Story at-a-glance

• Artificial sweeteners are worse for you than any form of sugar
• Fructose, including agave and high fructose corn syrup, is the worst natural sweetener you can consume and in large doses rivals the metabolic toxicity of even artificial sweeteners
• Stevia is a safe, natural sweetener that may have anti-diabetic properties
• Sugar alcohols such as xylitol may also be relatively safe in moderation
• Limiting your intake of sugar and fructose is one of the smartest moves you can make to protect your long-term health and reduce your risk of chronic disease

MSN Health actually did a fairly good job in assembling a list of the best and the worst for your health, which I expand on below.

The Best:

1. Stevia
2. Sugar alcohols
3. Honey (I recommend Manuka honey, or raw honey in very small quantities)
4. Pure glucose

The Worst:

1. Aspartame
2. Agave (which I would expand to include all sources of fructose)
3. Sucralose (Splenda)

Artificial Sweeteners are Worse Than Sugar

Sweetener lesson 101 is to avoid artificial sweeteners like the plague. There's little doubt in my mind that artificial sweeteners can be even worse for you than sugar and fructose, and there is scientific evidence to back up that conclusion.

In 2005, I wrote the most comprehensively documented book I ever wrote called Sweet Deception, in which I expose the many concerns related to the consumption of artificial sweeteners. It's an extremely well-researched book, and it's as valid today as it was when I first wrote it. I spent over three years and had five health care professionals work on it with me, as the maker of Splenda, Johnson & Johnson, had their legal firm write me a 20-page letter threatening to sue me if I published the book.  Needless to say, the book was published and they did not sue me as the information was all true.

Here's a breakdown of what you need to know:

Aspartame

Aspartame is a synthetic chemical composed of three ingredients – two amino acids and a methyl ester bond. The amino acids are phenylalanine and aspartic acid, two common components of many foods that are usually completely safe for consumption. But not in the case of aspartame.

Why?

Aspartame is the ingredient found in NutraSweet. It is also found in Equal, Spoonful, Equal Measure, AminoSweet, Benevia, NutraTaste, Canderel, and many popular "diet" foods and beverages. I've gone on record saying that aspartame is a bigger public health threat than high fructose corn syrup and can lead to birth defects, cancer and weight gain. It's also been linked to brain tumors.

Forgetting for a moment that aspartame is metabolized inside your body into both wood alcohol (a poison) and formaldehyde (which embalms tissue and is not eliminated from your body through the normal waste filtering done by your liver and kidneys), the trouble with the component parts of aspartame is one of volume.

In a normal protein like meat, fish or eggs, phenylalanine and aspartic acid comprise 4-5 percent each of the total amino acid profile. This is how nature intends the human body to encounter these two amino acids and there is nothing wrong with these substances if they occur naturally in a proper balance with other amino acids.

But in aspartame the ratio of these two amino acids is 50 percent phenylalanine and 40 percent aspartic acid (with 10 percent methyl ester bond, aka wood alcohol, a known poison). In other words, on a percentage basis this is a massive quantity of two unnaturally isolated amino acids that are simply not found in this ratio in nature, bonded together by a known poison.

The result of this chemical cocktail is a sweet tasting neurotoxin. As a result of its unnatural structure, your body processes the amino acids found in aspartame very differently from a steak or a piece of fish. The amino acids in aspartame literally attack your cells, even crossing the blood-brain barrier to attack your brain cells, creating a toxic cellular overstimulation, called excitotoxicity. MSG is also an excitotoxin, and works synergistically with aspartame to create even more damage to your brain cells.

Sucralose (Splenda)

Sucralose is a synthetic chemical created in a laboratory. In the five-step patented process of making sucralose, three chlorine molecules are added to one sucrose (sugar) molecule.

Some will argue that natural foods also contain chloride, which is true. However, in natural foods, the chloride is connected with ionic bonds that easily dissociate.. But in Splenda, they're in a covalent bond that does not dissociate. In fact, there are NO covalent chloride bonds to organic compounds in nature—they only exist in synthetic, man-made form. Aside from Splenda, other examples of synthetic covalently bound chloride compounds include:

• DDT
• PCB's
• Agent orange

Now, your body has no enzymes to break down this covalently bound chloride. Why would it? It never existed in nature, so the human body never had a reason to address it. And since it's not broken down and metabolized by your body, they can claim it to be non-caloric—essentially, it's supposed to pass right through you.

However, the research (which is primarily extrapolated from animal studies) indicates that about 15 percent of sucralose IS in fact absorbed into your digestive system, and ultimately stored in your body.

You've probably heard the claims that the FDA has reviewed over 100 studies on Splenda and are satisfied that it's a safe product, but what you don't hear is that most of those studies were on animals, and that they actually revealed plenty of problems! For example, some of these studies revealed:

• Decreased red blood cells -- sign of anemia -- at levels above 1,500 mg/kg/day
• Increased male infertility by interfering with sperm production and vitality, as well as brain lesions at higher doses
• Enlarged and calcified kidneys
• Spontaneous abortions in nearly half the rabbit population given sucralose, compared to zero aborted pregnancies in the control group
• A 23 percent death rate in rabbits, compared to a six percent death rate in the control group

Only two human trials on sucralose were completed and published prior to the FDA approving Splenda for human consumption, and these two trials included a total of just 36 human subjects. Worse yet, the longest running trial lasted only four days, and looked at sucralose in relation to tooth decay, not human tolerance. As for determining the absorption of Splenda into the human body, a mere eight men were studied.

Based on that singular human study, the FDA allowed the findings to be generalized as being representative of and regarded as "safe" for the entire human population!

After Artificial Sweeteners, the Worst Form of Sugar is Fructose (Including Agave!)

Now that artificial sweeteners are out of the picture, it's time to eliminate another health-harming sweetener that's masquerading as a healthy sugar alternative: fructose.

There is no question in my mind that fructose is the most toxic natural sugar known to man. However, it really is only toxic in large doses taken chronically. Just as smoking a few cigarettes will likely not cause lung cancer, small doses of fructose are not an issue since it is a natural sugar found in all fruits. However when it is consumed in doses that most people use, which is 500% of the dose that people consumed in pre-industrial times, then metabolic toxicity occurs. At these dosages I believe it is likely more toxic than even artificial sweeteners.

Please remember this is a dosing issue, small doses are harmless and large doses over time are pathogenic.

You've probably heard the news about high fructose corn syrup (HFCS) being bad for your health, and as a result many people interested in staying healthy have switched to agave as a safer "natural" sweetener. However, most agave is actually WORSE than HFCS because it has a higher fructose content than any commercial sweetener -- ranging from 70 to 97 percent, depending on the brand, which is FAR HIGHER than HFCS, which averages 55 percent.

Part of what makes fructose so unhealthy is that it is metabolized to fat in your body far more rapidly than any other sugar. The entire burden of metabolizing fructose falls on your liver, and it promotes a particularly dangerous kind of body fat, namely adipose fat. This is the fat type of fat that collects in your abdominal region and is associated with a greater risk of heart disease.

Further, fructose:

• Tricks your body into gaining weight by fooling your metabolism, as it turns off your body's appetite-control system. Fructose does not appropriately stimulate insulin, which in turn does not suppress ghrelin (the "hunger hormone") and doesn't stimulate leptin (the "satiety hormone"), which together result in your eating more and developing insulin resistance.
• Rapidly leads to weight gain and abdominal obesity ("beer belly"), decreased HDL, increased LDL, elevated triglycerides, elevated blood sugar, and high blood pressure—i.e., classic metabolic syndrome.
• Over time leads to insulin resistance, which is not only an underlying factor of type 2 diabetes and heart disease, but also many cancers.

According to Dr. Robert Lustig, fructose is 'isocaloric but not isometabolic." This means you can have the same amount of calories from fructose or glucose, fructose and protein, or fructose and fat, but the metabolic effect will be entirely different despite the identical calorie count.

Further, because most fructose is consumed in liquid form (i.e. soda and sweetened beverages of all kinds) its negative metabolic effects are magnified. So while HFCS has about the same amount of fructose as cane sugar, the fructose in HFCS is in its "free" form and not attached to any other carbs.

New research published in the European Journal of Nutrition once again showed that high-fructose corn syrup may be particularly detrimental to health, as it contains fructose in its 'free' monosaccharide form. In rats given access to sugary beverages, all of them displayed markers of increased risk of diabetes and heart disease, but those given 'free' fructose has the most significantly disrupted glucose homeostasis, which means they had the greatest risk of developing type 2 diabetes.

The fructose in fruits and in cane sugar is bonded to other sugars, which results in a decrease in its metabolic toxicity. That said, even consuming an excess of fruits is not recommended, as consuming any foods that contain high amounts of fructose -- even if it's a natural product -- is, to put it bluntly, the fastest way to trash your health.

Among the health problems you invite with a high-fructose diet are:

As a standard recommendation, I strongly advise keeping your TOTAL fructose consumption below 25 grams per day.  The average American is consuming THREE times this amount, so this is a fairly substantial reduction for most people.

For most people it would also be wise to limit your fructose from fruit to 15 grams or less, as you're virtually guaranteed to consume "hidden" sources of fructose if you drink beverages other than water and eat processed food. Here's a quick reference list of some of the most common fruits that you can use to help you count your fructose grams:

Fruit Serving Size Grams of Fructose Limes 1 medium 0 Lemons 1 medium 0.6 Cranberries 1 cup 0.7 Passion fruit 1 medium 0.9 Prune 1 medium 1.2 Apricot 1 medium 1.3 Guava 2 medium 2.2 Date (Deglet Noor style) 1 medium 2.6 Cantaloupe 1/8 of med. melon 2.8 Raspberries 1 cup 3.0 Clementine 1 medium 3.4 Kiwifruit 1 medium 3.4 Blackberries 1 cup 3.5 Star fruit 1 medium 3.6 Cherries, sweet 10 3.8 Strawberries 1 cup 3.8 Cherries, sour 1 cup 4.0 Pineapple 1 slice (3.5" x .75") 4.0 Grapefruit, pink or red 1/2 medium 4.3

Fruit Serving Size Grams of Fructose Boysenberries 1 cup 4.6 Tangerine/mandarin orange 1 medium 4.8 Nectarine 1 medium 5.4 Peach 1 medium 5.9 Orange (navel) 1 medium 6.1 Papaya 1/2 medium 6.3 Honeydew 1/8 of med. melon 6.7 Banana 1 medium 7.1 Blueberries 1 cup 7.4 Date (Medjool) 1 medium 7.7 Apple (composite) 1 medium 9.5 Persimmon 1 medium 10.6 Watermelon 1/16 med. melon 11.3 Pear 1 medium 11.8 Raisins 1/4 cup 12.3 Grapes, seedless (green or red) 1 cup 12.4 Mango 1/2 medium 16.2 Apricots, dried 1 cup 16.4 Figs, dried 1 cup 23.0

What About Sugar Alcohols Like Xylitol?

Sugar alcohols such as xylitol are not as sweet as sugar, but they contain fewer calories. One reason that sugar alcohols provide fewer calories than sugar is because they are not completely absorbed into your body. Because of this, eating many foods containing sugar alcohols can lead to abdominal gas and diarrhea.

However, sugar alcohols -- including xylitol -- do not make "sugar-free" foods calorie free. If foods containing sugar alcohols are eaten in large enough quantities, the calories can be comparable to sugar-containing foods. As with all foods, you need to carefully read the food labels for calorie and carbohydrate content, regardless of any claims that the food is sugar-free or low-sugar.

Maltitol, another commonly used sugar alcohol, spikes blood sugar almost as much as a starchy new potato. Xylitol, in comparison, does not spike blood sugar much at all. Pure xylitol also does not usually produce the gas or bloating associated with other sugar alcohols.

So in moderation, some sugar alcohols can be a better choice than highly refined sugar, artificial sweeteners, agave or high fructose corn syrup. Of the various sugar alcohols, xylitol is one of the best. When it is pure, the potential side effects are minimal, and it actually comes with some benefits such as fighting tooth decay. All in all, I would say that xylitol is reasonably safe, and potentially even a mildly beneficial sweetener.

As an aside, xylitol is toxic to dogs and some other pets, so be sure to keep it out of reach of your family pets.

Is Honey a Healthy Sweetener?

High-quality honey contains natural antioxidants, enzymes, amino acids, vitamins, and minerals. Unfortunately, most of the honey eaten today has been heavily processed.  Like most foods that have been chemically refined, many of the healthful benefits have been reduced or eliminated. Commercial honey is often treated with an excessive heating process that can destroy some of the critical natural enzymes, vitamins, and minerals. 

If you do consume honey, make sure it is unprocessed Manuka honey, which has such potent antibacterial properties it is now being used in medical products such as wound dressings. However, remember that all honey is very high in fructose, so it would be best to limit your use of even Manuka honey to less than one TEASPOON per day. Raw honey is another option but doesn't have the same potent antibacterial properties.

This would give you about 20 grams of fructose and leave you with a little room for a healthy serving of fresh fruit, or some of the inevitable fructose that is added to so many other foods that you normally eat.

Can This Safe Sweetener Actually Reverse Diabetes?

The herb stevia is one of my favorite options for an occasional sweetener. It's a safe, natural plant that's has been around for over 1,500 years and is ideal if you're watching your weight, or if you're maintaining your health by avoiding sugar. It is hundreds of times sweeter than sugar and truly has virtually no calories.

Further, research suggests it may actually have some beneficial properties, as a new study revealed that diabetic rats given stevia had a delayed but significant decrease in blood glucose level, without producing hypoglycemia, while also demonstrating a loss in body weight.

Personally I believe stevia is the best sweetener available today. Many complain about a bitter aftertaste with stevia, but this is typically related to the processing. I prefer to use it in its liquid form in flavors like English Toffee and French Vanilla (it only require a few drops to sweeten a drink). That said, like most choices, especially sweeteners, I recommend using it in moderation, just like sugar.

One More Safer Sweetener Option

Another safe alternative to sugar is pure glucose. You can buy pure glucose (dextrose) as a sweetener for about $1 a pound. It is only 70 percent as sweet as sucrose, so you'll end up using a bit more of it for the same amount of sweetness, making it slightly more expensive than sucrose—but still well worth it for your health as it has ZERO grams of fructose. Remember, glucose can be used directly by every cell in your body and as such is far safer than the metabolic poison fructose.

The Bottom Line …

When it comes to sugar, virtually all forms will be toxic to your health in the long run. Switching from refined white sugar to cane sugar, date sugar, coconut sugar, brown rice syrup, fruit juice, molasses, maple syrup, sucanat, sorghum, turbinado or agave syrup will NOT ameliorate any of the risks as they all contain HIGH amounts of fructose. But, if you want to RADICALLY reduce, and in many cases virtually eliminate, your risk of the following diseases

• Cancer
• Heart Disease
• Obesity
• Diabetes
• Alzheimer's

… then start getting VERY serious about restricting your intake of sugar, and particularly fructose. My nutrition plan offers a no-fuss guide to help you revise your current diet into one that's very low in sugar and still completely satisfying.