Sugar Substitutes
This resource from Children's Hospital of Philadelphia (CHOP) describes natural and artificial sugar substitutes.
Sugar substitutes decrease the amount of carbohydrates and added sugar in foods and beverages. Most contain less than 1 gram of carb per serving. These substitutes will help to manage blood sugar levels and reduce calories. They are found in a variety of zero-calorie beverages, sugar-free mints, gum and foods. Sugar substitutes are safe in small amounts. It is best not to replace healthy beverages such as water and milk with sugar-free beverages.
There are two types of sugar substitutes:
Artificial sweeteners
They are created rather than found in nature, like sugar or honey.
They do not contain calories or carbohydrates and will not raise blood sugar levels.
Artificial sweeteners can be used instead of sugar. Information on how much to use can be found on the food package or websites of the sweeteners.
Listed below are artificial sweeteners approved by the United States Food and Drug Administration (FDA) as safe for use in foods and beverages.
These sweeteners are safe for the public, including people with diabetes and children. The amount of sweetener that is safe for use varies depending on your child's weight. Please contact your diabetes nutritionist to determine your child's acceptable daily intake (ADI) of sugar substitutes.
Acesulfame potassium (acesulfame-K or ace-K)
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Products: DiabetiSweet and Sweet One
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Use for cooking and baking. The texture of baked goods may be altered. Use a combination of regular sugar and sweetener.
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When used in large amounts, there may be a slightly bitter aftertaste.
Aspartame
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Products: NutraSweet and Equal
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Not recommended for baking.
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Only add to cooked foods after the foods are heated.
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Contains phenylalanine. Do not use if you have phenylketonuria (PKU) .
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Some people get headaches from aspartame.
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One packet contains less than 1 gram carbohydrate.
Saccharin
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Products: Sweet'N Low, Sweet Twin and Sugar Twin
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Use for baking. There may be a slightly bitter aftertaste.
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One packet contains less than 1 gram carbohydrate.
Sucralose
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Products: Splenda
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Use for baking. This product is most like sugar.
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Found in a wide range of processed foods, baked goods and beverages.
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One packet contains less than 1 gram carbohydrate.
Alternative natural sweeteners
Natural sugars like honey, brown or white sugar are naturally high in carbohydrates and calories. Honey contains 6 grams of carbs per teaspoon and sugar contains 4 grams in each teaspoon. This causes blood sugar levels to rise.
Alternative natural sweeteners use plant-based ingredients without chemical modification.
The United States Food and Drug Administration (FDA) approved the list of natural sweeteners below. They are safe for use in foods and beverages in small amounts.
These sweeteners are safe for the public, including people with diabetes and children, in small amounts but should not replace drinking water and milk.
Stevia
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Products: Truvia, PureVia and Sweet Leaf SteviaPlus
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Stevia is a plant grown in Central and South America. The sweetener made from the stevia leaf is called "rebaudioside A," "Reb A" or "rebiana."
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Does not have calories or carbohydrates and will not raise blood sugar.
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Some products combine stevia and sugar alcohols. These products do have calories and carbohydrates that will raise blood sugar.
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Use for baking. The amount to use in recipes can be found on stevia packages and websites.
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Sweet Leaf contains 0 gram carbohydrate per packet. PureVia contains 2 grams of carbs and Truvia has 3 grams of carbs per packet.
Lo han guo
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Products: Monk Fruit in the Raw and PureLo
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A fruit sweetener made from the juice of a small fruit grown in Southeast Asia.
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Does not contain calories and will not raise blood sugars.
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Some products combine monk fruit and sugar alcohols. These products do have calories and carbohydrates that will raise blood sugar.
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An acceptable daily intake (ADI) has not been established due to the lack of studies.
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One packet may contain up to 2 grams of carbohydrate.
Sugar alcohols
Made from plant products such as fruits and berries.
Used in many sugar-free and reduced-sugar foods.
Contains fewer calories than sugar, but it still contains calories.
Contains carbohydrates and will have a small effect on blood sugars. This may make it difficult to dose insulin for carbohydrates containing sugar alcohols.
May have a laxative effect because they are not well digested or absorbed. They should be avoided or eaten in small amounts.
Common sugar alcohols in foods are sorbitol, mannitol, xylitol, maltitol, lactitol, erythritol, isomalt and hydrogenated starch hydrolysates. Erythritol has the lowest calories and does not cause laxative effects.
Serving size and grams of carbs can vary, read the package labels for details.
Reviewed on March 23, 2023, by Megan Robinson, MS, RD, CDCES, CSSD, LDN