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Sugar vs. Artificial Sweeteners: Which Is Healthier and Safer?

Ever do the sugar-or-sweetener cha-cha-cha at the coffee shop? You know, when you dance between the sugar shaker and the pink, blue, and yellow packets? If this were a cartoon strip, the thought bubble over your head would read, "What’s the more healthful choice? The no-calorie fakes? The full-calorie hard stuff? Help!"

It's like choosing between raising taxes and increasing the national debt. Pick your poison. Okay, neither sugar nor sweeteners are poison if they're eaten in reasonable quantities, but that's our point. There's nothing reasonable about the amount of sugars and syrups in all kinds of foods, from bagels to frozen veggie mixes. The effect of these added sugars? Imagine eating 22 teaspoons of sugar for breakfast every day. That's average for Americans. Canadians average 14 teaspoons of sugar a day.

What that does to your health reads like a dirty laundry list. Research shows it lowers HDL (good) cholesterol and raises bad triglycerides. It also gloms onto proteins that create destructive substances called AGEs (short for advanced glycation end products). These set you up for heart disease, stiff joints, wrinkles, Alzheimer's, diabetes, kidney problems, bone fractures, and vision loss. Phew. (Follow these steps to stop sugar cravings.)

That's why we YOU Docs are on a mission to get added sugars out of healthful foods, such as low-fat yogurt and whole-grain cereals. And that's why if you don't like black coffee (Dr. Mike's choice) or green tea (Dr. Oz's choice), we'd say -- reluctantly -- take the sweetener.

Why reluctantly? It's not that sugar substitutes cause cancer or make hair grow in weird places. In fact, sweeteners have been studied far more than most drugs (there've been at least 100 studies on sucralose/Splenda alone). The problem is that they subtly mess with how you react to food.

  • Sometimes it's a mind game. For instance, diet sodas can cloud common sense, making you think your no-cal drink "cancels out" the fat calories in burgers and fries.
  • Sometimes they make you eat more, not less. Because no-cal sweeteners essentially don't register in your brain's satiety center, instead of satisfying a sweet craving they can send you hunting for more sugary snacks . . . and then more sugary snacks. They also train your taste buds to go PING only when they detect intense sweetness.
  • Sometimes there's something going on no one even understands yet. Recent Texas research has linked drinking diet soda to bigger waists -- 70% bigger than in people who didn't touch the stuff. "Huh?" That's what we said. More to come on this. But Dr. Mike, who used to drink a daily diet cola (or six), is glad he gave 'em all up over a year ago.

There's also evidence that fake sugars and diet sodas don't help you lose weight, and up your risk of metabolic syndrome, which precedes diabetes, heart disease, and more. So it's hard to be enthusiastic about them.

But if you use reasonable amounts of sugar substitutes (get the scoop on artificial sweeteners here), that's way better than 22 teaspoons of sugar a day. Here's what we recommend the next time you do the sugar-versus-sweetener cha-cha:

If you drink regular soda, diet is a better choice. Every 12-ounce can of the real thing has about 135 calories and 10 teaspoons of sugar (usually in the form of high fructose corn syrup). Drink a can a day and that's 32 pounds of sugar and 49,000 calories a year -- a 16-pound weight gain. Ditch liquid candy!

If you suspect sugar is in something, trust your instincts. Added sugars/syrups lurk in the darnedest places, including in ketchup, peanut butter, crackers, salad dressings, soups, frozen entrees and fruit cups. Check the ingredients list. Sugar's aliases include high-fructose corn syrup, cane sugar, brown sugar, agave nectar, cane crystals, corn sweetener/syrup, dextrose, evaporated cane juice, fructose, fruit juice concentrates, glucose, invert sugar, lactose, maltose, malt syrup, molasses, honey, and sucrose.

If you love dessert, go for Mother Nature's original treat: fruit. Its sugar isn't added, and fruits' vitamins, minerals, and beneficial plant nutrients help protect you from added sugars' aging effects. Nibble an ounce of heart-friendly dark chocolate too, especially with walnuts, oranges, and pears. Yum.

These 3 foods can lower your risk of diabetes by 10% to 20%.

A different sugar substitute -- agave nectar -- has some things going for it.

RealAge Benefits

Eating a diverse diet that is low in saturated and trans fats can make your RealAge as much as 6.1 years younger if you're a woman, and 4.4 years younger if you're a man. Take the RealAge Test!

November, 2011