The best sweeteners to use if you have diabetes (and not only)

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Carlos Laforet Coll
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Those who want to lose weight or suffer from diabetes and have to keep sugar consumption under control often choose to use sweeteners. But is it really a good idea?

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Those who want to lose weight or suffer from diabetes and have to keep sugar consumption under control often choose to use sweeteners. But is it really a good idea? Which are the best? We asked Maria Cristina Varotto, dietician at Santagostino, a multi-specialist clinic.





Many varieties of alternative sweeteners to the classic sugar are now available in supermarkets, grocery stores but also in pharmacies or herbalists. In recent years, these have gained a large share of the market, especially as they are low-calorie (ie 0 or in any case low in calories) and due to the lower impact they have on blood sugar.

We asked the dietician Maria Cristina Varotto because a sweetener is generally recommended as an alternative to sugar. Here's what he told us:

The reason you choose a sweetener over sugar is that it is a calorie-free product. It allows us to perceive a sweet taste but not to introduce nutrients from which our body derives calories. The ideal for those suffering from diabetes is not to consume sugars but since it is very difficult to change habits and lifestyle, especially in the initial phase, an intermediate step in which a sweetener is used is often recommended. In this way the patient continues to perceive the sweet taste but at least avoids the intake of sugar which affects the metabolism of sugars.

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But are sweeteners really a better solution than sugar?

The long-term sweetener changes insulin resistance and therefore it is not good for a diabetic patient, in reality it is not recommended even for those who do not suffer from diabetes, even if, as always, the dose makes the difference. If I drink 3/5 coffee a day and put on the sweetener, consume zero drinks and sweetened biscuits, in the end I might as well use some sugar, also because the sweetener has another disadvantage from the metabolic point of view. When I take it my body feels the sweet taste and therefore prepares to handle this sugar that should arrive but does not arrive, so there remains the need to introduce other sugars, real sugars. 



What do you think of the erythritol that is talked about so much in this period? What is the best sweetener?

As with the whole family of sweeteners, the glycemic index of erythritol is 0 and therefore certainly fine. The caloric intake is very limited, it is very sweetening and you can use less of it but  I prefer to recommend the stevia. Stevia is a sweetener of natural origin but if it is consumed too much it could still have adverse effects and therefore cause some intestinal problems. It exists in different forms and as regards the recommended portions these are found on the package, the stevia sachet for example is the portion itself, then obviously it depends a little on the perception of taste.

How much should we limit the sweet taste?

The guidelines tell us that the maximum daily sugar consumption limit should not exceed 10% of the calories of the daily requirement, so it is individual because each of us has a different requirement. However, fruit is excluded from this count. We therefore speak of added sugar, in practice what we put in coffee and tea but also what is found in baked goods, sweets, drinks.

Certainly we don't have to count how much sugar we can use every day but that is the general indication valid for everyone to reduce the consumption of added sugar as much as possible and products that contain it, trying to get used to less sweet flavors. You can very well exploit fruit in this sense and then reduce the added sugar, perhaps by making a pear or apple pie, for example.

And for diabetics instead?

For diabetics it is very important to increase the level of fiber so that this can help metabolize sugars better. However, the diabetic's diet includes the consumption of fruit but fruit with the peel, eaten whole. As for the added sugars, as I said before, the goal is to eliminate them completely but it must be done gradually and if in the first phase you eat a sweet this must be put immediately after the meal so that the meal itself, complete, can improve sugar metabolism. On a full stomach, a intestine that is working with proteins, fats, carbohydrates and fibers and then sees the sugar from a slice of a birthday cake arrive, for example, can still manage it better. That sugar will get to the blood much slower because everything else will be there sooner.



What would you recommend to our readers in conclusion?

The indication, as already mentioned, is to limit the sugar as much as possible and, if to achieve this goal, I use the sweetener as an intermediate step it can be. However, it is important to use the sweetener without exceeding the dose. Also be careful not to fall into the error of cognitive restriction: “this yes, this no”, so it is easy to go overboard. It is always better to do a little bit of everything so as not to send the body into physical restriction and the mind into cognitive restriction, thus avoiding creating imbalances. Of course, those with diabetes will have to rely on a professional.

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