Pros and Cons of Stevia and Other Sugar Substitutes

Low-calorie sweeteners and sugar substitutes (also known as artificial sweeteners) are often considered healthier alternatives to sugar, and some are promoted to lower blood sugar and blood pressure, as well as lose weight, but some of these claims are weak, and many of these sugar substitutes can cause side effects. In addition, the products that contain them often contain significant amounts of other sugar-substitutes that labels don't clearly make evident.

The sweeteners fall mainly into three categories: High-intensity sweeteners that have no calories, such as stevia and monk fruit, as well as aspartame, saccharin, and sucralose (since such small amounts are needed, these are often combined with other, bulkier, sweeteners); Low-calorie sweeteners such as erythritol and xylitol as well as kabocha extract, allulose, lucuma, inulin, polydextrose and sorbitol; and sugar alternatives such as coconut sugar, date syrup, yacon syrup, glycerol and trehalose.

The pros and cons of using substitutes for regular, table sugar are summarized in the table below. More information about each specific sweetener, including safety concerns and discussions of brands, are in the full article.

Pros and Cons of Sugar Substitutes

High-Intensity, No Calorie Sweeteners:

Aspartame

• 200 times sweeter than sugar

• Should be avoided by people with PKU

• Linked with increased cancer risk

• Not heat stable

Monk fruit

• 100 to 250 times sweeter than sugar

• No reported side effects

• Often combined with low-calorie sweeteners such as erythritol

• Extracts vary widely in sweetness

Saccharin

• 200 to 700 times sweeter than sugar

• Linked to bladder cancer in some studies

Stevia

• Up to 400 times sweeter than sugar

• Seems to satisfy hunger

• Not suitable for baking or fermentation

• May cause mild side effects

• Might adversely affect the kidneys

Sucralose

• 600 times sweeter than sugar

• Heat stable

• Reduced glucose tolerance in humans

• Increased blood cancer risk in animal research

Low-Calorie Sweeteners:

Allulose

• Only 10% of the calories per gram as sugar

• Does not promote tooth decay

• Less sweet than sugar

• May cause GI distress

• May require adjustment to baking temperature and time when used for cooking

Erythritol

• Only 5% of the calories per gram as sugar

• Does not promote tooth decay

• Slightly less sweet than sugar

• May cause GI distress

• Linked with increased risk of heart-related adverse events (research underway)

Inulin

• About 60% fewer calories than sugar

• Only about 1/3 as sweet as sugar

• May cause GI distress

• May not be suitable for people at risk for, or with early-stage liver disease

Kabocha extract

• 40% fewer calories than sugar

• Is primarily xylitol, which can cause gas in some people and has other potential health concerns

Lucuma

• Fewer calories per tablespoon compared to sugar

• Contains small amounts of fiber and nutrients

• Only half as sweet as sugar, so you'd need twice as much

• No conclusive evidence of health benefits

Polydextrose

• 75% fewer calories than sugar

• Tastes tart, not sweet

• Can have laxative effects

Sorbitol

• 35% fewer calories than sugar

• Does not promote tooth decay

• Only about 60% as sweet as sugar

• May be less beneficial for cavity prevention than xylitol

• May cause abdominal pain at moderate doses and laxative effects at high doses

Xylitol

• 40% fewer calories than sugar

• Does not promote tooth decay

• Superior for baking compared to other sweeteners

• Slightly less sweet than table sugar

• Toxic to dogs

• Might increase clot risk in people (research underway)

Alternative Sugars:

Coconut sugar

• Slightly lower glycemic index than sugar

• Contains a small amount of nutrients

• Is mainly sugar

Date syrup

• Slightly lower glycemic index than sugar

• Is mainly sugar

Glycerol

• Slightly less sweet than sugar

• Contributes equal calories as sugar

Trehalose

• Causes a slower rise in blood sugar and reduced insulin secretion after consumption compared to glucose

• Less sweet than sugar

• Contributes calories equal to sugar

• May cause bloating, flatulence and diarrhea at high doses

• Some people may be intolerant

Yacon syrup

• Contains small amounts of fiber and nutrients

• Mixed evidence of benefit for weight loss

• Is mainly sugar

• May cause GI discomfort in large doses

Brands discussed in the full article include Alcohol-Free Stevia (NuNaturals), Allulose (Splenda), Allulose Zero Calorie Sweetener (Wholesome), BetterStevia (NOW Foods), Birch Xylitol Sweetener (Health Garden), BochaSweet, Great Value Stevia (from Walmart), Inulin Prebiotic Fiber Sweetener (It's Just), Lucuma Powder (Terrasoul Superfoods), Lucuma Powder (Zint), Monk Fruit Extract (It's Just), Monk Fruit in the Raw (Cumberland Packing Corp.), Monk Fruit Sweetener (Lakanto), Monk Fruit Sweetener (Llinea), Monk Fruit Sweetener (NuNaturals), Organic Coconut Palm Sugar (BetterBody Foods), Organic Coconut Sugar (Bob's Red Mill), Organic Coconut Sugar (MADHAVA), Organic Coconut Sugar (Terrasoul Superfoods), Organic Stevia (Micro Ingredients), Organic Stevia Extract (Trader Joe's), Pure Birch Xylitol (Morning Pep), PureVia (Pepsico and Whole Earth Sweetener Company), RxSugar (Nutrishus Brands), Simply Stevia (Stevita), Sweet Additions Stevia (from Aldi stores), Stevia Extract (BulkSuplements.com), Stevia in the Raw (Cumberland Packing Corp.), Swerve (Whole Earth Sweetener Company), Truvia (Cargill), and XyloSweet (Xlear), as well as various other products by NOW Foods, NuNaturals, Pyure, Splenda, Stevia Select and SweetLeaf.