Sugar substitutes are sweeteners that can be used instead of regular table sugar. Types of sugar substitutes include:

Natural sweeteners, such as fruit juices, honey, molasses and maple syrup, which often are promoted as healthier options than sugar or other sugar substitutes.

Artificial sweeteners, such as saccharin and aspartame, which are synthetic sugar substitutes.

Novel sweeteners, such as stevia and tagatose.

Sugar alcohols, which are carbohydrates that occur naturally in certain fruits and vegetables, although they also can be manufactured.

Confused by the variety of sugar substitutes nowadays? Understand the pros and cons to make an informed choice.

The topic of sugar substitutes can be confusing. One problem is that the terminology is often open to interpretation.

Some manufacturers call their sweeteners "natural" even though they're processed or refined. Stevia preparations are one example. And some artificial sweeteners are derived from naturally occurring substances — sucralose comes from sugar.

If you're trying to reduce the sugar and calories in your diet, you may be turning to artificial sweeteners or other sugar substitutes. You aren't alone.

Artificial sweeteners and other sugar substitutes are found in a variety of food and beverages marketed as "sugar-free" or "diet," including soft drinks and baked goods. Just what are all these sweeteners? And what's their role in your diet?

Natural sweeteners are sugar substitutes that are often promoted as healthier options than sugar or other sugar substitutes. But even these "natural sweeteners" often undergo processing and refining.

Natural sweeteners that the FDA recognizes as generally safe include:

Fruit juices and nectars

Honey

Molasses

Maple syrup

Natural sweeteners have a variety of uses both at home and in processed foods. They're sometimes known as "added sugars" because they're added to foods during processing.

Natural sugar substitutes may seem healthier than sugar. But their vitamin and mineral content isn't significantly different. For example, honey and sugar are nutritionally similar, and your body processes both into glucose and fructose.

It's OK to choose a natural sweetener based on how it tastes rather than on its health claims. Just try to use any added sweetener sparingly.

Artificial sweeteners are synthetic sugar substitutes. But they may be derived from naturally occurring substances, such as herbs or sugar itself. Artificial sweeteners are also known as intense sweeteners because they are many times sweeter than sugar. Artificial sweeteners can be attractive alternatives to sugar because they add virtually no calories to your diet. Also, you need only a fraction of artificial sweetener compared with the amount of sugar you would normally use for sweetness.

Some artificial sweeteners can even be used in baking or cooking. Note that certain recipes may need modification because unlike sugar, artificial sweeteners provide no bulk or volume. Check the labels on artificial sweeteners for appropriate home use. Also, certain artificial sweeteners may leave an aftertaste. A different artificial sweetener or a combination may be more appealing.

Artificial sweeteners don't contribute to tooth decay and cavities.

Artificial sweeteners have virtually no calories.

Artificial sweeteners aren't carbohydrates. So unlike sugar, artificial sweeteners generally don't raise blood sugar levels. Ask your doctor or dietitian before using any sugar substitutes if you have diabetes.

Health concerns: Artificial sweeteners have been scrutinized intensely for decades.

Critics of artificial sweeteners say that they cause a variety of health problems, including cancer. That's largely because of studies dating to the 1970s that linked the artificial sweetener saccharin to bladder cancer in laboratory rats. Because of those studies, saccharin once carried a label warning that it may be hazardous to your health.

But according to the National Cancer Institute and other health agencies, there's no sound scientific evidence that any of the artificial sweeteners approved for use in the United States cause cancer or other serious health problems. Numerous studies confirm that artificial sweeteners are generally safe in limited quantities, even for pregnant women. As a result, the warning label for saccharin was dropped.

Artificial sweeteners are regulated by the Food and Drug Administration (FDA) as food additives. They must be reviewed and approved by the FDA before being made available for sale. The FDA has established an acceptable daily intake (ADI) for each artificial sweetener. ADI is the maximum amount considered safe to consume each day over the course of a lifetime. ADIs are set at very conservative levels.

Novel sweeteners are hard to fit into a particular category because of what they're made from and how they're made. Stevia is an example. The FDA has approved highly refined stevia preparations as novel sweeteners but hasn't approved whole-leaf stevia or crude stevia extracts for this use. Tagatose is also considered a novel sweetener because of its chemical structure. Tagatose is a low-carbohydrate sweetener similar to fructose that occurs naturally but is manufactured from the lactose in dairy products.

Sugar alcohols (polyols) are carbohydrates that occur naturally in certain fruits and vegetables — although they can also be manufactured. Despite their name, sugar alcohols aren't alcoholic because they don't contain ethanol, which is found in alcoholic beverages.

Sugar alcohols aren't considered intense sweeteners because they aren't sweeter than sugar. In fact, some are less sweet than sugar. As with artificial sweeteners, the FDA regulates the use of sugar alcohols.

Sugar alcohols contain calories. But they're lower in calories than sugar, making them an attractive alternative.

Sugar alcohols generally aren't used when you prepare food at home. Food labels may use the general term "sugar alcohol" or list the specific name, such as sorbitol. But they're in many processed foods and other products, including chocolate, chewing gum and toothpaste.

When eaten in large amounts, sugar alcohols can have a laxative effect, causing bloating, intestinal gas and diarrhea.

In conclusion: When choosing sugar substitutes, it pays to be a savvy consumer. Artificial sweeteners and sugar substitutes can help with weight management. But they aren't a magic bullet and should be used only in moderation.

<em>Edited from an article written by Laurel Kelly, Mayo Clinic staff; www.mayoclinic.org

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