There are many options available to sweeten a cup of
coffee or a bowl of breakfast cereal. Parents, who are
careful enough to read the list of ingredients on a
breakfast bar or a cold drink, may be left cross eyed
and uninformed when the list hides sweeteners in plain
sight. Which sweeteners are natural sugars, which are
not, and which are safe for kids?
Pure cane sugar or sucrose is the standard of
sweeteners for taste and use in food and beverage.
Sucrose provides the taste that people expect in a
sweetener. There are various forms of sucrose available:
powdered, granulated, cubes and syrup. Sucrose does not
change its flavor when hot. That makes it ideal to use
in sauces and baked goods. No one is allergic to
sucrose. Even diabetics, who are sensitive to sucrose,
may eat reasonable amounts.
There are other kinds of sugar. Fructose is very
popular. It is less expensive than sucrose. Fructose
carries the same caloric price tag as sucrose, 15
calories per teaspoon or 4 grams. Some industry experts
recommend fructose for diabetics. Most physicians do not
recommend that diabetics eat large amounts of this
Honey is a solution primarily of water, fructose, and
glucose (another kind of sugar). Honey is just as likely
to cause tooth decay and weight gain as any other sugar.
All sugars have two problems, they cause tooth decay
and carry a high caloric price tag. Each level teaspoon
of sucrose weighs 4 grams and carries 15 calories. A
12-ounce can of soda may have 16 teaspoons of sugar or
240 calories. Sugar use over a long period may induce
the serious medical condition, diabetes.
Many items contain sugar without listing sucrose,
fructose, or sugar by name. Sucrose is known by many
names such as dehydrated cane juice, concentrated beet
juice, maltose, turbinado sugar, and brown sugar.
Fructose appears on ingredient lists as high fructose
corn syrup, corn syrup, concentrated pear juice,
levulose, and concentrated apple juice.
Read ingredient lists carefully; some products list
small amounts of various sugars to hide the true sugar
content. For the actual sugar content, divide the number
of grams of sugars by 4 to find the number of teaspoons
of sugar per serving.
For example, Kellogg’s Frosted Flakes Milk and Cereal
bars list sugar as an ingredient three separate times.
The label lists four other sugars as well. That is why
even though cereal and milled corn top the ingredient
list, sugars make up more than half of the 19 grams of
carbohydrate per serving.
Many of the refreshments that we drink every day have
more sugar than we imagine. For example, Cranberry juice
cocktail contains over one level teaspoon of fructose
per ounce of liquid; that means that 12 ounces of
“cranberry juice” delivers nearly 200 calories and will
cause decay as readily as other sources of sugar. Many
carbonated soft drinks carry even more sugar per ounce.
The super large soft drink that accompanies a burger at
many fast food chains may have more calories than the
Some people choose non-sugar sweeteners to avoid the
ill effects of sugar. The most well known is saccharine
(available in the popular pink “Sweet and Low” packets).
Saccharine is an artificial, non-nutritive (no calorie)
sweetener. Aspartame (available as “Equal” in blue
packets) is a protein that has a sweet and sugary taste.
Aspartame is not as stable as sugar or saccharine in
heat or solution, so do not use it for baking, and look
for expiration dates on soft drinks that contain Equal.
Since the disappearance of the artificial sweetener,
cyclamate (sold as “Sugar Twin” in yellow packets) from
store shelves in the US in 1969, and the implication of
saccharine as a cause of bladder cancer, consumers view
other artificial sweeteners with a jaundiced eye.
Xylitol, sorbitol, maltitol, mannitol, and sucralose
(available in yellow “Splenda” packets) are sugar
alcohols. Sugar alcohols are not sugar or alcohol, but
resemble both in some ways. They are stable in heat and
solution, and taste like sugar. Sugar alcohols have
fewer calories than sugar.
Delta Dental of Massachusetts and other dental health
agencies promote the use of
Xylitol due to its anticariogenic (anti-cavity)
effect. In other words, there is scientific evidence
that Xylitol (better
than other sugar alcohols) prevents tooth decay by
killing bacteria that harm teeth.
Stevia is a sweet herb. This “dietary supplement” is
available in convenient paper packets with the dosage
advice “Add one packet to your food or beverage.” The
Food and Drug Administration (FDA) does not consider
Stevia safe enough to be sold as a food or food
additive. Dietary supplements face a much lower level of
scrutiny. The best advice is to stay away from Stevia
until its safety can be proven.
How much sweetener is too much? There are two
considerations for sugars. Eating or drinking large
quantities of sugars will provide extra calories, and
some bacteria will cause tooth decay when exposed to
sugar. Fight the number of calories by lowering the
overall quantity of dietary sugars. Fight cavities by
decreasing the frequency of sugar consumption.
When decay-causing bacteria contact sugar, the
bacteria will produce acid. The acid eats into teeth and
forms cavities. Bacteria will continue to produce acid
for twenty minutes after the sugar is gone. That is why
babies who sip on formula or mother’s milk for hours at
a time or an adult who sips sugary beverages or eats
candy all day will develop serious tooth decay. Sticky
sweets like dried fruit (raisins and prunes) and chewy
fruit snacks (Fruit by the Foot and Fruit Roll Ups)
stick to teeth and lengthen the amount of time sugar is
available to bacteria. To decrease tooth decay, decrease
the number of times per day that sugar is eaten and the
length of time sugar stays in the mouth.
Some people believe that artificial sweeteners are
not safe. If artificial sweeteners are not safe, then
using less is safer. Eating 20 to 50 grams of sugar
alcohol per day may have a laxative effect. The exact
dose depends on which sugar alcohol and the person using
Dentists and dental hygienists receive training on
nutrition and the effects of sugar. If you have further
questions, please ask your dental health team.
Leader is the Chairman of the Health
Advisory Committee of the Lynnfield Schools, a member of
the Professional Advisory Committee of Tri-CAP Head
Start, and is a member of the Mass Dental Society
Council on Dental Care and Benefits Programs.