It’s all about the Sugars

Jennifer Bryant, MS, RD, LD, CDE

 So your friend told you that agave syrup has a lower glycemic index than sugar, and so you started buying it to put in your morning cup of coffee.  Your grandma tells you that honey will get rid of your cough, and your spouse is upset with you that you are spending more money on the sweetener that you think is better for you.  With so much conflicting information, how do you know what you should be consuming?

About 15% of the calories in the American adult diet come from added sugars. That’s about 22 teaspoons of added sugar a day.1   We are consuming altogether too many sugars!  The American Heart Association recommends limiting sweeteners to no more than 6 teaspoons for women and 9 teaspoons for men per day, on average. That includes all sources, whether it’s agave, sugar, high-fructose corn syrup, or anything else.  That means we are eating 2-4 times as much sugar as we should be!  Already we see that we need to reduce the amount of sugar we consume.  But when we do consume sugar, what kind should we choose?  Here we look at the common sugars available in the markets.

 High Fructose Corn Syrup (HFCS)

HFCS now represents > 40% of caloric sweeteners added to foods and beverages and is the sole caloric sweetener in soft drinks in the United States. It is estimated that the consumption of HFCS is about 132 kcal per day.  On the high end, the top 20% of consumers ingest 316 kcal from HFCS/day.2  HFCS is almost a 4 letter word in America right now.  HFCS has been blamed for America’s obesity epidemic as the trend to use more HFCS increases, so do our obesity rates.

The processing of HFCS starts as corn in a field.  It is harvested and sent to a refinery where the corn is crushed, and then the starch is separated from the rest of the plant.  An enzyme is then added to breakdown the starch into 42% fructose and 58% glucose.

A few words on glucose and fructose

You should know that fructose metabolism is different than glucose metabolism in our bodies.  Glucose is absorbed in the upper gastrointestinal (GI) track, and will cause a release of insulin, therefore, increasing the satiety (fullness) factor of the food we just ate.  Glucose is absorbed into the cell with the help of the Glut4 transporter.  Glucose is broken down in the glycolytic pathway eventually to 2 pyruvate molecules that ultimately will result in ATP (our body’s source of immediate usable energy).3

 Fructose on the other hand is absorbed in the lower GI track and doesn’t signal the release of insulin.  It is absorbed with help of the Glut5 transporter into the cell where it is then transformed into a molecule that helps form the backbone structure for the synthesis of triglycerides and phospholipids.  If we consume excess fructose, the extra carbon molecules from the breakdown of it produce excess lipogenesis (the making of fat) in the liver.3

 Sucrose is a disaccharide that when consumed is rapidly broken down into a 50/50 mix of glucose and fructose.  Glucose and fructose are monosaccharides which is the simplest of all of our carbohydrates.

 The processing of HFCS continues and after the sugar is in this form (42% fructose and 58% glucose) it goes through an activated carbon filter and the end result is a purified HFCS42.  It then goes through a liquid filtration to increase the fructose content to 90% fructose and 10% glucose.  The result is HFCS90.  HFCS90 and HFCS42 are then mixed to form a blended HFCS that is 55% fructose and 45% glucose.  This is the most common form of HFCS called HFCS55.

There have been some studies showing that the metabolic differences in sucrose and HFCS are significant enough to affect body weight and adiposity.  One study in rats showed a significant difference in the experimental group for increases in weight, central adiposity (fat around the mid-section), and triglycerides.Other animal studies show an effect on mental processing with an increase in consumption of HFCS.We always must keep in mind that these are animal studies and those cannot be translated into what would happen in humans.

Cane and Beet Sugar

Cane and beet sugar are actually lower in Calories per tablespoon than any of the other sweeteners we are discussing here.  The processing of sugar cane starts at the sugar mills (typically located next to the cane sugar fields) the raw sugar is separated from the plant.  The stalks are washed and cut, then rollers press the juice out.  Beet sugar is a very similar process, but starts with slicing the beet into thin strips called cossettes.  The cossettes go into a large tank called a diffuser where the raw juice is extracted.  The result is a liquid with the consistency of syrup.  The syrup or juice is then clarified.  Then it is concentrated6.  Then it is crystalized.  Our “raw sugar” product typically ends here, with one more filtration step.  Therefore, our “raw sugar” is still processed.  The rest of our sugar products go on remove the outer layer of molasses.  Then the sugar cane refinery processes this raw sugar into brown sugar, white sugar, and other sugar products.  Next, carbon filters remove any additional colors and impurities producing a white sugar syrup.  The water is then evaporated off.  Through this evaporation, the crystals form their appropriate size for their product.  The sugar is spun again and rinsed with fresh hot water.  Then the crystals go into a dryer to evaporate more of the water.  Cane sugar and beet sugar are what typically make up our “table sugar”.


Did you know that 76% of the honey sold in the U.S. has had the pollen filtered out?  Since the pollen is filtered, it doesn’t have the same health benefits as pure honey according to Food Safety News in an article published in 2011.7 “Ultra filtering is a high-tech procedure where honey is heated, sometimes watered down and then forced at high pressure through extremely small filters to remove pollen, which is the only foolproof sign identifying the source of the honey.”  “However, most beekeepers say traditional filtering used by most will catch bee parts, wax, debris from the hives and other visible contaminants but will leave the pollen in place.”  Most organic honey products still contained their pollen, which is where the health benefits occur.7

 Honey has been long known for its many health benefits.  There are many other health claims including wound healing, cough suppression, and relief from allergies.  Honey does contains small amounts of zinc, selenium, and some vitamins.8  A review published in the Journal of the American College of Nutrition reveals that honey can have a positive nutritional effect when consumed in higher doses of 50-80 grams daily.But it takes a lot to see any small effects.  50 grams of honey=152 Calories or about 2 ½ Tablespoons a day, and that is a lot of honey!

There may be a special protein in the honey that is deposited from the bee’s immune system that is responsible for its antibacterial properties.10  Another study found that it may be a different component of honey responsible for these antibacterial properties.  Researchers at Lund University in Sweden have identified a unique group of 13 lactic acid bacteria found in fresh honey, from the stomach of bees. The bacteria produce a myriad of active antimicrobial compounds.11

Honey boasts anti-inflammatory and antibacterial properties, although to date, none of these claims have been thoroughly substantiated.  The Mayo clinic currently gives honey a “C” rating for antibacterial properties, allergies, cough, and a few other health conditions, which means there is unclear scientific evidence for these uses.12


 Agave syrup is 1.5 times sweeter than sugar, meaning you may need to use less of it for the same sweetness factor.  It has 60 Calories per Tablespoon and although it is thought of as “less processed” it is still processed before it comes to your grocery store.

Blue agave is the plant whose stem has the most carbohydrates and so it is the one most commonly used for syrup.  Sap is extracted from the core of the plant.  It is then filtered and heated at a low temperature.  Using a low heat gives it grounds to be considered a “raw” food.  This heating process breaks down the carbohydrate into sugars.  It is filtered and purified before packaging.  The filtering and purification process that agave goes through is actually similar to how HFCS is produced.13

Agave is recommended as the best sweetener mainly for its low glycemic index, which varies depending on the type of agave from 11-35.

 A few words about Glycemic Index:

The glycemic index (GI) is a ranking of carbohydrates on a scale from 0 to 100 according to the extent to which they raise blood sugar levels after eating. Foods with a high GI are those which are rapidly digested and absorbed and result in marked fluctuations in blood sugar levels.  It was developed at the University of Sydney.  You can search the GI of many foods at their website:

Fat, protein, and fiber content all affect the GI of a food.  The GI is also varied depending on the person’s digestive system, gender, age, and weight.  With so many variables, you can see that the glycemic index has some flaws.  Most people don’t eat a single food at one time, which instantly makes the GI of that food invalid.  When you consider that fiber, protein, and fat all decrease the GI of a food, which means if you are eating a well-balanced meal, you should be eating low GI anyway!  Do any of you eat your agave syrup all by itself?

There is still limited information and research on agave syrup as it is a fairly new trend in popular sweeteners.  As reported by Dr. Ingrid Kohlstadt, a fellow of the American College of Nutrition and an associate faculty member at Johns Hopkins School of Public Health:  “Agave is almost all fructose, a highly processed sugar with great marketing.”

Pure Maple Syrup

Maple syrup is often thought of as a healthy lesser processed sweetener.  Here is a quick summary of how your pure maple syrup gets to your grocery store.  First, the sap is collected from maple trees in the early spring where the nights are still below freezing.  Sap flows typically for 4-6 weeks or as long as the temperatures are above freezing in the daytime, and below freezing at night. A small hole is drilled into the tree and the sap is collected.  After the collection of the maple sap, it is then boiled to evaporate water and achieve the syrup consistency. It takes approximately 35-50 gallons of maple sap to create one gallon of syrup after evaporation.  It is then filtered to remove impurities and then canned while hot.  Maple syrup contains antioxidants, and small amounts of vitamins and some minerals.  It consists of mainly sucrose and water.

Coconut Sugar

The now popular Paleo diet recommends this type of sugar as a more natural alternative to other sweeteners.  Many people are following this trend and choosing coconut sugar as their preferred option.  Coconut sugar is processed similarly to cane and beet sugar, although with a few less steps it is possible it retains slightly more nutritional value.  First, the coconut flower bud is cut and the sap is drained.  After that it is filtered, then evaporated to concentrate the sugar.  It is then granulated, grinded, and sent through a screen to remove impurities.  It is then dried one last time before packaging.  It’s nutritional profile is very similar to table sugar.  Table sugar is 99% sucrose, and coconut sugar is 70-79% sucrose with the rest a mix of glucose and fructose.  Coconut sugar boasts a lower Glycemic Index (GI) possibly because it contains small amounts of a fiber called inulin that may help to slow absorption.14

Have you made your decision yet?

 If you said, “no” don’t worry!  I am going to give you my two cents.  To compare all of the information we have talked about, I put together a graph.


Type of Sugar Calories per TBSP % Fructose Proposed Benefits Drawbacks  Cost per Pound  Glycemic Index
HFCS 53 55 Least expensive Highly processed?  High GI  $                       3.04 90
Cane or Beet Sugar 45 50 Lower Calories, Less expensive Higher GI  $                       3.68 60
Honey 60 56 Immunity?  Antioxidants Filtered honey not the same  $                       5.28 58
Agave 60 72 Lower GI More expensive, high fructose  $                       4.80 30
Maple Syrup 52 50 Least processed, has antioxidants Most expensive  $                       9.28 54
Coconut Sugar 64 44 Lower GI, Contains potassium. More expensive  $                       6.00 54


Knowing now that the glycemic index has many flaws.  I don’t believe that should be used as a strong indicator of which sweetener we should prefer.  I do think it is worth considering the Calories in the product, which would make our regular table sugar, at 45 Calories per tablespoon, a great choice.  Our highest Calorie option is coconut sugar at 64 Calories per tablespoon.  But as you can see they are all fairly close in terms of Calorie content.

 I also think it is worth looking at the fructose content in the different options.  Since we know that fructose has the potential to increase triglycerides and other lipids in our blood, we must be aware of the fructose content in our choices.  All of our sweeteners are all very similar at right around 50%, but coconut sugar does win the prize for lowest fructose content at 44%.  It is interesting that honey and HFCS have a slightly higher fructose content of 56 and 55% respectively.  Agave syrup is very obviously the highest in fructose content at 72%.   


If we now consider the expense of the product, we can easily see that HFCS is the cheapest option, where pure maple syrup is by far, the most expensive.  With coconut sugar, honey, and agave somewhere in the mid-range for price, and cane or beet sugar the second least expensive option. 


Bottom Line

We should all be eating LESS SUGAR!  No matter what the original form is, we probably all need to cut down on it.  Try tracking your sugar intake over the next week with the goal of eating less than 6 teaspoons per day for women and 9 teaspoons per day for men.  At 4 grams per teaspoon, that means women should keep added sugars below 24 grams per day, and men should keep them below 38 grams per day.  ADDED sugars include all those not found naturally in fruits and dairy products.  To give you an idea, one Hostess chocolate cupcake has 21 grams of sugars (all of them added), so there goes your entire daily allowance if you are a woman.  Added sugars will soon be appearing on your food label!  The new (July 2017) FDA food and nutrition label includes added sugars just under the sugars category.  You will be able to glance at your label and quickly tell how much of the sugar is added.

When you choose a sweetener, take into account fructose, Calories, and cost.  Personally I will choose from pure maple syrup, regular table sugar, and honey.  Although maple syrup is one of the higher priced items, its low processing, and moderately low fructose and Caloric content, make it a really good choice.  Table sugar is inexpensive, on the lower end for fructose, and the lowest in Calories per tablespoon, so I will be using that one also.  Lastly, honey has potential to be good for our immunity, and I like the taste.  The evidence so far doesn’t support spending more money on agave and coconut sugar no matter how good the marketing is—and it is REALLY GOOD—you thought they were better too didn’t you?


  1. Sweet Stuff: How Sugars and Sweeteners Affect Your Health October 2014.
  2. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. George A Bray, Samara Joy Nielsen, and Barry M Popkin. Am J Clin Nutr April 2004 vol. 79 no. 4 537-543.
  3. Academic Journal Review High fructose corn syrup: Production, uses, and public health concerns. Kay Parker, Michelle Salas and Veronica C. Nwosu.  Biotechnology and Molecular Biology Review. Dec 2010. Vol. 5(5), pp. 71 – 78.
  4. High-fructose corn syrup causes characteristics of obesity in rats: increased body weight, body fat and triglyceride levels. Bocarsly ME1, Powell ES, Avena NM, Hoebel BGPharmacol Biochem Behav. 2010 Nov;97(1):101-6.
  5. This is your brain on sugar: UCLA study shows high-fructose diet sabotages learning, memory: Eating more omega-3 fatty acids can offset damage, researchers say. Elaine Schmidt | May 15, 2012
  7. Tests Show Most Store Honey Isn’t Honey. By Andrew Schneider. Food Safety News. November 7, 2011.
  8. Ask A Scientist: Is Honey Healthier Than Sugar? Healthy Living. Huffington Post.  Updated Jun 09, 2014.
  9. Honey for Nutrition and Health: A Review. Stefan Bogdanov Swiss Bee Research Centre, Agroscope Liebefeld-Posieux Research Station ALP, Berne, SWITZERLAND , PhD, Tomislav Jurendic Swiss Bee Research Centre, Agroscope Liebefeld-Posieux Research Station ALP, Berne, SWITZERLAND, Robert Sieber Swiss Bee Research Centre, Agroscope Liebefeld-Posieux Research Station ALP, Berne, SWITZERLAND , PhD & Peter Gallmann Swiss Bee Research Centre, Agroscope Liebefeld-Posieux Research Station ALP, Berne, , PhD. Pages 677-689 | Journal of the American College of Nutrition.  Published online: 14 Jun 2013.
  10. How honey kills bacteria. P. H. S. Kwakman, A. A. te Velde, L. de Boer, D. Speijer, C. M. J. E. Vandenbroucke-Grauls, S. A. J. Zaat. The FASEB Journal, 2010.
  11. Lactic acid bacterial symbionts in honeybees – an unknown key to honey’s antimicrobial and therapeutic activities. Tobias C Olofsson, Èile Butler, Pawel Markowicz, Christina Lindholm, Lennart Larsson, Alejandra Vásquez. International Wound Journal, 2014
  12. Mayo Clinic Website.
  13. The Lowdown on High Fructose Corn Syrup and Agave “Nectar”.
  14. Coconut Sugar – Healthy Sugar Alternative or a Big, Fat Lie?  By Kris Gunnars, BSc.

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