Sugar, sorry to say, can make us sick. The most popular alternative, artificial sweeteners, have long posed health concerns and may lead to weight gain.

Enter stevia, a calorie-free herb said to be up to 300 times sweeter than sugar.

In what will surely spice up the decadeslong debate over sugar substitutes, companies as large as Coca-Cola and as obscure as Seattle-based Zevia say stevia’s time has come. But the U.S. Food and Drug Administration isn’t about to make things easy for consumers worried about sugar intake and often confused by the options.

Stevia has been used as a sweetener for hundreds of years in Paraguay and Brazil and has been added to soft drinks, ice cream, pickles, candies and breads in Japan since the 1970s.

But the FDA has not approved it as a food additive, citing safety concerns. The European Union and Canada also don’t allow food companies to add stevia to products.

“Reports have raised concerns about control of blood sugar and the effects on the reproductive, cardiovascular and renal systems,” the FDA wrote in a warning letter to Hain Celestial, which included stevia as an ingredient in one of its teas.

But stevia, also called stevioside, is widely available – and perfectly legal – in the United States when it’s purchased as a dietary supplement. It often can be found just a few aisles away from Equal, tucked among the vitamins, minerals and herbs. The sweet-leafed herb, derived from the bushy South American stevia rebaudiana plant, also is easily obtained via the Internet.

Stevia proponents believe this nonsensical situation – stevia is acceptable as a dietary supplement but not as an ingredient – has kept Americans in the dark about the herb’s candylike leaves, which can have a menthol-like bitter aftertaste. When used in low amounts for sweetening, stevia has zero calories, is not carcinogenic – on the contrary, it has been shown to reduce breast cancer in rats – and does not accumulate in the body, proponents say.

The lethal dose is very high, according to Belgian researcher Jan Geuns, author of “Stevioside: A safe sweetener and possible new drug for treatment of the metabolic syndrome,” a paper he presented at the 2006 American Chemical Society national meeting.

“Stevia is completely safe,” he said.

What worries stevia critics is that Americans tend to have a problem with moderation. Stevia might be fine if it’s used twice a day in a cup of tea. But “if stevia were marketed widely and used in diet sodas, it would be consumed by millions of people and that might pose a public health threat,” said the consumer watchdog group Center for Science in the Public Interest.

Regardless, Americans want a natural alternative. Nearly 7 of 10 U.S. adults say they want to cut down or avoid sugar completely, according to the market research firm The NPD Group, a concern that has driven up the use of artificial sweeteners. But two-thirds are concerned about the safety of sweeteners, according to another report.

The two leading chemical sweeteners, aspartame (NutraSweet, Equal) and sucralose (Splenda), have been approved by the FDA, but are still highly controversial.

Whole Foods says it won’t carry products containing sucralose, which is made by chlorinating sugar, because it believes many of the safety studies were commissioned by those who had a financial interest in its approval. And the granddaddy of the group, saccharin (Sweet’n Low), is a petroleum derivative that has been banned in Germany and France for almost a century.

“I’ve seen a shift in consciousness” about sugar substitutes, said Ann Louise Gittleman, author of “Get the Sugar Out” (Random House, $13.95). Gittleman recently updated her 1996 book to include more information on high-fructose corn syrup as well as sugar’s effect on aging and cancer.

“It’s part of people becoming more aware of toxins in the environment on all levels,” she said. “Try as we might, you can’t trick the body or Mother Nature.”

When we do try, by using no- or low-calorie artificial sweeteners, for example, it often backfires. A recent study by Purdue University researchers showed that artificial sweeteners can make you fat because the body is programmed to associate sweet tastes with calories consumed. When the natural connection is broken – false sweetness isn’t followed by lots of calories – the metabolic system is confused and people may eat more, or expend less energy than they normally would, said study co-author Susan Swithers.

Cue stevia. For Jessica Newman, 37, the intensely sweet leaf that can be dropped in tea, coffee or oatmeal was exactly what she needed to break her daily habit of five Diet Cokes.

An attorney, mother of three and marathon runner in Seattle, she fueled herself on diet soda and Powerbars, but longed for a healthy alternative to artificial sweeteners.

When she found stevia, she became such a proponent that she, along with her husband, Derek, and their friend Ian Eisenberg, developed a stevia-based dietary supplement called Zevia. The five-calorie sugar-free beverage, which is essentially a soft drink but can’t be labeled as such, has no artificial flavors, food dyes or phosphoric acid.

Demand has been brisk; Zevia is in a dozen states and within a month is expected to be available at Sunset Foods stores in Chicago’s north and northwest suburbs. Newman says they’ve received e-mail orders from every state and currently are offering a free six-pack to those willing to pay the shipping charges.

“Many of the people who are responding to Zevia already know about stevia and the dangers of artificial sweeteners,” Newman said. “We think we’re offering a choice to kick the diet soda habit. We call it “nature’s answer to diet soda.”‘

Coke, meanwhile, has filed several dozen patent applications for the ingredient and teamed up with Cargill to develop its own stevia product called Rebiana. It plans to introduce Rebiana in countries where the ingredient is already approved and petition the FDA to allow stevia to be used as a food additive.

“Stevia is wonderful; it has no glycemic properties, actually enhances blood sugar balance, is high in soluble fiber, and full of antioxidants,” said Chicago nutritionist Bonnie Minsky of Nutritional Concepts.

But not everyone wants to give up an occasional Diet Coke. Fifteen-year-old Christine Elizabeth Cauthen started a Facebook group called “I Drink Artificial Sweeteners and I’m Proud of It” after a friend planned to swear them off because studies have linked them to cancer.

“If you think about it, a lot of things in life cause cancer,” Cauthen said in an e-mail. “I don’t see anything wrong with having (Diet Coke) every once in a while.”

Stop! Don’t reach for that diet soda!

Although we all would be healthier if we cut sugar and sweeteners out of our diet, it’s a tall order. Humans are hard-wired for sweetness.

But since 1985, the annual per-person consumption of all added sugars – everything from beet sugar to high-fructose corn syrup – has climbed 30 pounds, from 128 pounds to 158 pounds. The result of this national sugar rush is an epidemic of inflammatory-related disorders, obesity and Type 2 diabetes.

“Most Americans’ taste buds are so completely out of whack that we don’t know what tastes sweet,” said Connie Bennett, author of “Sugar Shock” (Penguin, $14.95) “When you kick artificial sweeteners or sugar, your taste buds begin to change. Vegetables such as celery, jicama and sweet potatoes taste much better and more interesting.”

Tapering down is your best bet, because stopping “cold turkey” may cause withdrawal symptoms, sometimes severe. Here are a few ways to get started.

-“Unless there’s an overwhelming reason (such as diabetes) to cut sugar consumption quickly, begin by avoiding sugary snacks, foods and drinks until dinner,” said nutritionist Bonnie Minsky of Nutritional Concepts in Chicago. “Eating protein three times daily and substituting sugary snacks with nuts/seeds/dried fruits will prevent blood-sugar lows. Look forward to one sugary “treat’ (dark chocolate) after a balanced dinner. Keep cookies, cakes, and candies out of the house.”

-To wean yourself off diet soda, stick to two a day and don’t drink it between meals to satisfy thirst, said Ann Louse Gittleman, whose book “Get the Sugar Out” (Random House, $13.95) contains 501 ways to reduce sugar consumption. “If you drink it with food, you might be tempted to have something more nutritious. But don’t use (soda) as a stimulant to keep you going.”

-Drink half your body weight in ounces of water; when you crave something sweet, eat something sour, such as a pickle. Also, suck on cinnamon sticks or cloves, Gittleman said.

-If you’re a real sugarholic, substitute two pieces of dried fruit, a fig or date. “Eat a little of everything and a lot of nothing,” Gittleman said. “And eat it after a full meal where you have fat and protein to prevent your blood sugar from dipping.”

-Delay, distance and decode your craving, Bennett advised. “If you want diet soda, first get a glass of water. Then distance yourself from the tempting soda machine.”

-Find an acceptable alternative. Gittleman recommends Celestial Seasonings Bengal Spice tea and carbonated or regular water with a slice of lemon or orange.

More choices to help you move away from sugar

Although sugar is still sugar, the following can be used in small amounts in place of artificial sweeteners until you’re ready to give it up altogether. The products below are available at most health food stores and gourmet or specialty food stores. Online, visit Check Asian or Mediterranean grocery stores for ground date sugar. Prices listed are approximate.

Brown rice syrup

Amber colored, with a mild butterscotch or caramel-like flavor; it’s about half as sweet as sugar and is gluten free, according to Connie Bennett, author of “Sugar Shock.” The syrup is made by fermenting cooked brown rice with enzymes. After straining off the liquid, the process converts the rice starches into about 50 percent soluble complex carbohydrates, 45 percent maltose and 3 percent glucose.

Cost: $5 to $6 for 16 ounces.

Real maple syrup

A little drop goes a long way. It’s made by boiling down maple sap and contains a full complement of minerals and is particularly rich in potassium and calcium, said Ann Louse Gittleman, author of “Get the Sugar Out.”

Cost: $7 to $10 per pint.


Although it has more calories and raises the blood sugar even more than white sugar, Jonny Bowden lists raw, unfiltered honey in his book “The 150 Healthiest Foods on Earth” (Fair Winds Press, $24.99) because it contains enzymes and phytonutrients and has some reported medicinal benefits. But it could cause allergic reactions to pollen-sensitive individuals.

Cost: $3.50 and up – way up – for 16 ounces.

Blackstrap molasses

Another Bowden favorite, molasses is the thick syrup that’s left after sugar beets or cane is processed for table sugar. Blackstrap contains the lowest sugar content of the molasseses and has a bitter-tart flavor. It has good-for-you ingredients, but few consume enough of the strong-flavored syrup to benefit.

Cost: $5 to $6 for 16 ounces.

Sorghum syrup

The National Sweet Sorghum Producers and Processors Association makes this very clear: Sorghum syrup is not the same as molasses, a byproduct of the sugar-making process. Sorghum syrup comes from sorghum cane: Juices are extracted and then concentrated through evaporation. Genuine sorghum contains nutrients such as iron, calcium and potassium. The association recommends substituting sorghum cup for cup in any recipe or dish that calls for molasses, honey, corn syrup or maple syrup.

Cost: $8 to $12 for 16 ounces.

Date sugar

If you simply can’t do without sugar, this is Gittleman’s favorite stand-in. It’s made from pulverized dried dates; although it has the consistency of sugar, it isn’t refined like sugar. It also contains fiber and is high in many minerals. One tablespoon of date “sugar” is counted as one fruit exchange in the diabetic exchange system. Because it has an intense flavor, you might be inclined to use less.

Cost: $6 to $8 for 12 ounces.

Artificial sweeteners have been hailed as an effective way to cut calories and control weight, help manage chronic conditions such as diabetes and potentially prevent cavities.

But some contend that the ubiquitous pink, blue and yellow packets can be just as harmful as sugar.

Mounting research, meanwhile, shows they can actually trigger carbohydrate cravings and lead to weight gain.

Here’s a quick look at three common sweeteners approved by the Food and Drug Administration.

• Aspartame (NutraSweet and Equal)

Aspartame, a general all-purpose sweetener in foods and drinks, is 200 times sweeter than sugar. Despite concerns that aspartame is linked to a host of ailments, including cancer, autoimmune disorders, digestive distress, mood swings and joint pain – and efforts by two states to ban it – the FDA says the sweetener is safe unless you have a genetic disorder of metabolism known as phenylketonuria.

• Saccharin (Sweet’N Low, Sweet Twin)

Saccharin is 200 to 700 times sweeter than sugar. A petroleum derivative, it is found in gum, cosmetics, baked goods, tabletop sweeteners, soft drinks and jams.

In 1977, the FDA proposed a ban on saccharin because of concerns about rats that developed bladder cancer after receiving high doses of it.

The National Cancer Institute cleared saccharin of the charge, but it’ is banned in foods in Germany and France.

• Sucralose (Splenda)

Sucralose is 600 times sweeter than sugar on average and is marketed as a “no-calorie sweetener” even though it contains 96 calories a cup, said Ann Louise Gittleman, author of “Get the Sugar Out (Random House, $13.95) Made from table sugar, sucralose adds no calories because it isn’t digested in the body.

Although some report digestive distress, especially constipation and headaches, concerns also have surfaced over long-term safety. Whole Foods won’t carry products containing sucralose because the company doesn’t believe there’s enough balanced information. But in 1999, the FDA allowed sucralose as a general-purpose sweetener in all foods.

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