Sugar from milk and fruit sources, for instance, should not exceed 10% of total kcalories. Concentrated refined sugars (e.g., table sugar) should be limited as much as possible. The objective is to look for other names on food packaging that are sugars, including corn syrup, dextrose, sucrose, corn sweeteners, glucose, fructose, lactose, honey, molasses, maple sugar, maple syrup, sorbitol, mannitol, xylitol, maltose, or anything with ‘sugar’ in the name, e.g., confectioner’s sugar, or invert sugar.
The next step would be to reduce or replace simple sugars with these suggestions:
If substituting sugars, be aware that there are two types of sweeteners or sugar substitutes. The first type is a class of nutritive sweeteners that absorb slower than sucrose, they do not promote dental caries, and they do contain kcalories. The second is a class of artificial sweeteners that do not contain kcalories, and they are safe for use for diabetics and calorie reduced diets.
Using sugar substitutes (especially artificial sweeteners) should not give people license to consume large amounts of these products simply because they are low in kcalories. They also tend to be low in other nutrient values and it is unclear what medical conditions can arise from over-consumption. Hence, these products should not be a substitute for fresh fruits, vegetables, or other foods. However, if it is difficult to make it through the day without a pudding, for example, choose one made with skim milk and a sweetener than a high-fat, high-sugar type.
Sugar Substitute Sweeteners
Nutritive Sweeteners
Fructose – Found in fruits, honey, and some sweet vegetables. Fuctose absorbs more slowly in the GI tract than glucose and metabolizes directly in the liver independent of insulin. Large intakes of 70+ grams per day can cause diarrhea.
Sorbitol – A sugar alcohol found mainly in plants and used in confectioneries (candy), gum, toothpaste, and diabetic desserts. After absorption, sorbitol oxidizes into fructose. Sorbitol results in a slower, less pronounced rise in blood glucose than sugar. More than 10 grams per day may result in diarrhea.
Xylitol – A compound derived from wood sugar. It causes the least harm to teeth of all nutritive sweeteners. Does not increase blood glucose levels. Intake of more than 30 grams per day may result in diarrhea. Also, it may be associated with bladder stones and tumors.
Artificial Sweeteners
Acesulfame K – A synthetic sweetener that is very stable in heat. Marketed as Sweet One, Sunette, or Sun Sweet Tabletop.
Aspartame – Best known as NutraSweet, it is found mainly in soft drinks, gums, pudding mixes, and other foods. It consists of amino acids that break down in the GI tract, then it absorbs and metabolizes. It has a very low nutrient and caloric value.
Saccharin – Better known as Sweet’n Low, Nutra-diet, and Sugar Twin, Saccharin is used primarily in soft drinks and canned fruit. It neither metabolizes or stores in the body, but excretes in the urine. Saccharin has a bitter aftertaste, is low in kcalories, and may be a possible carcinogen.
Sucralose – Available only in Canada to date. It contains no kcalories and is derived from sugar. It is used in cooking and baking.
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