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In pursuit of sweetness

By Dr. Davis | October 6, 2012 134 Comments

In our wheat-free lifestyle, having an occasional sweet indulgence can be nice. Recipes such as cheesecake or cookies, for instance, require some amount of sweetener. So how can we choose our sweetener and minimize adverse physiologic consequences? Understanding the use of these benign sweeteners can be especially helpful for holiday cooking, entertaining family and friends, and an occasional indulgence. (Surely you’ve tried my Pecan Streusel Coffee Cake!)

Pick sucrose and we are exposed to the 50% fructose contained in the glucose:fructose molecule. Fructose is so awful at so many points in metabolism that it is worth absolutely minimizing.

There are several good choices but navigating among them is often confusing. Be aware that non-nutritive sweeteners, due to their sweetness, have the potential to increase appetite. Use these sweeteners sparingly, adding only enough to make your recipe slightly and pleasantly sweet. Thankfully, the majority of people who are wheat-free experience heightened sensitivity to sweetness and the need for sweeteners of any sort diminishes over time.

Stevia
While stevia has been around in the U.S. for decades as a “nutritional supplement,” it recently received a boost into mainstream use with the FDA’s “Generally Recognized As Safe,” or GRAS, designation in 2008 for its rebaudioside component, also known as rebiana. Agribusiness giant Cargill (yeah, yeah: I know!) launched its Truvía brand, which contains erythritol with rebiana, while PepsiCo launched PureVia, a combination of erythritol, rebiana, and a small quantity of the sugar isomaltulose.

Stevia plants are naturally sweet, often called “sweet leaf.” Some people grow the plants and chew the leaves for their sweetness or add the leaves to recipes.

Stevia is also widely available as powdered and liquid extracts that, in addition to the rebiana, have the other sweet components of the stevia leaf. Many of the powdered extracts are made with maltodextrin, erythritol, xylitol, or inulin to add volume or to mimic the look and feel of sugar. Maltodextrin is a polymer of glucose produced from corn or wheat. The maltodextrin may therefore represent a potential source of wheat gluten exposure for people who are extremely sensitive. Maltodextrin is also a source of calories, since it is essentially a chain of glucose molecules. While glucose provides 16 calories per level teaspoon, maltodextrin is digested less efficiently, it provides less than this but is variable depending on the length of the glucose chain. Stevia in the Raw brand made with maltodextrin and rebiana therefore lists less than two calories per teaspoon on its nutritional composition. Note that two calories per teaspoon equates to 96 calories per cup, or a total of up to 24 grams carbohydrates per cup. Carbohydrate exposure is therefore a concern when large quantities are used. Ideally, use the stevia extracts that are pure stevia or made with inulin, e.g., Trader Joes, SweetLeaf brand. Maria Emmerich advises me that the stevia glycerite form is less bitter for many people.

Liquid stevia extracts are highly concentrated with little else but stevia and water. The quantity required to equal the sweetness of sugar varies from brand to brand. The SweetLeaf brand, for instance, claims that two drops of their Stevia Clear extract equals one teaspoon of sugar, while some other brands require five drops for equivalent sweetness.

Because of the variety of ways stevia is purified and packaged, you will need to adjust the volume of powder or liquid used depending on the preparation. Most preparations will provide advice on what quantity matches the sweetness of sugar. Also, the presence of other ingredients like erythritol or maltodextrin can influence how various recipes respond; some experimentation may therefore be necessary, especially when trying a new brand of sweetener in a recipe. For instance, erythritol combined with stevia, e.g., Truvía, may not hold up as well in baking and can acquire a slightly bitter taste.

Xylitol
Xylitol is a form of “sugar alcohol,” i.e., a carbohydrate with an OH group attached, thus the term “alcohol,” a confusing designation as it contains no ethanol (the alcohol in a martini or glass of wine) nor shares physiologic effects of ethanol. Xylitol is found naturally in fruits and vegetables. It is also produced by the human body as part of normal metabolism.

Teaspoon for teaspoon, xylitol is equivalent in sweetness to sucrose. It yields two thirds of the calories of sucrose and, because digestion occurs in the small intestine rather than the stomach, triggers a slower and less sharp rise in blood glucose than sucrose. Most people experience minimal rise in blood glucose with xylitol. In one study of slender young volunteers, for instance, six teaspoons of sucrose increased blood sugar by 36 mg/dl, while xylitol increased it 6 mg/dl. Interestingly, several studies have demonstrated positive health effects, including prevention of tooth decay and ear infections in children, both due to xylitol’s effects on inhibiting bacterial growth in the mouth.

Xylitol can be used interchangeably with sugar in recipes. It also has the least effect on changing baking characteristics. While traditionally produced from birch trees, more recent large scale production uses corn as its source. (While I am no fan of corn, particularly genetically-modified corn, the purified xylitol is likely not a substantial exposure to anything but the xylitol.)

Erythritol
Erythritol, like xylitol, is a naturally occurring sugar alcohol, i.e., a carbohydrate with an OH group attached and thereby labeled an alcohol, though it has nothing to do with ethanol. It is found in gram quantities in fruit. In commercial production, erythritol is produced from glucose with a process using yeast. Also like xylitol, osmotic gas and bloating generally does not occur as it does with common sugar alcohols mannitol and sorbitol.

Over 80% of ingested erythritol is excreted in the urine, the remaining 20% metabolized by bacteria in the colon. For this reason, it yields no increase in blood sugar even with a “dose” of 15 teaspoons all at once. There are less than 1.6 calories per teaspoon in erythritol. Limited studies have demonstrated modest reductions blood sugar and hemoglobin A1c (a reflection of the previous 60 days’ blood sugar) in people with diabetes who use erythritol.

Erythritol is somewhat less sweet than table sugar. It also has a unique “cooling” sensation, similar to that of peppermint, though less intense. It may therefore confer a cooling sensation to your baked products. It also does not hold up in baking quite as well as stevia. When Truvía was used in testing the Wheat Belly bread recipes, it had a slightly bitter taste. Swerve is a commercial product that is useful for baking, a combination of erythritol and inulin.

Sucralose
Sucralose is manufactured from glucose by adding chlorine atoms. It has become the most popular artificial sweetener in the world, known to most Americans as Splenda.

Sucralose is very baking compatible, not changing in taste or texture with baking. The various forms of sucralose are usually combined with maltodextrin, such as in Granulated Splenda, and therefore pose some of the concerns listed above, including occasional abdominal complaints like bloating and gas and potential carbohydrate exposure of 0.5 grams carbohydrate per level teaspoon or 24 grams per cup, yielding up to 96 calories per cup. Carbohydrate content is therefore a potential issue only when large quantities are used. Like stevia, sucralose is also available as a liquid without maltodextrin.

Although sucralose has proven safe in worldwide consumption, there have been scattered reports of potential adverse effects. There’s the theoretical effect from the chlorine molecules contained within the sucralose molecule (since sucralose is glucose with added chlorine atoms, just as table salt is a sodium atom with a chlorine atom). However, there is no formal evidence that this has resulted in undesirable human effects. Limited animal evidence suggests alteration of bowel microorganisms; this has not been reproduced in humans.

Sweeteners to not use
Then there are the sweeteners that truly do have problems outside of potential appetite/insulin triggering. The sweeteners to avoid include sugar alcohols sorbitol, maltitol, and mannitol; they cause vigorous rises in blood sugar and provocation of small LDL particles, not to mention gas and diarrhea (unless, of course, you are not fond of your mother-in-law and would like to be entertained one evening). Avoid fructose sources, especially agave nectar, followed by maple syrup (real or high-fructose corn syrup-based), honey, and, of course, high-fructose corn syrup. (Yes, while honey has some good things in it, it is too rich in fructose. If you insist on using it, use the darkest honeys and use sparingly.) Beware of the “natural” sugars that are increasingly appearing on the market made from coconut and other plants; they are usually just sucrose or fructose.

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About Dr. Davis

Cardiologist Dr. William Davis is a New York
Times #1 Best Selling author and the Medical Director of the Wheat Belly Lifestyle Institute and the Undoctored Inner Circle program.

Nothing here should be construed as medical advice, but only topics for further discussion with your doctor. I practice cardiology in Milwaukee, Wisconsin.

Comments & Feedback...

  1. Denise

    July 16, 2013 at 11:23 am

    After my adverse reaction to Stevia , I have been searching for an alternative product. I found Swerve at Whole Foods and summoned up the courage to try it. I am pleased to report that I had no reaction to it and liked the taste. I have used it in both baking and my hot chocolate and it works well.
    However I have not been able to find monk fruit extract anywhere.

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    • Barbara in New Jersey

      July 16, 2013 at 12:08 pm

      This is sold as Nectresse with sugar and molasses by the same people who manufacture Splenda.
      Monk fruit is just being developed as a sweetener and it is difficult to find on shelves or even on an internet search. Recently approved by the FDA. Pure Lo Han, Full Sweetness and Purefruit are names that manufacturers are using to include in beverages. I guess we will have to wait until this is available in stores.

      I like Swerve for baking. WFMF has developed a sugar substitute that I will try when I send in my next order.

      Log in to Reply
      • Jan in Key West

        July 16, 2013 at 12:32 pm

        We bought WFMF’s sweetener with monk fruit extract and highly recommend it.

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        • Barbara in New Jersey

          July 16, 2013 at 1:44 pm

          Hi Jan,

          I am hoping that you will tell me you have used it in baking successfully!
          Does it sweeten coffee without an after taste? Does it work well for cold drinks too? I don’t care for lemonade or ice tea with trivia or stevia and some of the others because of the aftertaste.

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          • Jan in Key West

            July 16, 2013 at 3:39 pm

            Barb,
            Yes, recently, I used it in the WB carrot cake successfully so I’m sure it would work in other recipes as well. We tend to prefer the more savory, less sweet baked items….the focascia, flax seed crackers etc. I drink my coffee black so don’t know about that, but since it doesn’t seem to have a strong aftertaste, it should work. I’ll keep it in stock!

    • Dr. Davis

      July 17, 2013 at 12:32 pm

      The high-potency sweetener sold by Wheat Free Market is a combination of monkfruit and erythritol.

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  2. unterderlaterne

    July 18, 2013 at 2:52 am

    Here is a long list of Sweeteners with explanations!

    http://news.nationalgeographic.com/news/2013/07/130717-sugar-substitutes-nutrasweet-splenda-stevia-baking/

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    • Boundless

      July 18, 2013 at 10:15 am

      I suspect the average WBB blog reader knows more about sweeteners than the author of that superficial overview.
      * not comprehensive
      * failed to really distinguish between basic sweetening components and named mixes
      * no real discussion of blood sugar effects for each
      * no discussion of controversies regarding aspartame and sucralose

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  3. Em Duke

    July 30, 2013 at 11:03 am

    My husband and I have recently started the Wheat Belly diet and have already seen positive effects of removing wheat from our diet, however, I happen to be highly sensitive to any kind of sugar substitute, I have tried all of them that I know of (with unpleasant effects) and I love to bake. Is there any kind of sweet alternative someone like me can use that will not effect me. I get headaches almost immediately after consuming sugar substitutes, and acid indigestion, stomach ache and feel overall horrible. Aside from not having any kind of sweetener, I am hoping there is something out there I haven’t tried yet that I will not react to.

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  4. Kenzie

    August 13, 2013 at 6:22 pm

    How about coconut palm sugar? Can that be used on Wheat Belly plan?

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    • Dr. Davis

      August 13, 2013 at 7:39 pm

      It’s a form of sugar, Kenzie, despite its coconut source.

      So go VERY lightly, if at all.

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  5. Patti

    August 17, 2013 at 6:53 pm

    I’ve been wheat free for 9 months. I’ve had a few slips but was able to get back to wheat free quite easily. My problem is I can not get rid of the sugar thing. About 6 months in I started to use {reluctantly} the sugar substitutes – stevia, Xylitol, and Erythritol. For a moment, it did satisfy me enough that I did not want to eat sugar. I also tried to get myself into nutritional ketosis about 6 weeks ago to get rid of the sugar thing. It did not work because just a couple of weeks ago {bam} I went crazy for sugar. I was able to stop it, but then today it came back again. I have no idea how to get rid of the sugar thing. I am at a lost because the sugar substitutes don’t work any longer because I went for the sugar, and plus I am getting weird symptoms from them.

    I don’t know what to do – this sugar thing is awful.

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    • LydTN

      August 17, 2013 at 7:28 pm

      Are you eating plenty of fat? I have completely stopped craving sugar but the key for me has been lots and lots of healthy fats (pasture-fed butter and ghee, coconut oil, MCT oil, and EVOO). Coconut oil in my coffee is a delicious treat. Occasionally I’ll have some 85% dark chocolate, if I really want something sweet, or make some Bulletproof ice cream for something really special (http://www.bulletproofexec.com/get-some-ice-cream/). But mostly just make sure that you are eating lots of healthy fats and that you have eliminated all of the sneaky sources of sugar that could be sabotaging you (store-bought salad dressing and condiments are a major culprit, and you never know what might be in seemingly benign food when you go out to eat). If you’re really struggling with cravings, just try dropping everything sweet, (sugar substitutes included) and sticking to the lowest sugar fruit possible (raspberries, blackberries, strawberries) if you’re eating fruit, for an extended period of time while adding in more fat. Your mind and body will catch up. The key to any addiction is breaking the cycle!

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    • gingerbread

      August 17, 2013 at 10:39 pm

      You should probably be taking a probiotic if you aren’t already taking one. Sounds like you have candidiasis, which is an infection that craves sugar. The probiotics will enhance the good bacteria.

      Log in to Reply
      • Jan in Key West

        August 18, 2013 at 6:05 am

        In conjunction with the probiotics, check into adding ‘fermented foods’ to your diet….together, they help build healthier gut bacteria.

        Log in to Reply
  6. Dawn

    October 29, 2013 at 5:13 pm

    I would like to know if we can use nutritional yeast?

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    • Dawn

      November 1, 2013 at 4:54 pm

      Can we use nutritional yeast??

      Log in to Reply
  7. Fleming

    December 8, 2013 at 10:05 am

    Dr. Davis said: “Stevia in the Raw brand made with maltodextrin and rebiana therefore lists less than two calories per teaspoon on its nutritional composition. Note that two calories per teaspoon equates to 96 calories per cup, or a total of up to 24 grams carbohydrates per cup. Carbohydrate exposure is therefore a concern when large quantities are used.”

    I use Stevia in the Raw every day, but since reading this I’m rethinking that choice. I probably use about 4 to 5 teaspoons total in the green tea I drink all day. Do you think that’s too much maltodextrin? Does the “malto” part of the term mean it’s derived from wheat? And does “dextrin” mean dextrose, a sugar? Sounds to me like it should be avoided altogether.
    Thanks!

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  8. Boundless

    December 29, 2013 at 10:17 am

    Whey Low ?
    wheylow dot com*

    This just popped up on the alternative sweetener radar, when the family cook was looking for something that works well in the new ice cream maker.

    Dr.Davis remarked on it at:
    https://www.wheatbellyblog.com/2012/03/orange-cream-cookies/comment-page-2/#comment-20099
    “While I have no experience with it, Theresa, the fact that it is made from lactose raises some concerns due to potential lactose intolerance. It does sound more benign than sugar. But be careful: Less harmful is not always good.”

    The company makes grand claims:
    “100% Natural
    75% fewer Calories than sugar
    70-80% lower Glycemic Index than sugar”
    and many LC and diabetic sites seem to endorse it. No one seems to know what the exact GI claim is. The net carbs are suspiciously low.

    The actual ingredients are deeply troubling:
    crystalline fructose (from corn),
    lactose monohydrate (from milk) and
    sucrose (ordinary cane sugar)

    … in other words, 100% simple sugars.

    They admit that the fructose is from corn, which implies that it’s HFCS without the glucose, and which makes their “all natural” claim highly suspect. Perhaps they mean “contains no supernatural ingredients” :).

    They claim that the precise formulation causes these sugars to cross-inhibit each other “… work synergistically in the small intestine to interfere with the normal absorption of each other into the bloodstream.” Sorry, but my skeptometer went off scale several claims earlier.
    _________
    * There was a similar product sold by Barry Farm, which shows up in search results. Based on the current BF site, it looks like ViviLac got after them for trademark violation. In any case, BF raises the general rule: don’t buy “healthy, nutritious food” products from fat people.

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    • Boundless

      December 29, 2013 at 12:39 pm

      If the goal is for a food element to cause NO increase in blood sugar, this product fails.

      If their charts are credible at:
      http://www.wheylow.com/Articles.asp?ID=266
      the stuff is a lot less provocative than plain sugar, but it still causes a spike. And the “D” version of the product (for Diabetic) is little improved.

      There is no data on the site regarding triglycerides. Also, their charts only look out 3 hours. They’d need to look out 6-8 hours to catch a TG rise.

      I’m thinking that anyone who wants to experiment with this stuff needs to own a glucometer, and get some post-meal 30-minute-interval 6-hour baseline runs prior to consuming Whey Low.

      Log in to Reply
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