Oklahoma Cooperative Extension Service T-3157

Dietary Sugar
and
Alternative Sweeteners
Janice R. Hermann, PhD, RD/LD
Nutrition Education Specialist Oklahoma Cooperative Extension Fact Sheets
are also available on our website at:
Simple Sugars [Link]
versus Complex Carbohydrates
The term carbohydrates includes monosaccharides and
disaccharides, which are sometimes called simple sugars; corn syrup, honey, syrups, crystalline fructose, lactose, invert
and polysaccharides, which are sometimes called complex sugars, glucose, maltose, and concentrated fruit juices.
carbohydrates or starch, and fiber. Sugars have several important roles in foods. For example,
The term monosaccharide means one sugar molecule. they give foods sweetness. Besides improving the flavor of
Foods contain three common monosaccharides: foods, they improve the texture and color of baked goods.
• Glucose Sugar also helps to thicken, firm, or preserve foods such as
• Fructose puddings, jams, and jellies.
• Galactose The main function of sugars (and all carbohydrates) in
the body is to provide energy. Energy does indeed, “keep us
The term disaccharide means two sugar molecules. Two going.” It is necessary for good health, growth, and proper
monosaccharides combine to form a disaccharide. Three im- body function and activity. Foods in the USDA MyPyramid
portant disaccharides are: food groups that contain natural sugars supply energy and
• Maltose = Glucose + Glucose also provide important vitamins, minerals, protein, and fiber.
• Sucrose = Glucose + Fructose Sugar by itself and foods high in sugar, supply calories, but
• Lactose = Glucose + Galactose do not provide the added bonus of other nutrients.

The term polysaccharide means many sugar molecules. Intake of Added Sugar
Dietary polysaccharides contain hundreds of sugar molecules The Dietary Guidelines for Americans and USDA My-
and include: Pyramid recommend people choose and prepare foods and
• Complex carbohydrates or starch beverages with little added sugars or caloric sweeteners.
• Fiber Several national food intake surveys have reported that
added sugar intake has increased. The largest source of added
Simple sugars and complex carbohydrates or starches sugar comes from regular soft drinks, which accounted for 2/3
occur naturally in many foods that also supply other nutrients, of intake. Other sources were table sugars, syrups, sweets,
including milk, fruits, vegetables, breads, cereals, and grains. sweetened grains, regular fruitades, and milk products.
Sugars also are added to foods during processing and prepara-
tion. Most sugars found naturally in foods or added to foods are
disaccharides, or two sugar molecules. The body cannot tell Health Effects of Sugars
the difference between naturally occurring and added sugars
because they are chemically the same. Nutritional Deficiencies
Our bodies can only absorb monosaccharides, or single In excess, sugar can contribute to nutritional deficiencies
sugar molecules. During digestion enzymes break down disac- by supplying calories without providing nutrients. Bakery items,
charides into two monosaccharides, which can be absorbed candies, and soft drinks provide calories with few nutrients.
by the body. Digestive enzymes also break down complex Honey does provide a few vitamins and minerals, but the
carbohydrates or starches, which contain hundreds of sugar amounts are very small. On the other hand, grains, vegetables,
molecules, into monosaccharides or single sugar molecules fruits, and dairy foods contain natural sugars and starches, but
for absorption. The body cannot tell the difference between also protein, fiber, vitamins, and minerals. Sugar can contribute
monosaccharides that come from the breakdown of a simple to nutrient deficiencies only by displacing nutrients.
sugar or from a complex carbohydrate. For nutrition sake the appropriate attitude to take is not
that sugars are “bad” and must be avoided, but that nutrient
Caloric Sweeteners dense foods must come first. The goal is good nutrition and
moderation. The amount of sugar a person can afford depends
Caloric sweeteners include many regular sugars includ-
on how many calories are available beyond those needed for
ing: refined sugars, corn sweeteners, dextrose, high fructose
nutrients.

Division of Agricultural Sciences and Natural Resources • Oklahoma State University

Tooth Decay • Sugar Free: Less than 0.5 g sugar/serving.
In excess, both sugars and starches can contribute to • Reduced Sugar: The sugar content of the product has
tooth decay. Both sugars and starches begin breaking down been reduced by at least 25%.
to glucose in the mouth. Bacteria in the mouth ferment sugars • No Sugar Added: No sugar or any other ingredient con-
and in the process produce an acid that can dissolve tooth taining sugar added to product.
enamel. Many factors are involved such as how long foods
stay on the teeth, how often foods are eaten, and dental hy- Healthy Choices to Lower Sugar
giene. Overall, the risk of dental caries increases with intake
of nutritive sweeteners; however, sugars and carbohydrates Grain Group
do not work independently from other factors such as oral
• Many commercial bakery items are high in sugar. Look at
hygiene and fluoridation. For most people good oral hygiene
the Nutrition Facts Panel to compare the sugar content
will prevent dental caries.
of bakery items.
Diabetes/Hypoglycemia • Ready-to-eat cereals vary in sugar content. Read the
Nutrition Facts Panel to compare the sugar content of
The influence of food on blood glucose has led to the over cereals. The grams of sugar per serving is both sugar
simplification that food controls blood glucose concentrations. added by the manufacturer and naturally occurring sugar
Foods do not, the body does. In some people, blood glucose in fruits such as raisins and dates.
controls fail. When this occurs diabetes or hypoglycemia can • Add fresh fruit or raisins to plain ready-to-eat breakfast
develop. Glucose may be modified as part of the treatment, cereals instead of sugar.
but hormonal regulation or obesity (in the case of type 2 • Use yeast breads instead of sweets for the holidays. There
diabetes) is the cause not glucose. is a variety to choose from and they use less sugar than
traditional holiday treats.
Hyperactivity or Misbehavior in Children
• Gradually decrease sugar in recipes by one-quarter to
Controlled studies have failed to show an adverse rela- one-third the amount called for in baked items as long
tionship between sugar and hyperactivity or misbehavior in as the product is acceptable. Bring out the sweetness
children, even in children who by report are sensitive to sugar. with vanilla, lemon, or almond extract.
The mechanism by which carbohydrate, including sugars, may • Use fresh fruit toppings or unsweetened applesauce for
affect mood is uncertain, but may involve the production and pancakes, waffles, and French toast instead of syrup or
release of serotonin in the brain. High carbohydrate intake honey.
stimulates the brain production of serotonin, which actually
can make a person sleepy. Fruit and Vegetable Groups
• Fruits canned in light syrup or natural juices have less
Heart Disease
sugar than fruits canned in heavy syrup.
Usual intakes of sugar do not increase blood triglycerides • Use fruits instead of sugar to sweeten other foods such
in most persons, provided calories are in balance. However, as breads, cereals, desserts, and main dishes.
a small percent of people are carbohydrate sensitive. These
people respond to high amounts of sugar or carbohydrate with Meat and Beans Group
abnormally high insulin, which promotes triglyceride forma- • Try making your own breading and coating mixes for meat
tion, which can increase heart disease risk. However, it is and poultry. Some commercially prepared ones contain
important to keep the effects of sugars in perspective. Other more than 50 percent sugar.
dietary factors such as total fat, saturated fat, and obesity • Grind your own peanut butter (many grocery stores now
have a much stronger association with heart disease than have machines for this) or look for peanut butter without
sugar intake. added sugar.
Obesity Milk Group
Obesity is a complex issue and cannot be attributed to • Choose yogurts with non-caloric sweeteners.
one factor. Excess body fat arises from energy imbalance • Choose frozen dairy desserts, including ice creams, frozen
caused by taking in too many calories and by using too few. yogurts, and ice milks with non-caloric sweeteners.
Because sugar adds calories to foods and beverages, it has
been suggested that sugar has a role in causing obesity. Re- Fats, Oils, and Sweets
search does not support a direct connection between sugar
• If you are trying to lower the sugar in your diet, the an-
and carbohydrate intake with obesity, unless excess intake of
swer is not to cut out all foods such as milk, fruits, and
sugar containing foods leads to excess calories and weight
vegetables that naturally contain sugar. The body needs
gain.
nutrients found in these foods. The better place to start
Sugar on the Food Label cutting sugar from the diet is from foods that contain large
amounts of added sugar, but are not sources of other
Sugars added to foods are listed in the food ingredient list. nutrients.
The Nutrition Facts Panel on the food label lists the grams of • Ingredient labels provide information on sugar content.
added sugar per serving of food under Total Carbohydrates. Sugar goes by a number of names, so look for the follow-
The following terms are used on food labels to describe the ing terms on the ingredient list: sugar, sucrose, powdered
sugar content of foods:

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 sugar, maple sugar, brown sugar, glucose, dextrose, corn Large amounts can cause gas, abdominal discomfort, and
syrup, fructose, levulose, high fructose corn syrup, honey, diarrhea due to fermentation by intestinal bacteria (similar to
milk sugar, lactose, or maltose. lactose intolerance). For this reason, food products containing
sugar alcohols carry a label “Excess consumption may have
Beverages a laxative effect.”
• Substitute 1/2 fruit juice and 1/2 club soda for soft drinks, The real benefit of using sugar alcohols is that they do
punches, and other drinks. not contribute to dental caries. Bacteria in the mouth can not
• Try unsweetened tea with a twist of lemon, lime, or a sprig metabolize sugar alcohols as rapidly as sugar.
of fresh mint.
• Try water, mineral water, or club soda with a slice of fresh
Non-Caloric Sweeteners
lime or lemon.
• Reduce consumption of soft drinks containing sugar. Non-caloric sweeteners are used in many foods. Most
Instead choose fruit juices, unsweetened iced tea, but- non-caloric sweeteners do not provide significant calories;
termilk, and low-fat milk. however, foods containing non-caloric sweeteners may not
• Try unsweetened coffee with a stick of cinnamon or an always be lower in calories than similar products that contain
orange slice. sugars.
The FDA has approved four non-caloric sweeteners; sac-
Snacks charin, aspartame, acesulfame K, and sucralose. The body
• Substitute popcorn, raw vegetables, and fresh fruits for does not metabolize saccharin, acesulfame K, or sucralose,
sweet snacks. Make these healthful foods easy to find they pass through the body unchanged. The body does digest
and eat. Prepare them ahead of time and store in the aspartame, so technically it is a caloric sweetener, but the
refrigerator. Store in an airtight plastic container labeled calories provided are insignificant. Three other non-caloric
“snack foods.” sweeteners have petitioned FDA and are awaiting approval;
• Make your own dips, since commercially prepared ones cyclamate, alitame, and neotame.
often contain sugar. Then use raw vegetables as dippers • Saccharin. Used around the world since the turn of the
in place of snack crackers, which often contain sugar. century. It is 300 times sweeter than sugar. It is very stable
in foods, but has a bitter aftertaste. The common brand
Condiments name is Sweet and Low.
• Aspartame. Aspartame is 180 times sweeter than sugar. It
• Try making your own salad dressing. Many commercial
contains the two amino acids, phenylalanine and aspartic
dressings, both bottled and packaged mixes, contain a
acid. It is an excellent sweetener with no aftertaste. Aspar-
large amount of sugar.
tame can not be used in baking, because it breaks down
• Try coriander, basil, nutmeg, cinnamon, and ginger for a
with heat. Persons with PKU (phenylketonuria) should
light, sweet taste.
avoid its use. The common brand names are Nutra-Sweet
• Read labels on bottled sauces and packaged seasoning
and Equal.
mixes. You can easily make a similar version at home
• Acesulfame-K. Acesulfame-K is 200 times sweeter than
without the added sugar.
sugar. Acesulfame K is stable and does not break down
in cooking. The common brand name is Sunette.
Sugar Alcohols • Sucralose. Sucralose is about 600 times sweeter than
Sugar alcohols provide calories, although they provide sugar. Sucralose is extremely stable and does not break
fewer calories than regular sugars because they are not com- down in cooking. The common brand name is Splenda.
pletely absorbed. This allows products, which contain sugar
alcohols to be labeled “sugar free,” or “reduced calorie.” Prod- References
ucts may claim to be “sugar free” but this does not mean they
United States Department of Agriculture. MyPyramid: Steps to a
are “calorie free.”
Healthier You. Accessed at [Link]. 2005
Sugar alcohols occur naturally in fruits and vegetables.
United States Department of Agriculture. 2005 Dietary
The body absorbs sugar alcohols slowly and incompletely.
Guidelines for Americans. Accessed at: [Link]/
As a result they enter the blood stream slower than natural
dietaryguidelines/dga2005.
sugars. Because of the incomplete absorption sugar alcohols
Whitney, E.N. and Rolfes, S.R. Understanding Nutrition, 10th
produce a lower blood glucose response than sugars. However,
ed. 2005. Thomson/Wadsworth Publishing Co., Belmont,
side effects also occur because of the incomplete absorption.
CA.

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Issued in furtherance of Cooperative Extension work, acts of May 8 and June 30, 1914, in cooperation with the U.S. Department of Agriculture, Robert E. Whitson, Director of Cooperative Ex-
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