What is the best sugar substitute?

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Last updated: April 9, 2025View editorial policy

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From the Guidelines

Stevia is the best sugar replacement option, as it is a natural, zero-calorie sweetener that provides sweetness without affecting blood sugar levels. According to the study published in Pediatrics in 2019 1, stevia is one of the FDA-approved nonnutritive sweeteners that is 200-400 times sweeter than sugar. The study also notes that stevia has been accepted as Generally Recognized as Safe (GRAS) and has no known contraindications.

When considering sugar replacements, it's essential to think about the specific needs and uses. For example:

  • For cooking and baking, erythritol is a good option as it measures similarly to sugar and has minimal aftertaste.
  • Monk fruit extract is another excellent option, offering sweetness 100-250 times more potent than sugar without calories or glycemic impact.
  • If concerned about blood sugar management, xylitol has a low glycemic index but contains some calories.
  • For everyday use in beverages, allulose closely mimics sugar's taste and behavior while providing only about 10% of the calories.

It's also important to note that the American Heart Association recommends that the daily intake of calories from added sugars not exceed 10% of total calories 1. Additionally, a study published in Diabetes Care in 2014 notes that the use of nonnutritive sweeteners has the potential to reduce overall calorie and carbohydrate intake if substituted for caloric sweeteners without compensation by intake of additional calories from other food sources 1.

Overall, when replacing sugar, it's crucial to start with small amounts and adjust recipes as needed, as sugar replacements can affect texture and browning in baked goods. Most sugar replacements are safe for most people, but some sugar alcohols like erythritol and xylitol may cause digestive discomfort in larger amounts.

From the Research

Sugar Replacement Options

  • Stevia is a natural sweetener that is 100-300 times sweeter than sucrose, making it a potential replacement for sugar 2, 3.
  • Stevia has been shown to have anti-diabetic properties, reducing oxidative stress and lowering the risk of diabetes 2.
  • Non-nutritive sweeteners, including stevia, have been found to have minimal effects on 24-h glucose profiles and postprandial glucose, insulin, and energy intake 4, 5, 6.

Comparison of Sugar Replacement Options

  • Artificial non-nutritive sweeteners, such as aspartame, have been compared to natural non-nutritive sweeteners, such as stevia and monk fruit, with no significant differences found in their effects on glycaemic control 4, 5, 6.
  • The exchange of a single serving of sucrose-sweetened beverage with a non-nutritive sweetener has been found to have minimal effect on 24-h glucose profiles in healthy males 5.
  • The consumption of calorie-free beverages sweetened with artificial and natural non-nutritive sweeteners has been found to have minimal influences on total daily energy intake, postprandial glucose, and insulin compared to a sucrose-sweetened beverage 6.

Potential Benefits of Stevia

  • Stevia has been found to have antibacterial, anti-inflammatory, hypotensive, antiseptic, diuretic, anti-fertility, and cardiotonic properties, in addition to its hypoglycemic property 3.
  • Stevia has been documented to have good effects on treating skin diseases such as dermatitis, acne, and eczema 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Stevia as a Natural Sweetener: A Review.

Cardiovascular & hematological agents in medicinal chemistry, 2020

Research

Recent evidence for the effects of nonnutritive sweeteners on glycaemic control.

Current opinion in clinical nutrition and metabolic care, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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