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These days, sugar is public enemy number one, blamed for the epidemics of obesity, type 2 diabetes and more. But does sugar deserve its unfavorable reputation? Even if it does, who wants to go through life without indulging their sweet tooth?

Sugars—caloric sweeteners—can be divided into two groups: intrinsic sugars, such as lactose in dairy products and fructose in whole fruits; and added sugars, such as sucrose (table sugar), high fructose corn syrup and concentrated sugar sources such as honey, syrups and fruit concentrates.

Nutritionist Marion Nestle reports that from 1980 to 2004 the yearly supply of sugars in the United States increased from 120 pounds per person to 142 pounds per person. The U.S. Department of Agriculture (USDA) estimates the average American eats 31 teaspoons (five ounces) of sugar per day—that’s more than two pounds per week! Sugar accounts for 500 calories per day in the average American diet, or 25 percent of average daily energy requirements.

Conventional wisdom tells us that so much sugar can’t be good for us. Sugar is popularly associated with many of America’s health problems, from hyperactivity to heart disease. But does science support these claims?

That depends on who you ask. In 2001, Anne Mardis of the Center for Nutrition Policy and Promotion (a division of the USDA) wrote a review of the available research on sugar intake and health. Conceding only that sugar was a cause—but not the only cause—of tooth decay, Mardis concluded, “Recent evidence shows that…the intake of added sugars is not directly related to diabetes, heart disease, obesity, and hyperactivity, as was previously thought.”

Nestle disagrees, and she’s not alone. In 2004, Jim Mann refuted Mardis’ conclusions in The Lancet, the respected British medical journal. According to Mann, sugar may not directly cause chronic disease, but substantial evidence links sugar consumption to obesity, which contributes to coronary heart disease, type 2 diabetes and other chronic diseases. Also in 2004, a team of medical researchers linked type 2 diabetes to corn syrup and other refined carbohydrates.

Regardless of what it does do, sugar is notable for what it doesn’t do; namely, provide the body with essential nutrients. Sugar calories are empty calories—they provide energy and nothing else. According to Nestle, “It is all too easy to eat sweeteners in prodigious amounts, driving healthier foods out of your diet, adding unneeded calories and forcing your metabolism to go into glycemic overload.” Replacing sugar calories with healthier alternatives a step towards better nutrition.


Sharp increases in blood glucose (sugar) have been associated with type 2 diabetes, obesity, heart disease and cancer. To measure the impact of foods on blood sugar, scientists developed the glycemic index. The glycemic index is a measure of the increase in blood sugar after eating a particular food—the greater the increase, the higher the glycemic index. Only carbohydrates affect blood sugar levels, and fat and protein can lower the glycemic response. Pure glucose has a glycemic index of 100; in contrast, peanuts have a glycemic index of only 14.

Blood glucose levels are also affected by how much food is eaten. The combined effect of serving size and glycemic index on blood sugar is referred to as the glycemic load. A double serving size of carbohydrates will double the glycemic load. To decrease your glycemic load and increase your health, eat mostly foods with a low glycemic index (such as whole grains, fruits, legumes and non-starchy vegetables) and avoid starchy foods (such as white rice, potatoes and white bread) and sugary foods (such as cookies, candy and soft drinks).


The food industry has responded to the demand for sugar alternatives with a variety of calorie-free artificial sweeteners. Some of the most popular include aspartame (NutraSweet, Equal), saccharin (Sweet’N Low, SugarTwin), acesulfame potassium (Sunett, Sweet One) and sucralose (Splenda). These sweeteners are common ingredients in diet soft drinks, low-fat yogurt products, sugar-free candy and more. Theoretically, artificial sweeteners, which are calorie free and have no glycemic impact, avoid many of the pitfalls associated with sugar.

However, many consumers are wary of artificial ingredients, and artificial sweeteners are no exception. A study from the 1970s reported a connection between saccharin and bladder cancer in rats. Although the mechanism responsible for this connection does not occur in people, concern about artificial sweeteners lives on. A quick Internet search reveals numerous Web sites claiming connections between artificial sweeteners and cancer, toxicity and more.

Clinical evidence suggests that there is no link between artificial sweeteners and cancer (in 2006, scientists at the National Cancer Institute determined that aspartame did not cause cancer in humans, despite an earlier study reporting a link between aspartame and cancer in rats). This is not, however, to say that artificial sweeteners are free of consequences. In 2007, a team of researchers published a study in Circulation that linked increased soft drink consumption with metabolic syndrome (a collection of risk factors such as obesity, high blood pressure and impaired glucose tolerance). Surprisingly, this connection also applied to those who drank artificially sweetened diet soft drinks. Clearly, the health consequences of artificial sweeteners are not yet fully understood.


Fortunately, those who wish to reduce their sugar consumption—without sacrificing sweetness or resorting to artificial additives—have alternatives. Health food stores sell many caloric and non-caloric natural sweeteners. While not technically supplements, these sweeteners have a place in every health-conscious kitchen.


Stevia is a perennial shrub native to regions of South America. In traditional Brazilian and Paraguayan medical systems, the stevia leaf was used to treat diabetes, obesity, tooth decay, high blood pressure, fatigue, depression and more. But modern interest in stevia has little to do with the plant’s medicinal properties.

Interest in stevia centers on stevioside, a chemical constituent that is 300 times sweeter than table sugar and essentially calorie free. Indigenous tribes in Brazil and Paraguay have used stevia as a sweetener for centuries. During World War II, the British used stevia when their supply of sugar was cut off. And Japanese food processors have used stevia to prepare pickled foods since the early 1970s. However, the FDA has banned stevia as a food additive, and regulatory agencies in Canada and the European Nation have done likewise.

Regulators argue that stevia may cause reproductive problems and cancer and interfere with energy metabolism. But stevia supporters disagree. According to herbalist Daniel Mowrey, “Few substances have ever yielded such consistently negative results in toxicity trials as have stevia. Almost every toxicity test imaginable has been performed on stevia extract or stevioside at one time or another. The results are always negative.” Furthermore, there have been no reports of adverse effects in Japan and other countries where stevia is used as a sweetener.

Stevia may not be available as a food additive, but it is available as a dietary supplement. Stevia supplements are sold as whole leaves, capsules, liquids and powders. Liquids and powders are the best for use as sweeteners. Remember, stevia is extremely sweet, so only a small amount is necessary (three to four teaspoons of stevia powder provide the sweetness of one cup of sugar).

The FDA may not lift its ban on stevia anytime soon (although PepsiCo and Coca-Cola have both recently developed stevia-sweetened beverages), but you can still enjoy stevia in your own home. Just remember—a little stevia goes a long way.


Xylitol belongs to a class of caloric sweeteners known as sugar alcohols. Sugar alcohols are naturally occurring carbohydrates derived from the fibers of fruits, vegetables and other plants. Because they are not completely metabolized, sugar alcohols provide fewer calories than sugar. And because metabolizing them requires little—if any—insulin, sugar alcohols have a low glycemic impact.

Emil Fischer, a German chemist, discovered xylitol in 1891. Xylitol has been used as a sweetener since the 1960s. It is as sweet as sucrose and has no unpleasant aftertaste. Unlike sucrose, which provides four calories per gram, xylitol provides only 2.4 calories per gram.

Xylitol is a common ingredient in chewing gum and toothpaste, as well as in mints, candies, mouthwashes, cough syrups, multivitamins and more. Several brands offer xylitol powder for cooking and baking.

Studies first suggested that xylitol might benefit oral health in 1970. Since then, research has shown that xylitol fights cavity-causing bacteria, reduces plaque and prevents tooth demineralization. In 1995, researchers from the University of Michigan published the results of a 40-month double-blind study showing that xylitol chewing gum can reduce rates of dental cavities. In 2006, citing this study and others, the American Academy of Pediatric Dentistry (AAPD) recommended xylitol for long-term cavity prevention. According to the AAPD, the ideal dose of xylitol is four to ten grams per day, divided into three to seven servings.

The American Diabetes Association approves of xylitol as a sweetener for people with diabetes. However, xylitol is low-glycemic, not non-glycemic; therefore, diabetics must still control their xylitol consumption, as should everyone else—because xylitol is not broken down completely in the intestines, large quantities may cause diarrhea.


As a source of food, the cactus-like agave is nothing new. For thousands of years, native Mexicans consumed agave nectar, which they referred to as the “nectar of the gods.” Later, the Spaniards used the plant to produce tequila. Today, agave syrup is gaining popularity as an alternative sweetener.

Agave syrup, which has a slightly runnier consistency than honey, is nearly three times as sweet as sucrose. Even so, agave syrup scores low on the glycemic index, releasing energy into the bloodstream slowly rather than causing a quick spike (and subsequent crash). The glycemic index of agave syrup is between 11 and 19—much lower than sucrose (58 to 110) and honey (32 to 58). This is because agave syrup is composed primarily of fructose, the same natural sugar that gives fresh fruit its sweetness.

Agave syrup also contains inulin, a prebiotic that may support healthy bacteria in the intestines.

Most health food stores sell both light and dark agave syrup. Light agave syrup has been filtered and has a neutral flavor. Dark, unfiltered agave syrup has more minerals and a distinctive vanilla-like flavor.

Agave is delicious on fruits and cereals and dissolved into hot drinks. Agave can even be used for baking—just replace one cup of sugar with one third of a cup of agave syrup.


For thousands of years, luo han guo that has been used as a food and a traditional healing herb. Luo han guo is a small fruit native to southern China, where both the dried fruit and the powdered extract play an important role in daily life.

Traditionally, luo han guo was used to purify the blood and treat cold symptoms and gastrointestinal disorders. Today, preliminary research suggests that luo han guo may protect against cancer. In 2002, an article in the journal Pure and Applied Chemistry reported that mogroside V, a component of luo han guo, inhibited skin cancer in mice. In 2003, researchers from Japan’s Kyoto University attributed the same effect to different constituents of luo han guo called glycosides.

Despite the potential health benefits of luo han guo, most interest lies in the culinary use of the fruit. Luo han guo extract is reported to be 150 to 300 times as sweet as sugar. Because it dissolves in water and retains its flavor when cooked, luo han guo is a suitable alternative to artificial sweeteners.

Luo han guo extract is calorie free and does not raise blood sugar levels. In addition, luo han guo may prevent maltose (a carbohydrate found in grains such as barley) from raising blood sugar levels. In 2005, Japanese researchers published a study on the effects of luo han guo extract on blood glucose levels in rats. The researchers observed that the extract inhibited blood sugar increases when given to rats three minutes before an oral dose of maltose. However, the researchers observed no such effect when the rats were given glucose. These findings suggest that luo han guo extract may inhibit maltase, the enzyme responsible for metabolizing maltose.


Sugar is delicious, but the consequences aren’t so sweet. Fortunately, there are alternatives. Look to nature instead of the laboratory next time you crave something sweet, and support your health along with your sweet tooth.


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Dhingra, R., et al. 2007. “Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle aged adults in the community.” Circulation 116(5):480–488.

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Lim, U. et al. 2006. “Consumption of aspartame-containing beverages and incidence of hematopoietic and brain malignancies.” Cancer Epidemiology, Biomarkers and Prevention 15(9):1654–59.

Mäkinen, K.K., et al. 1995. “Xylitol chewing gum and caries rates: a 40-month cohort study.” Journal of Dental Research 74(12):1904–13.

Mann, J. 2004. “Free sugars and human health: sufficient evidence for action?” Lancet 363(9414):1068–70.

Mardis, A.L. 2001. “Current knowledge of the health effects of sugar intake.” Family Economics and Nutrition Review 13(1):87–91.

Nestle, M. 2006. What to Eat. New York: North Point Press.

Schardt, D. 2000. “Stevia: a bittersweet tale.” Nutrition Action (April).

Suzuki, Y.A., et al. 2005. “Triterpene glycosides of Siraitia grosvenori inhibit rat intestinal maltase and suppress the rise in blood glucose level after a single oral administration of maltose in rats.” Journal of Agricultural and Food Chemistry 53(8):2941–46.

Swithers, S.E. and T.L. Davidson. 2008. “A role for sweet taste: calorie predictive relations in energy regulation by rats.” Behavioral Neuroscience 122(1):161–73.

Takasaki, M. 2003. “Anticarcinogenic activity of natural sweeteners, cucurbitane glycosides, from Momordica grosvenori.” Cancer Letters 198(1):37–42.



Most of us understand the importance of including a wide variety of fruits and vegetables in our diet. Fruits and vegetables are rich sources of antioxidants and other phytonutrients that help cells fight damage from free radicals, molecules that contribute to the aging process and a wide variety of diseases, including cancer. Recently, several novel types of fruits have reached our shores, and scientific evidence reveals that they offer important benefits in helping to prevent disease and boost overall health. These fruits include acai berry, mangosteen, goji berry, and the more familiar pomegranate, all of which are discussed in greater detail below.


The acai berry is a small, round fruit that’s both great tasting and healthy, thanks to its high content of powerful antioxidants. The main sources of antioxidants in acai are anthocyanins, potent chemicals that give the berries their purple color. Acai contains ten to thirty-three times the amount of anthocyanins found in red wine, which researchers have studied for its role in preventing heart disease. But more than just another antioxidant fruit, acai also contains valuable amino acids, unsaturated fats, and phytosterols that promote health throughout the entire body.



Phytosterols, also referred to as plant sterols, are natural substances that are found in the cells and membranes of plants. These sterols provide numerous benefits to the human body, including reducing harmful cholesterol levels. Sterols can also be an effective treatment for benign prostate hyperplasia, a common condition among middle-aged and elderly men. Acai contains a number of valuable phytosterols, including beta-sitosterol, which has been studied for its value in supporting a healthy immune system.


Acai is also rich in calcium, vitamins C and E, unsaturated fats, iron, manganese, chromium, copper, and boron. The acai berry is so rich in nutrients, it could almost be considered a “multivitamin” in the form of a fruit.


Acai’s abundant nutrients have some real and important effects on your health, including the following:


Acai is an excellent source of fiber. Important scientific research has demonstrated that a high-fiber diet can help protect against cancer, diabetes, heart disease, and obesity. And since many people only get about half the fiber they need each day, adding acai and other fruits and vegetables to the diet can help fill that gap.


Many health experts believe that inflammation contributes to the development of many serious diseases. Inflammation occurs as a result of disease, injuries, and when the body attacks its own tissues in the case of autoimmune disorders. Acai’s powerful antioxidants neutralize enzymes that attack connective tissues, thereby helping to alleviate inflammation.


Anthocyanins protect the endothelial cells on blood vessel walls by countering free radical attacks. Each of these attacks damages endothelial cells, which eventually leads to a buildup of arterial plaque, which can lead to atherosclerosis and heart disease.


Nutritional supplement manufacturers are currently producing a variety of acai products—from supplements in capsule and powder form to acai juices and juice concentrates, and acai is now readily available from health food stores, warehouse clubs, and numerous Web sites.


Acai is an excellent source of fiber. Important scientific research has demonstrated that a high-fiber diet can help protect against cancer, diabetes, heart disease, and obesity. And since many people only get about half the fiber they need each day, adding acai and other fruits and vegetables to the diet can help fill that gap.


The mangosteen is a small, firm fruit that is the size and shape of a medium tomato. It has a deep eggplant-purple skin. When sliced open, the mangosteen reveals a deep red rind called a pericarp, which is about 1/2 inch thick, which protects the succulent white-segmented fruit and black seeds at its heart. It is these white, pulpy segments, five to eight in number, that are eaten. The spongy, deep red, astringent pericarp is usually discarded. The delicious white segments, however, are not the part of the fruit that contains all of the potent antioxidants, but they are rich in phytin, an organic phosphorus compound.

Fruits that are rich in polyphenolic antioxidants are usually deep red, blue, or purple, like the mangosteen’s pericarp. Although the pectin-rich pericarp has been made into an edible purple jelly in some countries, it is so astringent that it must first be soaked in a 6 percent brine solution to reduce its 7 to 14 percent catechin and tannin content.

The pericarp contains a wealth of other phytochemicals that are of interest to researchers. Apart from its catechins and tannins, the pericarp contains one of the highest amounts of xanthones, phenolic plant compounds that may have antitumor, antibacterial, and fungicidal properties. It is the dried and powdered pericarp that has traditionally been used medicinally in Singapore, India, and China.



Catechins are plant polyphenols that have significant antioxidant activity. In the same category as tannins, catechins have found their claim to fame in green tea. They are also found in abundance in grapes, wine, and chocolate. The pericarp of the mangosteen is extremely rich in catechins. An average mangosteen pericarp contains approximately 50 to 60 mg of catechins, about the same as 100 grams of dark chocolate.


Xanthones are also polyphenols, and one type of xanthone is mangostin, which has been shown to inhibit the oxidation of LDL cholesterol, which is implicated in plaque formation in atherosclerosis. Mangostin’s health benefits also include antibacterial, fungicidal, and antitumor properties.



Scientists have conducted two in vitro studies of mangosteen xanthones to determine if they inhibit the growth of human leukemia cells and cancerous liver cells. Both studies have demonstrated great success in killing cancer cells, which suggests that alpha-mangostin and its cohorts might be potential candidates for eventual preventative and therapeutic cancer treatments.


Used in China for its many healing properties for thousands of years, the goji berry has been discovered in the West, and its amazing antioxidant and health benefits are now available to all. Writing in a physician’s handbook during the Ming Dynasty (1368 to 1644 A.D.), Ben Cao Gang Mu said that, “taking in Chinese goji berry regularly may regulate the flow of vital energy and strengthen the physique, which can lead to longevity.” In fact, the ancient Chinese revered three medicinal herbs above all others: ling tzi, ginseng, and the goji berry.


Another in vitro study tested the antibacterial activity of xanthones on antibiotic-resistant Staphylococcus aureus bacteria and shows promising pharmaceutical applications. Still another study shows in vitro activity against tuberculosis.


The Beijing National Research Institute in 1988 conducted a study of the nutritional components of goji berry and found a true powerhouse. Goji berries contain over 500 times more vitamin C than oranges, twenty-one trace minerals, eighteen amino acids, more beta-carotene than carrots, and more calcium than spinach. Eight ounces of goji berries contains 4,000 percent RDI of vitamin B-1; 1,000 percent RDI of vitamin B-3; 190 percent RDI of fiber; and over 100 percent of the RDI for chromium.

In addition, goji berries contain powerful antioxidant flavonoids, the water-soluble plant pigments that give blueberries, peppers, and oranges their distinctive color. For the body to optimally utilize flavonoids, and the phytochemicals they contain, they should be consumed in whole foods like fruits and vegetables. A study conducted by Huang Yuanqing and colleagues at the Ningxia Medical College in Yinchuan, China, revealed that the total flavonoid constituents of goji berry have a significant inhibitory effect on the heat output of L1210 cells, producing a powerful free radical–scavenging effect.



Numerous studies have demonstrated that goji berries support healthy immune system functioning by boosting T-cell immune response. One study showed that after taking goji berry, lysozyme, IgG, and IgA in serum increased in all study participants. The activities of interleukin 2 (IL-2) increased by 226 percent in two-thirds of the participants. In another study, eating goji berries strengthened immunoglobulin A levels (an index of immune function).


Both ancient wisdom and modern scientific studies have demonstrated that goji berries are beneficial for improving vision. One study tested the effects of goji berries on the eyesight of twenty-seven subjects. Dark adaptation dramatically improved, physiologic scotoma decreased, and serum vitamin A and carotene content increased—all of which are indicators of eyesight acuity. Also, the pigments lutein and zeaxanthin, both of which are contained in goji berries, have been demonstrated to protect the retina by neutralizing the free radicals from sunlight that may damage eye tissue.


The goji berry has also demonstrated beneficial effects on blood sugar levels, which may offer help to those suffering from diabetes and pre-diabetic conditions.

Qiong Luo and collaborators at the University of Hong Kong and Wuhan University, in a study of the goji berry’s glucose-stabilizing properties, said, “It was found that the three Lycium barbarum [goji berry] fruit extracts/fractions could significantly reduce blood glucose levels and serum total cholesterol (TC) and triglyceride (TG) concentrations and at same time markedly increase high density lipoprotein cholesterol (HDL-c) levels after ten days treatment in tested rabbits, indicating that there were substantial hypoglycemic and hypolipidemic effects.”


Pomegranates are an excellent source of polyphenols, especially anthocyanins, punicalagin, tannins, ellagic acid, potassium, and vitamin C. A study that compared pomegranate juice with cranberry juice, red wine, blueberry juice, and orange juice, found that pomegranate juice not only had more polyphenols than any of the other juices, but the polyphenols in pomegranate juice were significantly more active. Pomegranate juice also neutralized more free radicals and prevented LDL cholesterol oxidation, which contributes to atherosclerosis.


With baby boomers hitting fifty and sixty, the emphasis today is on active lifestyles, maintaining good health, and living longer. To do this, more and more people are turning to fruits and vegetables that contain a variety of healthful antioxidants. As modern science continues to research and better understand the role of free radical damage in the aging process and development disease, potent phytochemicals contained in acai berries, mangosteen, goji berries, and pomegranate offer potentially important benefits for those who want to take control of their health.


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