Alternatives to Sugar?

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White sugar is the commonest sweetener used in our daily life. From morning coffees to evening tea, sugar plays a very crucial role in our cuisine. But the sweet lifestyle is also the main reason for increase in obesity, diabetes and other health problems among us.

"brown sugar is not healthier than white sugar, as the mineral content is very little to have any beneficial effect"

Sugar is made out of sugar beet, a type of plant which contains a thick syrup that’s converted to sugar. Refinery processes remove molasses (a dark brown by product) and the thick dark syrup is converted to white sugar. If the molasses is left in the mixture, then brown sugars are made.  

Brown Sugar VS White Sugar

The difference between White Sugar and Brown Sugar is the refinery process involved as mentioned. Brown sugar has some molasses left, while white sugar is well refined.

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In terms of nutrient content, brown sugar has more minerals compared to white sugar. Thanks to molasses it has iron, magnesium and other mineral whereas white sugar has none. Calorie value of both types of sugar are the same. So, one teaspoon of white sugar gives same amount of energy as white sugar, and increases blood sugar level equally.

Essentially, brown sugar is not healthier than white sugar, as the mineral content is very little to have any beneficial effect.

Alternatives to sugar

Honey

Is honey a healthier alternative to sugar?

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The short answer is no. 

Honey contains sugar too. Before the creation of sugar from sugar beets or sugarcane, honey was used as sweeteners. The calorie value of honey is almost similar to sugar, if not more depending on the manufacturing process. But honey also contains many vitamins especially Vitamin B and minerals such as calcium.

"The calorie value of honey is almost similar to sugar, if not more depending on the manufacturing process"

So, adding honey instead of sugar might give the additional benefits of vitamins and minerals but it does not make much difference in terms of calorie and the rise in blood sugar level. 

Thus honey is not a good alternative for people with diabetes or those who want to prevent diabetes.

Artificial sugar

Artificial sugars such as saccharin and aspartame (Equal brand) are commonly used as sugar alternatives. How does it work?

Artificial sugars are not absorbed in our gut, thus it carries zero calorie. It does not cause an increase in blood sugar level.

Aspartame has been heavily used until studies suggested the linkage between artificial sugars and cancers, especially bladder cancer and blood cancers such as leukemia. Association of bladder cancer in rats with saccharin (a type of artificial sugar) was first reported in 1978 by Reuber MD. 

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He reported that high dose of saccharin leads to bladder cancer in rats. In response to this, the US Congress mandated that saccharin carries a hazard label stating it’s possibly hazardous for consumption at that time.

But many other studies fail to prove the same among humans. It was found that rats respond to chemicals in the urine differently than human, so humans have no risk of bladder cancer when saccharin is consumed.

What about Aspartame? 

Heavy artificial sweetener use (>1680 mg per day) leads to an increased relative risk of 1.3 for bladder cancer in humans

Aspartame is the common artificial sugar used in brands like Equal. Aspartame has been linked with blood cancers previously but many subsequent studies have failed proof that claim.  A review on artificial sugars in Annals of Oncology concluded that there is no risk of cancer by using Aspartame or Saccharin as artificial sugar. 

But the author also warned that “Heavy artificial sweetener use (>1680 mg per day) leads to an increased relative risk of 1.3 for bladder cancer in humans” but no specific artificial sweetener can be identified as the culprit. For comparison, one packet of Equal brand artificial sugar contains 1000mg of sugar. FDA recommends us not to take more than 40mg/kg of aspartame.

According to American Cancer Society, after looking at several strong researches, people who drink aspartame containing beverages did not have increased risk of cancers.

So, the studies are controversial. Most say it’s harmless, some say it’s harmful.

But are they beneficial? Not many scientists agree that it is. For example, Swithers SE in Appetite journal argue that artificial sugar is not the answer to reducing the prevalence of obesity among children. 

He claims that artificial sweeteners will lead to overeating as people won’t be worried about adverse effects of sweetened food or beverage anymore.  A team of scientists recently discovered that artificial sweeteners can actually lead to diabetes by causing changes to the bacteria that live in our digestive tracts. 

This is supported by Taylor Feehley from University of Chicago, who wrote a commentary piece on this issue. She mentions that “artificial sugar consumption correlated with disease markers linked to obesity, such as elevated fasting blood-glucose levels and impaired glucose tolerance”. Both are related to diabetes mellitus.

In conclusion, there is no evidence based healthier alternatives to sugar. Honey and brown sugar are often called as natural sweeteners and people assume it’s healthier than white sugar. It is not. Artificial sweeteners on the other hand do provide zero calorie sweetness but it’s safety is very controversial, till today.

The best method would be to reduce the amount of sugar in our food and be mindful of what we consume. We must keep in mind high carbohydrate diet also be converted to sugar in our body. So, even if we go sugar-free, we still need to keep in mind on how much carbohydrate we consume per day.

For further reading

1.       FDA Article on Artificial sweeteners

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm397711.htm

2.       Review on Annals of Oncology on artificial sweeteners

http://annonc.oxfordjournals.org/content/15/10/1460.full

3.       Artificial Sweeteners linked to change in gut microbiota

http://www.ncbi.nlm.nih.gov/pubmed/25231862

4.       Artificial Sugars and Childhood obesity

http://www.ncbi.nlm.nih.gov/pubmed/25828597

5.       American Cancer Society on Aspartame

http://www.cancer.org/cancer/cancercauses/othercarcinogens/athome/aspartame

6.       Commentary on artificial sweetener

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4449731/

Anti-diabetic properties of bittermelon

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Bitter melon or bitter gourd originated from India and was introduced to many parts of the world. It is widely known for its medicinal benefits. Let's see the top 3 scientifically proven benefits of bitter gourd or  "Momordica charantia". 

 

1.     Acts as a natural anti-diabetic

Two studies have proven that bitter gourd helps in diabetes mellitus by working the same way as diabetic medications. 

Study by Chandru S et al compared the efficacy of bitter gourd juice and glitazone (a type of diabetic drug) in diabetic rats. In animal studies, it is shown that bitter gourd juice had reduction in blood sugar and was comparable with glitazone. 

Authors of this study postulate that bitter gourd juice works by increasing insulin sensitivity and causing the pancreas to secrete more insulin. 

"Bitter gourd juice proves to reduce blood sugar level"

Study by Rahman IU et al also reported similar findings among patients with Type 2 Diabetes Mellitus. 95 patients in this study took 2g (60mls) or 4g(120mls) of bitter gourd juice daily for 10 weeks. Both groups had blood sugar reduction. Their HBA1C level dropped along with fasting blood glucose level. 

Fuangchan A et al studied the effect of bitter melon and compared it to Metformin 1g, a standard first line medication for diabetes mellitus type 2. They proved that bitter melon juice has blood sugar reducing properties but not as strong as Metformin. This suggests that bitter melon juice can be used as supplement for sugar control in people with diabetes.

2. Added values in people with complications of diabetes

Raish M et al studied the effects of bitter melon juice  on the progression of diabetic kidney disease. Normally in patients with uncontrolled diabetes, many complications develop over time. 

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Kidney failure is one of it, and it causes many patients to be dependent on dialysis machine for the rest of their life. Other than that some patients develop nerve problems, in which patients will feel numbness and tingling over their feet. Some may even lose balance.

In his study, it was shown that bitter melon given by mouth improves kidney function in rats. Scientists suggest that bitter melon provides kidney protection by reducing the high sugar level and also by reducing the oxidative damages to kidney. But more research will be needed to find out if bitter gourd will be effective in patients with complications.  

Study by Kim JW also proves that kidney functions improves with bitter melon juice . This study

focuses mainly on combined effect of oats and bitter melon on sugar level and diabetic nephropathy. But significant reduce in blood sugar and protective effects on kidneys are shown even in rats that were only treated with bitter melon juice. But again, this study did not talk on those with established kidney disease. 

From preliminary information available largely from animal studies, it appear that bitter melon juice helps in reduction of blood sugar level and prevention of diabetic kidney disease. Bitter melon juice has anti-oxidant properties and anti-diabetic properties which help to achieve this. 

How to prepare fresh bitter melon juice

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Use unripe fresh bitter melon

Wash thoroughly, cut the melon and remove the seeds

 Use electric juicer to extract the juice

This method is used in the study by scientists Rahman et al.  

They prepared the bitter melon juice in this manner, and proceeded to freeze it to make it into powder form but it' s not necessary for personal use. 

They discovered anti-diabetic benefits at 2g of bitter gourd juice powders. 2g of powder is equivalent to 60mls of bitter gourd juice. 

For further reading:

Lower hypoglycemic but higher antiatherogenic effects of bitter melon than glibenclamide in type 2 diabetic patients.

Hypoglycemic effect of bitter melon compared with metformin in newly diagnosed type 2  diabetes patients

Synergic effects of bitter melon and β-Glucan composition on STZ-induced rat diabetes and its complications.

Momordica charantia polysaccharides mitigate the progression of STZ induced diabetic nephropathy in rats.

Evaluation of Protein Kinase Cβ and PPARγ Activity in Diabetic Rats Supplemented with Momordica charantia