Screen Shot 2015-07-10 at 9.11.49 AM

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 sweeteners and minimize adverse physiologic consequences? Understanding the use of these benign sweeteners can be especially helpful for holiday cooking, entertaining family and friends, keeping the kids happy, as well as for enjoying an occasional indulgence. (Surely you’ve tried my Pecan Streusel Coffee Cake!)

Choose sucrose (common table sugar) 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. This is why we banish sucrose, high-fructose corn syrup, agave, and minimize honey and maple syrup. We also avoid the sugar alcohols sorbitol, maltitol, lactitol, and mannitol; they cause vigorous rises in blood sugar and provocation of small LDL particles, not to mention gas and diarrhea. Beware of the common usage of these sugar alcohol sweeteners in “sugar-free” ice cream and frozen yogurt, and sugar-free candy.

There are several good choices among benign sweeteners, but navigating among them can be confusing. You should be aware that non-nutritive and otherwise benign 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. Also, recall that the majority of people who are wheat- and grain-free experience heightened sensitivity to sweetness and the need for sweeteners of any sort diminishes over time and only modest amounts are needed.

More recently, sweeteners such as aspartame, saccharine, and sucralose (Splenda) have been shown to introduce unhealthy changes into bowel flora that can contribute to insulin resistance, so these sweeteners are on the “avoid” list.

Here is my list of sweeteners that have proven to be benign and can be used in the Wheat Belly and other healthy wheat/grain-free recipes:

Stevia and rebiana
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. 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 widely available as powdered and liquid extracts that, in addition to the rebiana, have the other sweet components of the stevia leaf. But be careful: Many of the powdered extracts are made with maltodextrin 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, as well as a source of sugar, since it is essentially a chain of glucose molecules. Stevia in the Raw is one such brand made with maltodextrin that we avoid. Ideally, use stevia extracts that are pure liquid or powdered stevia or made with inulin that can contribute to positive prebiotic fiber effects on bowel flora.

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.

Some people experience an unpleasant aftertaste with stevia. If you experience this, you can reduce this effect by combining sweeteners, e.g., stevia + monkfruit, or stevia + erythritol, of purchase a pre-mixed product (listed below).

Monkfruit (lo han guo)
Monkfruit is a relatively newcomer. Like stevia, it is a natural product obtained from a fruit that grows in China and Thailand, causing it to be available in only limited supplies. Of all the sweeteners, this is the one that, to my palate, provides the nicest level of sweetness without the aftertaste that some people experience with stevia. I’ve been using a liquid extract that bears the Skinny Girl label, $2.99 at a mainstream grocery store. I’ve used it in a variety of ways and have not encountered any negative aspects in flavor, baking, etc.

Monkfruit has been studied extensively and no adverse effects have been identified.

Erythritol 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. Some brands are sourced from corn; you should be aware of this in case you experience an adverse effect that may be due to the small quantity of corn protein residues, though they should be negligible and not a concern for most of us. Also like xylitol (below), 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 also appears to reduce potential for dental decay.

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.

Xylitol, like erythritol, is a form of sugar alcohol but without the gastrointestinal effects like sorbitol or maltitol (unless extreme quantities are used, which we do not). 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, as with erythritol, likely does not provide substantial exposure to corn proteins. You should know that xylitol is toxic to dogs and they should not be allowed to ingest any at all.

Inulin is available as a white powder. While classified as a fiber, it provides a mild sweetness while also providing a useful prebiotic fiber/resistant starch effect for cultivation of bowel flora. It is most useful as a sweetener when combined with another safe sweetener such as stevia or monkfruit.

There are also combinations of safe sweeteners that you can purchase. Among the best are:

Wheat-Free Market’s Virtue Sweetener–A combination of erythritol and monkfruit that uniquely yields sweetness 4-times that of sugar, meaning a little goes a long way and thereby making it among the most economical of natural sweeteners.

Swerve–A combination of erythritol and inulin useful for baking.

Truvia–While I am not fond of the manufacturer (Cargill), this is a pretty good product, a combination of rebiana (from stevia) and erythritol.