Sugar alternatives to help fight diabetes

By Rosemary Black, for MDLinx
Published February 27, 2019

Key Takeaways

Got a sweet tooth? Then dressing up your favorite dishes with a spoonful of sugar is a guilty pleasure you probably indulge in on occasion. So, those who like their sweet treats may be interested to know that products like date sugar and coconut sugar are joining ordinary granulated sugar on store shelves these days. These sweet alternatives are being stirred into drinks, sprinkled on cereals, and folded into a wide variety of foods—and some even have nutrients.

Unfortunately, that doesn’t mean you can eat all the sweets you want.

“While some sweeteners do provide antioxidants, vitamins, and minerals, a large amount would need to be eaten for them to provide substantial amounts,” says registered dietitian nutritionist Kayle Skorupski, MS, RDN-AP, CSG, CNSC, assistant professor of practice, Nutritional Sciences, University of Arizona, Tucson, AZ. “And these sweeteners do increase the overall calorie intake in the diet.”

As a nation, Americans love sugar. These days, the typical American consumes 66 pounds of added sugar in one year.

“Added sugars are not a good thing, and the literature says one of the biggest problems is the amount of added sugar we consume,” explains Wesley McWhorter, MS, RD, LD, CSCS, chef and dietitian, School of Public Health, The University of Texas Health Science Center, Houston, TX. “It’s recommended that you get less than 10% of your daily calories from added sugar. For a 2,000 calorie-a-day-diet, that amounts to about one bottle of soda.”

So, does added sugar provide any benefit?

“The only benefit to adding sugar is enjoyment and pleasure,” says McWhorter. “If you didn’t consume any added sugar, it would be wonderful, but we all enjoy going to a party and eating the cake.”

If you’d like to have your cake and eat it too, here are five sugar alternatives to consider.


Molasses is made when sucrose (sugar) is removed from sugarcane and the nutritious part of the plant is left behind, says Adrienne Raimo, RD, LD, an integrative and functional dietitian and a Columbia University Certified Health Coach, Columbus, OH. “Though molasses is still sweet, it has iron, magnesium, potassium, B vitamins, and more,” she says. “Blackstrap contains a more concentrated form of this nutrition as a result of the triple-boiling process.”

Dark and blackstrap molasses have the highest antioxidant activity of the refined sugar alternatives, Raimo says. “A 2009 study shows that brown sugar, maple syrup, and honey showed intermediate antioxidant activity while white table sugar, agave nectar, and corn syrup showed minimal antioxidant activity,” she says.

The amount of antioxidants in a serving of molasses is about equal to that in a serving of nuts or berries, Skorupski says, but the sweetener weighs in at more than 500 calories while the almonds have 162 calories and the berries have 42 calories.

However, molasses may have another selling point: “Molasses may not spike the blood glucose levels as much after a meal as regular sugar,” says registered dietitian and certified diabetes educator Amy Hess Fischl, MS, RDN, LDN, BC-ADM, CDE, University of Chicago Kovler Diabetes Center, Chicago, IL.

Monk fruit extract

Monk fruit extract comes from the fruit of the same name and is a zero-calorie option, Raimo explains. “It is high in antioxidants called mogrosides, and it tastes sweet—about 100 to 250 times sweeter than regular white sugar,” she says.

In addition, monk fruit extract doesn’t appear to elevate blood sugar, making it a low-glycemic sweetener, says Lise Alschuler, ND, FABNO, professor of clinical medicine, University of Arizona Center for Integrative Medicine, Tucson, AZ. “It also does appear to have some antioxidant properties,” she adds.

In theory, monk fruit extract can be a good sweetener for individuals with diabetes simply because you consume so much less, McWhorter says. However, he adds, these types of non-nutritive sweeteners are often packaged with starches to add bulk, negating any positive benefit.

Is monk fruit extract better than other non-nutritive sweeteners? “It really comes down to taste and what you like best,” McWhorter says.

Date sugar

Date sugar is made by grinding down the whole fruit, Raimo explains. “It still contains all of the date’s nutrients, including vitamins, minerals, antioxidants, and fiber,” she says. “You would have to eat quite a bit of it in order to get any substantial nutritional benefit, but it’s still a better option to use in lesser quantities and in place of refined white sugar.”

Date sugar, with 10 calories per teaspoon, has one third fewer calories than regular sugar, notes Hess Fischl. “And because it is made from ground-up dates, it does add potassium and fiber to the diet,” she says.

Coconut sugar

Coconut sugar is less refined, so it retains the minerals (iron, zinc, calcium, and potassium) found in the sap of the coconut palm tree from which it’s made, Raimo says. “While 100 grams, or 25 teaspoons, has a little over 1,000 mg of potassium, it would mean eating quite a bit of added sugar,” she says.

Coconut sugar looks and tastes like regular brown sugar, but it has a lower glycemic index (35) compared with ordinary sugar (65), Skorupski says. Coconut sugar also contains inulin, a type of soluble fiber that can slow the absorption of food in the gastrointestinal tract and blunt the post-meal blood sugar spike.


While erythritol may not have antioxidants, it and other sugar alcohols are useful for individuals with diabetes who want to eat sweet food.

“Erythritol is found in fermented foods and fruits and has a mild flavor, so many find it a better flavor choice versus other sweeteners,” Skorupski says. “It also is calorie-free.”

Because the sugar alcohols have fewer calories, they affect blood glucose less than regular sugar. But they still contain carbohydrates, calories, and fat, so they shouldn’t be considered a guilt-free food. (Likewise, there may be more fat in sugar-free baked goods, so it always pays to be a label reader.)

Also, be aware that erythritol and other sugar alcohols can have a laxative effect in some people.

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