of organizations have created recommendations around daily consumption of added sugar, or sugar that doesn’t occur naturally in food. The American Heart Association, for example, recommends women take in no more than 6 teaspoons, or 25 grams, from added sugars per day, and men no more than 10 teaspoons, or 38 grams, from added sugars per day.

But the U.S. Department of Agriculture found in 2010 that people between the ages of 19 to 79 take in an average of 20 teaspoons, or 79 grams, of added sugar per day.

Nearly 36 percent of that added sugar comes from soda and other sugar-sweetened beverages, the USDA found.

“We just continue to get evidence against why we should drink fewer sugar-sweetened beverages,” Cluskey said. “It just keeps showing up and showing up.”

Nutritive vs. non-nutritive

A simple way to think about sweeteners is to divide them between nutritive (those that contain calories) and non-nutritive (those that don’t).

In the nutritive category, sugar alcohols, also known as polyols, are often added to gums and beverages that are labeled sugar-free. They contain two calories per gram, unlike sugar, which contains four calories per gram. The downside of sugar alcohols is they can have a laxative effect if consumed in large quantities, Zanini said.

Some non-nutritive sweeteners are extremely sweet, which means one would likely use less of them. Sucralose, for example, is 600 times sweeter than sugar. Aspartame is 180 times sweeter. Saccharin is 300 times sweeter.

Although some research has linked the non-nutritive sweeteners aspartame and saccharin to certain cancers, most medical organizations, including the American Cancer Society, National Cancer Institute, American Diabetes Association and the Academy of Nutrition and Dietetics, consider them to be safe.

Saccharin required a warning label for decades before a study in 2000 found the mechanism that triggers bladder cancer in rats that consume the sweetener does not exist in humans.

The Center for Science in the Public Interest, a nonprofit consumer advocacy group, recommends against saccharin consumption, but aspartame is at the top of its list of sweeteners to avoid. CSPI points to independent studies that found it caused cancer in rats and mice. A 2012 study in the American Journal of Clinical Nutrition found drinking diet soda increased men’s risk of non-Hodgkin lymphoma and multiple myeloma, but concluded it could have been by chance.

Cluskey said CSPI tends to be more conservative than other organizations about whether or not they consider products safe.

The most important consideration when choosing a sugar substitute is simply which one tastes the best to you, Cluskey and Zanini agreed. And what you plan to use it for.

“My main message is it’s a personal decision,” Zanini said. “They have to look at their overall eating plan and figure out what’s best for them and what’s their goal. Is their goal to lower their blood sugar? Is their goal to lower their calories? And what do they think tastes best to them?”

— Reporter: 541-383-0304,