David L. Katz, MD
Photo: Mackenzie Stroh
Q: What's the best type of sugar or sugar substitute to use for cooking and coffee, and to look for in diet drinks? Is it true that brown sugar is better than white?
— Shari Glickman, East Meadow, New York

A: White sugar, usually in the form of granulated sugar, is purified sucrose from sugar cane or beets, the crystals of which are naturally white. Brown sugar is, if you will, white sugar's rustic cousin. It can be less refined and contains some of the sugar cane's molasses. Nutritionally, the differences between white and brown sugar are trivial. Brown sugar can pack tighter than white, so a cup could have 829 calories versus 774 for white. The molasses in brown sugar contains calcium, iron, and potassium, but not enough to make it a significant source.

As for artificial sweeteners, there are several options. Aspartame, marketed as Equal and NutraSweet, is made by linking two amino acids that together taste about 200 times sweeter than sugar. Aspartame contains 13 calories per teaspoon, but a packet contains only four calories. (FDA regulations allow a product to be labeled free of calories if it contains fewer than five calories per standard serving.) Lengthy heating can break down the sweetener, so it's not always suitable for baking. There is ongoing controversy about health risks linked to aspartame, but the FDA has analyzed and dismissed claims that it can cause brain tumors or neurological disorders.

Sucralose, sold as Splenda, is made by adding chlorine atoms to sugar molecules, resulting in a substance 600 times sweeter than the real stuff. It is marketed in the United States as a no-calorie sweetener, but because you can bake with it, you should know that it delivers 96 calories per cup, about one-eighth the calories of sugar. There are about two calories in a teaspoon of Splenda.

Stevia is a sweetener made by purifying extracts from an herb that grows in South America. Stevia is available as a dietary supplement but not a food additive in the United States because of a lack of data regarding its safety. This means you can buy packets to use in your coffee or for baking, but you won't find it already added to packaged foods. Stevia has been widely used in Japan for the past several decades without any apparent adverse effects. It actually has no calories and tastes up to 400 times sweeter than sugar, but it can produce a slightly bitter aftertaste. It won't raise blood sugar, and it may even help stabilize blood sugar levels.

The sweeteners sound like a good idea, but I am not a fan. Some research suggests that they don't ultimately help people lose weight; we tend to make up the calories elsewhere in our diet. I recommend that, instead, you try to reduce your intake of sugar and your preference for sweet-tasting food. First, look carefully for sugar on ingredient lists—you'll see it mostly in the form of high-fructose corn syrup. It turns up in places you don't expect, like salad dressings, chips, bread, and pasta sauces. I believe this stealth sugar increases your desire for sweetness, and when you actually want something sweet, you need more and more to feel satisfied. Eliminate sugar in foods where it doesn't belong and you'll get your sweet tooth under control, reduce calories, eat less overall, and lose weight. And you might consider replacing a portion of the sugar in recipes with nonfat powdered milk. It contains lactose, a mild milk sugar. As for diet drinks, I have a personal favorite—it's called water.

As a reminder, always consult your doctor for medical advice and treatment before starting any program.

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