Top 10 Best Sweeteners & 10 Worst (Ultimate Guide)

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Dr. Sten Ekberg
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Video Transcript:
Hello Health Champions. If you're human you  probably have a sweet tooth but you also know how bad sugar is and all the health problems sugar  causes and people are looking for alternatives for sugar substitutes and as a result the list  of substitutes is growing longer by the day. But are the alternatives any better or are  they in some cases even worse?
In order to answer that question we have to understand what  are the consequences and issues with different sweeteners. So the first issue is that sweeteners  are not food they are typically highly processed and they provide empty calories. There's  nothing in there that your body actually needs.
The second issue is that some of them  will raise your blood sugar some of them can give you a carbohydrate overload and they  stimulate insulin with high chronic insulin we get insulin resistance and if this goes on for a  long time we have type 2 diabetes. The third issue is that a lot of them have fructose and while  fructose doesn't raise blood sugar very much it is very stressful on the liver and it has  an even greater likelihood to create insulin resistance and type 2 diabetes. The fourth issue  is pretty controversial and it has to do with artificial sweeteners.
Every time I bring it up  there's some angry people who say that there is no evidence where is the research and so forth  now i am of the opinion that for some things you just don't need to wait for the research  just because you can't prove that it's unsafe doesn't mean that you can prove that it is safe  either. And from a philosophical perspective if something is purely synthetic. If it is purely  foreign if it has never existed on the planet as that type of molecule then it has no business  in our bodies.
Based on my clinical experience and the type of testing that we do in my office I  believe that it is one of the worst chemicals that we can come across I believe it has the potential  of zapping circuits very much like metals or chemicals or pesticides they do their damage in  the body by interfering by short-circuiting the information the signals that the body is trying  to use to regulate activity. The fifth issue has to do with digestive health. So some of these  sweeteners cause gas and bloating or even diarrhea and if they cause that sort of upset on your  digestive health then we have to ask what impact does it have on your biome on your microbial  flora that we know is so critically related to our overall health.
Let me start with the worst  and work my way through to the better ones the artificial ones are also called non-nutritive  because they have no calories they have no blood sugar but they are unnatural and why is that such  a big deal now I am a total fan I am super excited about all the technological progress that humans  are making. Life is getting better every day as a result of technology it's more convenient the  cars and the phones and the computers everything's getting better but when it comes to biology that's  a totally different department and humans have yet to create life and until they do I think that  anything man-made should stay outside of the body as much as we can help it. Artificial sweeteners  are molecules that never existed on the planet.
They're combining chemicals and forcing  things together that don't belong together and therefore we have no idea what it does now  in my experience they do a lot of harm but even in the absence of proof I think it's a really  good idea to avoid artificial things. Like I said i think these foreign molecules can zap circuit  they can short-circuit the regulation your body's attempt at creating balance and homeostasis  and the most common offenders are aspartame, saccharine, sucralose and acesulfame potassium. I  urge you to read the ingredient list very very carefully because sometimes they sneak them  in where you least suspect it.
Then we get to the natural ones. Things that occur in nature but  because of how we process it and the quantities that we consume they become really really bad.  And these are things like white sugar, agave syrup, and high fructose corn syrup.
We all know that  white sugar is something we should stay away from but a lot of people are being told and believe  that agave syrup is a good thing. Now most people know that high fructose corn syrup is a bad  thing but it turns out agave syrup and high fructose corn syrup are pretty much the same thing.  They have a low glycemic index and the reason they have that is that they're higher in fructose. 
Fructose is the thing that lowers the glycemic index compared to glucose and that high fructose  is very very stressful for the liver and it has a huge impact on insulin resistance and type 2  diabetes. And it's very disturbing to me when I see things like this: wholesome sweetness, organic agave.  This looks like something good, right?
Low glycemic but this is very very high in fructose so this is  just another form of high fructose corn syrup and it's the quantity that makes it bad if you had  a teaspoon once in a while that's not a big deal especially if you're insulin sensitive. So when  we talk about things like berries they also have glucose and fructose in them but it's all about  the quantity and you can even have some berries on a keto diet and it's totally fine. It is all about  the quantity then we get to the natural sweeteners that are a little better but they're still pretty  bad and these are things like coconut sugar, honey, maple syrup, date sugar, and the list goes on  and on and on but what we have to understand is that there's still sugar i hear people  all the time they read keto cookbooks and they're told that you stay away from  white sugar stay away from this or that but these are the healthy ones and they're  in every health food store on the planet.
But read the name: sugar, syrup, sugar, honey.  They're still the same thing. And here's how you want to look at that.
Sugar is 50% glucose  50% fructose. The glucose raises blood sugar creates insulin insulin resistance. The fructose clogs  the liver and creates insulin resistance.
High fructose corn syrup and agave is the same  stuff the proportions are just a little bit different and then when we take a look at these  so-called healthy ones sold in health food stores then it's 99% the same thing it's still sugar  and the fact that they keep just a little bit of nutrients a few minerals and vitamins  doesn't change the fact that it's still all sugar. Is it a little bit better? Of course it  is but it's still sugar and as such it's all about the quantity these molecules are not bad  or evil in themselves a teaspoon once in a while wouldn't be a bad thing but too much sugar will  slowly kill you.
Then there's an example here of a natural thing that canna acts differently  and there's probably going to be more of these as time goes on. Allulose is a natural rare  sugar so this chemical formula, C6H12O6, that's the exact same thing as glucose. It's the exact  same thing as fructose but these molecules act very differently because the atoms are configured  just a little bit different.
And some of them we have enzymes to break up and some of them we don't.  So this is one that we can't break up it tastes pretty much like glucose and they refine it and  they now start selling it as a sugar alternative. Because we can't metabolize it, it has virtually zero  calories.
No impact on blood glucose or insulin. And like anything they get really excited about  they do some research and they start finding different benefits so now they've found that it's  anti-inflammatory maybe or it may improve insulin sensitivity. But here's the problem now that they  start refining these things and they start doing some research now they're in the pill mentality  again now they're in the medicine mentality take this for that they're forgetting that this  is not food.
It's not anything that the body is looking for. Can you use it? Yeah I think that  you could probably have a little bit I think it fits right in with some of the semi healthy  natural sweeteners but don't start using it as a medication to treat something since the beginning  of time every species on the planet has been looking for food as sustenance as nutrition  and fuel and building blocks and this is not food.
So it doesn't make it totally bad just  realize the difference. And then I saw this quote next to the Allulose information consuming  more than 54 grams of Allulose per day may cause digestive issues such as bloating gas  and abdominal pain this was in us news health how do they come up with 54 grams? So 53 grams  is totally okay but as soon as you cross that threshold now you're in trouble it doesn't  work like that.
So some people might get these symptoms at half of that dose or a tenth of that  dose and some people may not get it at all but it's not about the symptoms that's just when  you went too far. If 54 grams causes pain then half of that amount causes something. So can we  have a teaspoon once in a while probably yes but just keep in mind when they say things like  that that it's ridiculous and they have really no foundation for picking a number like that.
Now  it gets a little more complicated but I'm going to do my best to keep it really simple and  summarize this in a way that makes sense we get erythritol, mannitol, sorbitol, xylitol, and  maltitol and if you notice what these have in common they all end with -ol which means they're  sugar alcohols and they're very very complex it's a whole field of study for each one and I don't  know all the details about every one of them. But why are they so popular because  unlike many of the other sweeteners these actually taste pretty good. Their sweetness is in  the same range as sugar.
Some are really close some are a little bit less but they taste pretty  much like sugar so for certain applications they work much better. These sugar alcohols are  getting very popular and when they're included in food they're usually subtracted from the net  carbs they're treated as fibers. They're treated as if all the sugar alcohols are pretty much the  same and that's a bit of a discrepancy.
There's a problem here because erythritol has virtually zero  calories whereas xylitol and maltitol has like 60-65% the calories of sugar. So they're not  all the same they do have some metabolic effects and if they have calories if they have metabolic  effects, then they have to either get absorbed or fermented and these sugar alcohols vary widely  on how much gets absorbed and absorbed means that they cross the barrier they cross the intestinal  membrane in your small intestine and they pass into the blood so now they're circulating in  the bloodstream. If they can't get absorbed if they don't make it into the bloodstream then they  pass through the small intestine and they end up in the large intestine and now they become food  for the bacteria in your large intestine and they have the potential to become fermented to become  fuel for the bacteria there.
And because they're going to become either absorbed or fermented as  soon as you put them in your mouth that's going to be one of the two then these two numbers are  going to end up 100%. So next thing we need to understand is out of the portion  that gets absorbed now two things can happen they can either be metabolized by the liver and  that means the liver has an enzyme it can turn it into glucose and now we will have some blood sugar  effect and some insulin effect and you'll make it into energy just like you would glucose or it will  be excreted by the kidney if it's not something that the liver can work with it's just going  to pass through and the kidneys are going to excrete it. So for erythritol for example basically  0% is metabolized by the liver.
First of all because almost all of it gets absorbed  in the bloodstream and all that gets absorbed in the bloodstream gets excreted by the kidney so  erythritol is very different than these other guys because it has very very little interaction with  the body there's virtually no metabolic effects which you can see from 0. 2 calories. So next on  the list is mannitol and we can see that it has one and a half calorie per gram which is about  40 percent of that of sugar but zero percent is metabolized by the liver that means none of that  gets converted into glucose so then what happens to it?
Well 75 percent of it passes through to be  fermented by bacteria and these bacteria then turn it into short chain fatty acids that get back into  the system and become energy so that's not a bad energy that's typically a quite beneficial energy  and therefore has very little impact on blood sugar. The last three on the list we can see that  virtually none of it goes out through the kidney so that means that it's processed either by the  liver or the gut bacteria and we can see that these have about 60 to 65 percent of the calories  of sugar two and a half to two point seven And next we want to look at the glycemic index  and this is why it's so important to understand the difference between these sugar alcohols that  you cannot simply subtract all the sugar alcohols from net carbs because the first two have  basically a zero impact on blood sugar but the last one which is maltitol which is very  popular in some candies like chocolate products on the market. It has basically half of the blood  sugar impact of sugar and more than half about 65% of the calories of sugar but perhaps  the biggest drawback of these sugar alcohols is their potential for digestive upset.
If they  cause gas and bloating we have to ask why is that? It's because your gut bacteria are producing  that gas it's the only way that you can get gas and bloating is your bacteria made that gas and  it's because you fed them. And what did you feed your gut bacteria you fed them something called  FODMAP and this is a protocol that people with upset stomachs with ibs and with  small intestinal bacterial overgrowth they often learn to avoid the FODMAP because  these things feed your bacteria and if you get the gas and bloating you're probably feeding  the kind of bacteria that you don't want the kinds that create trouble and FODMAP stands  for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
So FODMAP is anything  that your gut bacteria can ferment and all the saccharides are basically sugar and the polyols  are all of the sugar alcohols. So basically small carbohydrates different forms of sugar  and the sugar alcohols are the things that fit into that FODMAP category and all of these sugar  alcohols have a significant FODMAP content except the erythritol because 90% of the erythritol gets  absorbed very quickly in the small intestine so only very small amounts get passed through to  the large intestine to be fermented so therefore only trace amounts of the erythritol actually gets  fermented and has the potential of causing gas. But even so I don't recommend overdoing the  erythritol I think it is clearly the best one of the sugar alcohols but you still don't want to  overdo it for all the different reasons that we talked about it's not a food it's not a nutrient  and people still will have some digestive upsets if they eat too much of it one more thing I want  to mention is concerning xylitol and dogs because xylitol works differently on dogs than basically  any other species usually insulin is released is triggered by a rise in blood sugar but in dogs  it is also triggered by xylitol without a rise in blood sugar so if they consume this then the  insulin will push their normal blood sugar too low and they can frequently die from hypoglycemia. 
And this brings us to the best ones from a health perspective in my opinion these are the natural  non-nutritive so they don't have an impact on glucose they don't have an impact on insulin they  don't have any calories but they are natural as opposed to the artificial non-nutritive sweeteners  and this is monk fruit stevia and chicory root and stevia and monk fruit are pretty much the same.  They're very similar they're two different plants but they work the same they're very very sweet  they're two to three hundred times sweeter than sugar so you only need microscopic amounts  chicory root or inulin is a little different but it's not a sugar alcohol it is about as sweet  as sugar and it is classified as a fiber and even though it's technically not a sugar alcohol large  amounts of this can still cause digestive upsets. Now with all this information what do we do with  it what do I do well I never touch the artificial stuff if i can help it i had a diet soda about  40 years ago and i've never had one since because the taste was just totally horrendous metallic  artificial.
My body just said this is not something you want to put inside. I think I've had one or  two tastes of something since then by mistake and I've been able to spit it out so I don't touch the  stuff if I can help it. Sugar I probably have less than a teaspoon a day on average most days i don't  have any but if i do it'll probably be something like a dark chocolate or dark chocolate covered  espresso beans or something like that.
I use stevia monk fruit and chicory root on a regular basis  mostly stevia I like some stevia sodas that are on the market and i probably have one or two a  day usually I eat my yogurt plain without anything added but occasionally I put some berries in there  and then I like to sweeten with stevia if I do a smoothie like a chocolate smoothie i typically put  some stevia in there i do use some sugar alcohols in small amounts I use erythritol and xylitol and  the reason is that even though I like stevia in a lot of things I can't stand it in coffee I just  don't like it however if I do a cappuccino or something I love to have a little bit of xylitol  or erythritol even just half a teaspoon just brightens it up a little bit. And if I'm gonna do  some baking then I'll probably use erythritol and if I have some ice cream then it'll probably be  something with erythritol in it as well. So now that you have a big long list here's  the thing I really want to emphasize that just because it's on the list and I think  it's okay it does not mean that it is food.
It is still a treat. It's an exception. It's something  you do once in a while or just a little bit.
Don't turn it into a food group we have this tendency as  humans we go down the list and that one's okay so I'm just gonna eat that and nothing else don't  do that use it as a treat. If you enjoyed this video and you'd like to learn more about how  the body works and how to truly master health then that video will be perfect for you next. Thank  you so much for watching I'll see you next time.
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