By: Erin Stair, MD, MPH
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 and 3) no one makes it out of here alive.
I don’t use a lot of sugar, but when I do, I use regular, organically-farmed sugar and add cinnamon to it. Cinnamon helps lower the glycemic index, which means that it helps lower the level of sugar in your bloodstream, and therefore helps lower the level of insulin. In randomized controlled trials, cinnamon has also been shown to improve BMI, lower body fat and lower visceral fat. If you prefer regular ol’ 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.
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. 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, they 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. A randomized trial in obese, diabetic patients showed that stevia 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.
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. 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 every-day 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 optimal weight and, most importantly, optimal health.