By: Erin Stair, MD, MPH, follow on Instagram
Mirror, Mirror on the Wall, what’s the Healthiest Sugar of All? I feel like everyone is always searching for the answer to that question.
I’m not a big sugar person, but I’m also not one of those “sugar is the enemy” people. My diet is rooted in moderation, not elimination. No matter what sugar you eat, Sucrose, Stevia, Splenda.., moderation is key. In the wellness world, it’s easy to fall prey to reductionism, or when we start labeling individual ingredients as “bad” or “good.” I’m mindful not to do that, because: 1) such thinking can make you paranoid and create excess stress; 2) I firmly believe the toxicity is in the dose; 3) no one makes it out of here alive. Going back to number 1, I often say that people who try to avoid all the toxins and “bad” things in the world are afflicted with Wellness Paranoia Syndrome. I made that up, yes, but if you want to dive into it deeper, read my new book when it comes out, Yours in Wellness.
So when I talk about the healthiest sugar, here’s the scoop: Healthy should refer to how much and how often you eat any sugar ( no matter what it is), versus focusing on the sugar itself. A little of ANYTHING, won’t kill you. (Sans cyanide et al, you get it…) I don’t use a lot of sugar, but when I do, I use regular, organically-farmed sugar and add cinnamon to whatever I’m putting the sugar in. I choose to eat organically to avoid pesticides and plus, it’s kinder to Mother Earth. Why do I add cinnamon? Cinnamon helps lower the glycemic index, which means that it helps lower the level of sugar in your bloodstream after you eat a meal, and therefore helps lower insulin release. In randomized controlled trials, cinnamon has also been shown to improve BMI, lower body fat and lower visceral fat. If you prefer regular ol’ (organic) sugar like I do or want to help prevent Diabetes, I highly recommend adding cinnamon, whether to baked goods, coffee or something else you cook. If you don’t like cinnamon for some reason, you can drink diluted Apple Cider Vinegar after you eat something sugary. Apple Cider Vinegar has been shown to lower the glycemic response after high carb meals and high sugar foods. ( I realize that people claim Apple Cider Vinegar cures everything, but this mechanism of action has actually been studied and documented in randomized controlled trials. You can read more about Apple Cider Vinegar here.)
If I ask you what the healthiest sugar is, and you say artificial sweeteners, I’ll tell you that you’re wrong, or at least, that the evidence doesn’t support you. I avoid artificial sweeteners, because they make me moody and make me bloat. Many holistic doctors suggest avoiding them as they can make irritability, depression and bipolar disorder worse. Studies suggests that artificial sweeteners alter the gut microbiota, which potentially is a mechanism for mental disease. As discussed in a previous blog, alterations in the gut microbiome have been linked to mental illness. I also find formaldehyde, one of the byproducts of the popular artificial sweetener aspartame, to be especially toxic and unappealing. And as someone who used to chew a lot of sugarless gum, I’ve noticed that all artificial sweeteners make me bloat. Stevia, a natural sweetener from a plant, has become very popular and is said to be 300 times sweeter than sugar. I don’t like the taste at all, and its ingredient, Rebaudioside A, has also been shown to alter the microbiome and induce insulin release. Just because something is “natural” doesn’t mean it’s good for you. These sweeteners were once considered metabolically inert, but I think as we learn more and more about the microbiome, we’ll continually prove that premise false.
Artificial nor natural sweeteners by themselves are shown to decrease weight or improve body fat composition, especially in the long-term. One randomized study in humans showed that, compared to sugar, artificial sweeteners had no impact on post-meal glucose or insulin levels, nor did they reduce calorie consumption. In a 12 week long randomized trial, Aspartame was not shown to reduce weight nor appetite, nor was it shown to increase weight or appetite. It didn’t do anything significant. A randomized trial in obese, diabetic patients showed that Stevia, often marketed as the healthiest sugar, did not significantly reduce post-meal blood glucose or insulin when compared to regular sugar. A randomized controlled trial in rats showed that natural and artificial sweeteners did not result in a significant reduction in appetite nor weight loss when compared to regular sugar.
We all know that guy or gal who eats horrifically but washes everything down with a diet coke. Am I right? Artificial sweeteners have also been linked to weight gain. A randomized controlled trial compared obese women who drank artificially-sweetened drinks to women who replaced artificially-sweetened drinks with water, and after 18 months, the women who drank water lost more weight and showed improved insulin-resistance. Other analyses, including this review, show that low-calorie sweeteners are associated with weight gain, diabetes and metabolic issues, but if combined with cognitive and behavioral interventions, may result in weight loss. I think the end result of the cognitive and behavioral interventions is to make people more aware of their eating patterns and when they are doing things like eating their feelings or eating their stress away. It’s never a bad thing to be more mindful of what you eat, when you eat, how you feel when you eat, and how your daily events and behaviors relate to your weight, energy level and overall health status. In fact, “mindful eating” and “mindful living” might be the most natural, effective ways to achieve optimal weight and, most importantly, optimal health. I’ve repeatedly written this over and over again in this blog, but mindful eating was the ONLY thing that helped me overcome bulimia and get on track to a healthier lifestyle.
What sugar do you use? Feel free to post below.
Thanks for reading! If you haven’t checked out my podcast, Causes or Cures, yet, please do! There are a lot of interesting people on it, talking about timely health and wellness topics.
Other topics in my blog that may interest you:
A Supplement for Bulimia AND OCD: Here is what the evidence says
Natural, evidence-based ways to prevent Bloat.
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High on Placebos Organic Tote Bag artwork by me.
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