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Many people have questions about alternatives to “regular” sugar/table sugar/white sugar. This is not without cause – scientists are increasingly realizing that excessive sugar intake can play a role in many chronic diseases. As such, the best option for everyone is to work on reducing your reliance on sweet and sugary foods over time. As you adjust your palate, you can worry less about whether the type of sweetener you put in your iced tea is safe or how it stacks up to regular sugar. Sugar is a “habit,” and often, people find that by decreasing sweet foods, they actually lose their taste for them after a few weeks. Later, if they do eat something sugar-sweetened, it tastes “too sweet.”

If you really want to eat something sweet after a meal, and you have no health-related reasons not to, plan A should be to substitute fruit for dessert, as we note in The Science of Living Well, Beyond Cancer. Fruit contains other nutrients, and the fiber in fruit causes it to be digested more slowly, limiting the spike in blood sugar and insulin (vs. sugar alone). (Read more about how Dr. Lew Cantley, a prominent researcher on how sugar affects the growth of cancer, incorporates whole fruit, but not fruit juice, into his diet.)

What about other sugars, like date sugar, coconut sugar, maple syrup, and honey? They’re sometimes billed as healthier and “more natural,” but, to your body they’re essentially like regular sugar. Unfortunately, the minor differences – such as the trace minerals and fiber (inulin) found in coconut sugar, or a slightly lower glycemic index – don’t make up for the fact that they’re still mostly “empty” (non-nutritive) calories.

You may have heard of a few other substitutes that appear to be safe exist, such as erythritol and stevia. Another natural alternative, monk fruit extract, is over 100 times as sweet as sugar, and zero calories, so it doesn’t raise blood sugar. (It may be mixed with other ingredients, such as dextrose—so be sure to check the label first.) Monk fruit extract is generally recognized as safe by the FDA and many other countries and has been used in Asia for centuries. Sorbitol and xylitol are generally safe but may cause GI distress in large amounts. Finally, there are artificial sweeteners like saccharin and aspartame (often used to sweeten things like diet soda), which have been shown to cause cancer in laboratory animals.

Three bottom-line recommendations on sugar: 1) Moderation is key, for all sweetened foods. Although any of these table sugar substitutes may give you the treat burst that you need, they won’t help you move away from being a slave to your sweet tooth, 2) Read labels. Know what’s in your food, staying away foods with a high percentage of calories from sugar and high fructose corn syrup (a common additive in food with similar effects to pure sugar). 3)  On those rare occasions when only a slice of old-fashioned chocolate cake will do, that’s ok. Don’t stress, balance with a range of healthy vegetables on the special occasions when you splurge, and when possible, bake vs. buy your sweet products so you know exactly what is in them.