Hold the sugar, keep the sweetness?

Sugar and sweet foods are part of everyday life for many people. And yet, excess sugar and calories contribute to the detrimental effects of chronic conditions like obesity and type 2 diabetes, which take a substantial toll on individuals, communities and our health care system. As we confront the realities of how diet impacts health, a broad swath of the U.S. population is making efforts to improve their daily food choices.

By tracking consumer views on dietary trends and food choices in the annual Food & Health Survey, the International Food Information Council (IFIC) Foundation has documented public opinion shifts on dietary trends, purchasing drivers and consumer perceptions around sugar and sugar alternatives.

The 2019 iteration of the Survey indicated that 3 out of 4 respondents believe they’re following a better diet than they did 10 years ago, and the number one way they say they’ve changed their diet is by limiting sugar intake. In fact, 80% of respondents state that they’re trying to limit or avoid sugars, with the top reported sugar reduction strategy being drinking water instead of caloric drinks and eliminating certain foods and beverages from their diet. A smaller percentage—around 20%—claim they are now using low-calorie sweeteners instead of sugar, switching from full-calorie drinks to low- and no-calorie options, or choosing sugar-free options when available. All this is to say that people are trying to consume less sugar through a variety of different means, and this effort seems to be paying off; the 2013-2014 National Health and Nutrition Examination Survey (NHANES) indicates that consumption of added sugars as a percentage of total calories has decreased over the past two decades, although mean energy intake from added sugars still remains above national targets.

With a few exceptions, the types of sugars consumed are nutritionally equivalent—each provides about four calories per gram. Nonetheless, certain caloric sweeteners have had the luxury of being thought of as “healthier” than table sugar, also known as sucrose. This healthy halo extends to calorie-containing “natural” sweeteners like agave, honey, maple syrup and coconut sugar, which may provide trace amounts of nutrients like vitamins and minerals. Unfortunately, the beneficial components contained in these foods are far outweighed by the calories and grams of sugar they provide.

One exception to this is allulose, a rare, naturally-occurring sugar that has gained traction in recent years after achieving Generally Recognized As Safe (GRAS) status in three separate notifications in 2012, 2014 and 2017. In April 2019, FDA exempted allulose from “Total Sugars” and/or “Added Sugars” on the Nutrition Facts label, instead allowing it to be listed under the grams of “Total Carbohydrate.” This exemption is due to its lower caloric value and impact on blood sugar and dental caries compared to added sugars.

Sugar alcohols, a type of carbohydrate with a chemical structure that partially resembles sugar and partially resembles alcohol, provide another option for calorie and sugar reduction. They are incompletely absorbed and metabolized by the body, so they consequently contribute fewer calories than most sugars. However, total daily intake of some types of sugar alcohols, like sorbitol and mannitol, should be limited due to their potential to cause gastrointestinal discomfort and laxative effects.

Low- or no-calorie sweeteners (LNCS) provide yet another alternative to caloric sweeteners, lowering added sugar intake while still providing the satisfaction of enjoying something sweet without the potential side effects associated with some sugar alcohols. When added to foods and beverages, they reduce or completely eliminate the calories and sugars and do not cause an increase in blood sugar. The 2019 Food & Health Survey indicated that 1 in 3 people primarily use LNCS to sweeten foods, as opposed to sugar or not using any type of sweetener. Primary reasons for choosing LNCS include a desire to consume less sugar, to lose weight, consume fewer calories and manage diabetes or blood sugar.

In the U.S., there are several “high-intensity” (meaning that they are many times sweeter than sugar) LNCS permitted for use: aspartame, sucralose, acesulfame potassium (ace-K), steviol glycosides (often referred to as stevia sweeteners), monk fruit extracts, saccharin, neotame and advantame. Two of these, stevia and monk fruit sweeteners, are derived from plant sources and are often thought of as “natural” sweeteners. With 38 percent of Food & Health Survey respondents indicating that they buy products because they are advertised as “natural” on the label, this distinction may influence purchasing decisions for calorie- and sugar-conscious consumers who are still seeking sweetness.

Despite their lack of calories and effect on blood sugar, some consumers show skepticism over the healthfulness and safety of LNCS—even those thought of as “natural”. Over 70 percent of Food & Health Survey respondents who do not use LNCS to sweeten a food or beverage state that they abstain because they think LNCS are unhealthy, and nearly 3 in 10 say they have been advised to avoid them by a health care professional. However, these concerns are not borne out by safety regulations in the U.S. and around the world – the U.S. Food and Drug Administration, European Food Safety Authority and other international health agencies have repeatedly reviewed and emphasized the safety of LNCS currently on the market.

While diet trends may come and go, IFIC Foundation consumer research indicates that an interest and effort toward lowering sugar intake isn’t just a passing fad. Sugar intake data from NHANES support this trend. The wide spectrum of available sugar alternatives and reduced-sugar products on the market today gives people the opportunity to choose what best fits their needs, providing them with the ability to control their sugar intake without having to sacrifice sweetness. Such options fill a critical need that shows no sign of slowing. Accordingly, the IFIC Foundation’s focus on addressing consumer questions and knowledge gaps fills a critical need for effective communications around sugars and alternatives that prioritizes evidence over anecdote.

Learn more about natural sweeteners from Ali and others during the “The Shift from Sugar to Natural Sweeteners” session on Saturday, Oct. 19 at 8:30am, at SupplySide West in Las Vegas.

Ali Webster, Ph.D., RD, is the associate director for Nutrition Communications at the International Food Information Council Foundation. In this role, she is responsible for developing and managing nutrition science-focused communication programs for consumers and health professionals. Webster holds a doctorate in nutrition and a bachelor’s in nutrition science, both from the University of Minnesota, and completed her dietetic internship at the University of Minnesota Medical Center.