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Diabetes Qualified

Sugar & sweeteners – The sweet truth

Sugar & sweeteners – The sweet truth

Written by Rebecca McPhee, Accredited Practising Dietitian (APD) & Health Coach Consultant.

As a health professional, you’ve likely encountered the questions, ‘Is sugar bad for me?’ or ‘Are sugar substitutes the better option, and if so, which one?’ For clients deciding what to put in their supermarket trolley, it can be a little tricky given the number of nutrient and health claims on sugar, which often contradict each other. So, what sweet truths can you give them?

The basics – Not all sugars are the same

The sugar matrix in a banana is different to the one you find in a chocolate bar! Natural occurring sugars in fruit, dairy and wholegrains are part of a healthy balanced diet and are not cause for concern. They supply us with essential nutrients including vitamins, minerals, antioxidants, and dietary fibre and are part of the five food groups. Fruit contains a mixture of sucrose, fructose and glucose, while dairy foods (such as milk and yoghurt) contain lactose. Both fructose and lactose are also low GI (Glycemic Index), meaning they are digested or absorbed more slowly at a slower rate, prompting less fluctuation in glucose levels. You can find out the GI value of different carbohydrate foods using the GI Foundation’s searchable Low GI Database.

‘Added sugars’ are the ones we need to advise clients to limit because they don’t automatically come with a package of micronutrients. Excess consumption is associated with negative health outcomes including obesity, type 2 diabetes, and tooth decay. The World Health Organisation (WHO) recommends to limit (but not avoid) foods with lots of ‘free or added sugar’ with little nutritional value such as confectionery, biscuits, cakes, desserts, and soft drinks. Free sugars also include fruit juices, honey, maple syrup, coconut sugar, agave syrup, rice syrup and date syrup. While we still need to limit the amount eaten, floral honeys, agave syrup, date syrup and pure maple syrup are all low GI compared to white sugar which has a medium GI.  They are also sweeter in taste and add flavour, so you often need less. Using a small amount in recipes means the total amount of calories and carbohydrate is lower which is a bonus when you are trying to manage weight and glucose levels.

How much sugar can we eat and what are the health effects?

Many of our clients know that eating too much of the sweet stuff is not good for their health yet it still manages to creep into their diet. In fact, the average Aussie consumes 50g of added sugars a day plus another 10g a day of free sugars from fruit juices and juice drinks. This is a total of 60g of sugar per day (approx.14 teaspoons of sugar) which is around 22kg of sugar per year. The World Health Organisation recommendation is to limit sugar to less than 10% of energy (50g or 12 teaspoons), although they suggest that it might be even better to limit it to 5% (25g). To put this into perspective, one 600ml bottle of flavoured milk contains 8 teaspoons of sugar!

Should clients avoid sugar?

Think moderation, not avoidance. Adding a drizzle of honey or yoghurt to morning porridge is completely fine, as it can make high fibre foods taste good. When it comes to special occasions such as Christmas or a birthday, enjoying treats is not going to cause harm and is all part of a balanced diet. It is how often and how much we eat that can be a problem. Small treats may stop us from feeling deprived and thus less likely to binge. It is important to remember that a healthy balanced approach to food and health is the important message to teach.

What about natural sweeteners?

In response to the growing prevalence of obesity and diabetes, natural sweeteners have gained popularity in the food market, offering calorie free, zero carbohydrate alternatives. No carbohydrates mean it does not affect glucose levels so it can benefit our clients with diabetes. Many of these natural sweeteners come from plants and are intensely sweet tasting, which means they do not need much at all. Whilst the sweetness is extracted from plants, be aware that they are extracted, concentrated and added to food as purified steviol glycosides. Just as ‘added sugars’ need to be limited, the same applies to natural sweeteners. They may be sweeter than sugar and low calorie/carbohydrate, but it does not give us licence to eat excessive amounts.

Comparison of ‘added sugars’ and natural sweeteners

Here is a guide to the most popular ‘added sugars’ and natural sweeteners on the market, including, their nutrition information and GI value.

ProductFast factsNutrition InformationGI value
SugarIn Australia, extracted from cane sugar and sugar beets in EuropePer 100g 310 calories
100g carbohydrates
Medium = 65
Low GI cane sugarA natural raw cane brown sugar which is enriched in antioxidant derived from extracts of sugar cane. Consists of the anhydrous disaccharide sucrose, composed of the monosaccharides fructose and glucose as well as polyphenols.Per 100g
404 calories
97.7g carbohydrates
Low GI = 51
Honey/Low GI Honey Made from bees from the nectar of flowers.Sweeter than white sugar due to high fructose content so you use less.The higher fructose amount, the lower the GI valuePer 100g
337 calories
83.1 carbohydrates
Honey Low-medium
GI = 45-60 Low GI Honey Low GI = 42 
AgaveA sweet liquid derived from a plant native to MexicoPer 100g
309 calories
76g carbohydrates
Low GI = 28
Date syrupA concentrated liquid 100% from datesPer 100g
301 calories
74.2g carbohydrate
Low GI = 54  
SteviaExtracted from leaves of a south American plant200-300 times sweeter than white sugarCalorie free
Carbohydrate free
Does not impact on blood sugar levels
No GI value as zero grams of carbohydrates
Monk fruitSweetener extracted from monk fruit seeds and skin made into a concentrated powder100-250 times sweeter than white sugarCalorie free
Carbohydrate free
Does not impact on blood sugar levels
No GI value as zero grams of carbohydrates
Erythritol A sugar alcohol70% the sweetness of sugarFound in fruit e.g., melon, pear and fermented derived foods e.g., mushrooms, cheeseAlmost calorie free 0.2g calories per gram.
4g carbohydrates per teaspoon
No GI as low in carbohydrates

Take home message for clients

Ideally, we need to train our tastebuds away from excessive sweetness by cutting down on how much and often we eat added and natural sweeteners. Adopting the 80/20 rule means that we base 80% of our diet on plant-based foods, including vegetables, fruit, wholegrains, legumes and nuts/seeds, with moderate amounts of healthy protein and fats/oils. The other 20% can be indulgences, which may include ‘added sugars’ or products with natural sweeteners. For those wanting to better manage their glucose levels, choosing a low GI option can help, but remember it is the dose that makes the poison!