Do you love sweetness in your food and drinks, but worry about the effect of sugar on weight or blood sugar control? That’s where sugar substitutes are supposed to help. But how can we choose among all the sweeteners available today, and are they really healthier than sugar? Let’s take a look.

Artificial sweeteners: possibly worse than sugar

On the surface, artificial sweeteners like saccharin (Sweet ‘N Low), aspartame (Equal), sucralose (Splenda), acesulfame potassium, neotame and advantame seem to be ideal sugar substitutes. They pack a huge punch when it comes to sweetness, from between 200 and 600 times to advantame’s 20,000 times as sweet as table sugar. Since these sweeteners are free of sugars and other carbohydrates, they’re suitable for diabetics and those on low-carb diets.

However, the long-term health effects of artificial sweeteners remain controversial. Some studies have found an association between diet soda consumption and higher rates of obesity, metabolic syndrome, type 2 diabetes and cardiovascular disease. It’s also unclear if artificial sweeteners increase appetite and overall calorie intake, thus canceling out any weight loss advantage of their being noncaloric. In addition, aspartame is harmful to people with the metabolic disorder phenylketonuria.

Fortunately, there are plenty of natural alternatives to sugar, as laid out in the next few sections.

Natural, less refined, but still forms of sugar

The highly refined table sugar is essentially pure sucrose, which breaks down into two other simple sugars, glucose and fructose. Glucose rapidly drives up blood sugar levels, whereas fructose burdens the liver for its metabolism. An excess of these refined sugars can contribute to diabetes, weight gain and heart disease over time.

Relatively unprocessed or less refined sources of sugar, such as fruit juices, honey, molasses and maple syrup, are considered healthier because they provide some vitamins, minerals and antioxidants. More processed natural sweeteners, including brown rice syrup and agave nectar, often have little nutritional value besides sugars. The organic versions of natural sweeteners may be lower in pesticide levels, but they’re still high in calories and sugar, and should be treated as such by dieters and people with diabetes.

Lower-calorie natural sugars with bonus benefits

Fructooligosaccharides (FOS) and sugar-alcohols are not only sweet but also known to promote digestive and oral health. These naturally occurring fruit and vegetable carbohydrates, unlike table sugar, are incompletely metabolized by the body, allowing them to have only 6% to 65% of the calories but up to 100% of the sweetness of sugar.

FOS, a prebiotic that feeds beneficial bacteria in the gut, is abundantly found in yacon syrup. Sugar alcohols include sorbitol, mannitol, xylitol, maltitol, lactitol, isomalt and erythritol. They’re not converted in the mouth into acids and can even inhibit bacteria that cause tooth decay, making them perfect in sugarless gum and mints.

Yacon syrup and sugar alcohols do have calories and can raise blood sugar levels to varying extents, so diabetics and dieters still need to take them into account. Moreover, overconsuming these poorly digestible, fermentable carbs can cause bloating, gas or diarrhea, especially in people sensitive to FODMAPs. Erythritol is a good choice in this regard, because it’s efficiently absorbed, leaving little to linger and cause trouble in the gut. Besides, it’s only 0.24 calorie per gram.

All-around healthiest natural sweeteners

Natural, plant based, zero calorie, supersweet and safe for diabetics, with no known negative health effects. Indeed, stevia and monk fruit extracts are becoming the sweetener choices for those who accept no compromise. Both sweeteners are versatile enough to be either added directly to food and beverages or used in baking and cooking.

A traditional herb in South America, stevia leaves contain steviol glycosides, which are 200 to 400 times sweeter than table sugar. Among these compounds, rebaudioside A (Rebiana) doesn’t have a bitter aftertaste, whereas stevioside does. The FDA considers high-purity steviol glycosides to be safe for human consumption.

Monk fruit, known as “luo han guo” in its native China, contains sweet-tasting antioxidants called mogrosides. They allow monk fruit extract to be 150 to 300 times sweeter than table sugar while being sugar free and calorie free. Monk fruit has been used for centuries for its health benefits, especially in inflammation, lung function and metabolism.

To sum up, cutting down on sugar doesn’t have to mean cutting sweetness out of your life. Natural, healthier alternatives to sugar can be part of a successful effort to improve weight and blood sugar management and feel better overall.