When I was at nutrition school over 10 years ago, the “bad news” about sugar was that it contained empty calories and caused cavities. That didn’t seem SO bad. If you consumed just a little sugar – not enough to allow weight gain – then you’d be okay. And you had to brush your teeth after eating jelly beans.

Fast forward to 2011, and sugar has become the new sodium. Health care professionals are cautioning against excessive sugar intake, and are linking the sweet stuff to heart disease.

With ingredients like high fructose corn syrup (HFCS), agave and stevia making headlines, consumers are more confused than ever about which sweeteners are healthy to use. Is there a better option for those with a sweet tooth?

The science of sweet

The amplified attention on sugar may be because we consume about 25 teaspoons each day, but nutrition guidelines recommend no more than 10 teaspoons. And that’s just the amount of table sugar we consume; it does not include our intake of foods made with HFCS.

Both table sugar and HFCS are a mix of simple glucose and fructose molecules. Fructose is almost twice as sweet as glucose, so the more fructose in a substance, the sweeter it will be. HFCS is 55 percent fructose, and 45 percent glucose, while table sugar is a 50:50 split.

Some researchers believe that HFCS is worse for us than sugar, since the increased use of HCFS in packaged foods coincides with the rise in obesity and related diseases. However, others argue that HFCS and sugar are largely the same and the biggest problem is excessive consumption of both.

Either way, tons of table sugar and HFCS are added to packaged foods, and many of us don’t realize how much we’re consuming.  These numbers may surprise you: 

There is suggestive evidence that excessive sugar consumption – and primarily fructose consumption – is linked to an increased risk of heart disease. The pathway is not as direct as sugar causing cavities, but it goes something like this:

• Consume excess fructose (from soft drinks, candy, processed foods)
• Fructose is converted to fat by the liver
• Fat accumulates in liver
• Fatty liver leads to insulin resistance
• Insulin resistance leads to metabolic syndrome, which lead to heart disease

Research in this area has mostly been conducted on rats, so the effect on humans is an educated guess at best. But it has raised enough concern for scientists to investigate further, and research in this area is on-going.

Some alternatives

Your best bet is to cut back on sugary processed foods altogether and swap soft drinks for water. But, if your sweet tooth overpowers you, there are many options. Some are better than others. Note: sugar has 16 calories per teaspoon.

Agave (20 calories per teaspoon): This syrup from the Mexican agave plant is high in fructose  (it varies from 55-95% fructose depending on the agave). The fact that agave is “natural” may not mean that it’s healthy, especially if the link between fructose and insulin resistance is further validated.

Aspartame (0 calories per teaspoon): This artificial sweetener is sold commercially as Equal or NutraSweet. Studies on the link between aspartame and an increased cancer risk are mixed, and it is approved for use in Canada. However, the non-profit Centre for Science in the Public Interest caution against its use – especially in children – since studies on long-term consumption are lacking. 

Maple syrup (17 calories per teaspoon): Tapped from maple trees, this distinctively flavoured syrup has the added benefit of being rich in antioxidants. It’s the lesser of evils, and it’s what I keep in my fridge to lightly sweeten my oatmeal and plain yogurt.

Splenda (0 calories per teaspoon): A low-calorie artificial sweetener, Splenda is the trade name for sucralose. The Centre for Science in the Public Interest lists Splenda on its “SAFE” list of food additives, yet lists sugar, HFSC and fructose on its “CUT BACK” list.  It is approved for use by Health Canada for adults and children, and has approval in 80 countries based on over 100 safety studies.

Sweet ‘n Low (0 calories per teaspoon): In Canada, this artificial sweetener is made from cyclamates, which are banned in the US. However, Sweet ‘n Low is made from saccharin in the US, which is banned in Canada. Hmm... a sweetener that’s made from ingredients that are safe in one country but banned in another? I’d skip it.

Stevia (0 calories per teaspoon): This natural, calorie-free sweetener is extracted from leaves of the Stevia rebaudiana plant and is available as powder, liquid or in whole-leaf formats. Stevia is commonly added to natural health products, but has not yet been approved by Health Canada for the commercial food supply – they need to establish that it’s safe before it’s used more widely. Research is on-going, and some studies link stevia to lower blood pressure levels and glucose tolerance. 

Ultimately, the choice is yours – it depends on your taste buds, your overall diet and any health conditions you may have.

My best advice? Cut down on foods that are high in processed sugar or HFCS (which may appear on food labels as “glucose-fructose”) and don’t always assume that “natural” means healthy. Satisfy your sweet tooth with fruit instead -- the high content of fibre, vitamins and antioxidants outweigh the small amount of naturally occurring fructose found in fruit.