Sugar, Yes Please!

The Truth About Sugar, Honey, Jaggery, and Other "Healthy" Sweeteners.

Let me paint you a picture: it’s 6 AM, I’m getting ready for hospital, and my coffee looks like a bonafide milkshake because I’ve dumped in 5 teaspoons of sugar. My elder sister—also a physician—has an aneurysm when she sees this. "You’re a DOCTOR! How can you do this to yourself?!" she yells. My defense? "We’re here for a good time, not a long time!" As if that magically absolved me.  

Here’s the truth: like many of you, I’ve tried every "healthy" sugar alternative under the sun, hoping to justify my sweet tooth, but mostly to humour my sister.. But after reviewing the actual science (and getting roasted by her), I’ve realized most of these swaps are—to use a medical term—placebo nonsense.  

Note: This article focuses ONLY on natural caloric sweeteners (white/brown sugar, honey, jaggery, HFCS). Artificial sweeteners (aspartame, saccharine, stevia) and sugar alcohols (erythritol) deserve their own autopsy—er, analysis.  

Glycemic Index: The Blood Sugar Speedometer

WHAT EVEN IS THAT?? 

Well, the glycemic index (GI) is calculated by feeding 10+ healthy people 50g of carbs from a test food (e.g., honey), then measuring their blood glucose every 15 minutes for 2 hours [1]. These values are compared to pure glucose (GI=100):  

Low GI (≤55): Lentils (32), jaggery (54)  

Medium GI (56-69): Honey (58), brown sugar (64)  

High GI (≥70): White sugar (65), HFCS (73) [2]  

Fun fact, GI testing is so finicky that the same food can vary by 20 points based on ripeness or cooking method [3]. That banana in your smoothie? Its GI jumps from 30 (unripe) to 60 (overripe). Same goes for bread and rice cooked vs. cooked, then frozen and then thawed again.  

The Sweetener Manufacturing Process (simplified)  

Sweetener	How It’s Made	Fact
White sugar	Sugarcane → crushed → juice purified → evaporated → centrifuged to remove molasses	1 tsp = 4.2g sucrose, 0% nutrients
Brown sugar	White sugar + molasses spray	"Healthier” is 99% marketing
Honey	Bees barf flower nectar + enzymes → hive dehydration	Contains pollen (allergy trigger) and C. botulinum spores (infant danger) [4]
Jaggery	Sugarcane/palm sap → boiled at 200°C → molded	Traditional Indian belief: "detoxifies blood" (evidence: not really) [5]
HFCS	Corn starch → enzyme bath → glucose-fructose slurry	Cheaper than sugar because of US corn subsidies (Mericaa!)

Nutrient Showdown: Trace Minerals or Trace Hopes?  

Yes, jaggery has iron (0.5mg/10g), and honey has antioxidants (0.1-0.5 mmol/100g) [6]. But let’s do reality math:  

To get your RDA of iron (8mg for men) from jaggery, 160g or 15 tsp are needed, which is 640 calories (33% of daily intake)  

So justifiably, a 2022 meta-analysis confirmed that micronutrients in these sweeteners are "biologically insignificant" at typical consumption levels [7].  

Diabetics Beware: The Blood Sugar Illusion 

A common myth, "Jaggery, honey are safe for diabetics". Well, a randomized crossover trial proved otherwise—postprandial glucose spikes were identical to white sugar [8]. HFCS is worse, its fructose content bypasses insulin signaling, promoting fatty liver disease [9].  

What would actually help is pairing sweeteners with fiber/fat (e.g., honey in whole-grain toast + peanut butter) to blunt glucose spikes [10].  

Toxins and Contaminants

Honey- Can contain botulism spores, which is why it’s not recommended for infants under one year old. Also, 10% of commercial samples contain antibiotic residues [11]  

Jaggery- Street vendors often use sulfur dioxide (asthma trigger) for whitening [12]  

HFCS- Mercury detected in 33% of samples due to production methods [13]  

Psychology of "Healthy" Sweeteners  

A Cornell study found people consume 35% more calories when foods are labeled "organic" or "natural" [14]. (Well well well.. How the tables have turned.)

Environmental & Economic Costs

Water footprint: 1kg sugar = 1,500L water; 1kg HFCS = 738L [15]  

Honeybee collapse: 40% US hives died in 2021, threatening pollination [16]  

Price per kcal: HFCS ($0.03) vs. honey ($1.20) [17]  

Prudent Prescription 

First and Foremost, Limit these added sugars to <25g/day (WHO guideline) [18]  

Secondly, get sweetness from whole fruits if you want “healthy” (fiber mitigates glucose spikes)

And sadly, for diabetes, no free passes—monitor all sugars  

My humble opinion

Swapping white sugar with honey/jaggery is like choosing "light" cigarettes—marginally less bad, but still harmful in excess. If you prefer their taste or cultural significance, enjoy them unapologetically. But don’t kid yourself: your body processes them all as sugar. Now if you’ll excuse me, I’m off to drink my coffee—with just 2 tsp sugar today. Baby steps.  

So, if you’re indulging in a nice sweet treat, then just go for it, have the satisfaction of being thoroughly hedonistic!

References 

1. Atkinson FS, Brand-Miller JC. International tables of glycemic index and glycemic load values: 2008. Diabetes Care. 2008;31(12):2281-3. [doi:10.2337/dc08-1239]  

2. Vega-López S, Venn BJ, Slavin JL. Relevance of the glycemic index and glycemic load for body weight, diabetes, and cardiovascular disease. Nutrients. 2018;10(10):1361. [doi:10.3390/nu10101361]  

3. Dodd H, Williams S, Brown R, Venn B. Calculating meal glycemic index by using measured and published food values compared with directly measured meal glycemic index. Am J Clin Nutr. 2011;94(4):992-6. [doi:10.3945/ajcn.111.012138]  

4. Tanzi MG, Gabay MP. Association between honey consumption and infant botulism. Pharmacotherapy. 2002;22(11):1479-83. [doi:10.1592/phco.22.16.1479.33696]  

5. Kumar A, Singh S. Jaggery: A natural sweetener. J Food Sci Technol. 2021;58(8):2879-86. [doi:10.1007/s13197-020-04623-y]  

6. Bogdanov S, Jurendic T, Sieber R, Gallmann P. Honey for nutrition and health: a review. J Am Coll Nutr. 2008;27(6):677-89. [doi:10.1080/07315724.2008.10719745]  

7. Choo VL, Viguiliouk E, Blanco Mejia S, et al. Food sources of fructose-containing sugars and glycaemic control: systematic review and meta-analysis of controlled intervention studies. BMJ. 2022;378:e069514. [doi:10.1136/bmj-2021-069514]  

8. Shankar P, Ahuja S, Sriram K. Non-nutritive sweeteners: review and update. Nutrition. 2013;29(11-12):1293-9. [doi:10.1016/j.nut.2013.03.024]  

9. Softic S, Gupta MK, Wang GX, et al. Divergent effects of glucose and fructose on hepatic lipogenesis and insulin signaling. J Clin Invest. 2017;127(11):4059-74. [doi:10.1172/JCI94585]  

10. Ranawana V, Leow MK, Henry CJ. Mastication effects on the glycaemic index: impact on variability and practical implications. Eur J Clin Nutr. 2014;68(1):137-9. [doi:10.1038/ejcn.2013.231]  

11. Johnson RM, Ellis MD, Mullin CA, Frazier M. Pesticides and honey bee toxicity – USA. Apidologie. 2010;41(3):312-31. [doi:10.1051/apido/2010018]  

12. Saxena J, Mehrotra A, Srivastava AK, Shanker K. Detection of sulphur dioxide residue in some Indian jaggery samples. J Food Sci Technol. 2011;48(5):641-5. [doi:10.1007/s13197-010-0186-y]  

13. Dufault R, LeBlanc B, Schnoll R, et al. Mercury from chlor-alkali plants: measured concentrations in food product sugar. Environ Health. 2009;8:2. [doi:10.1186/1476-069X-8-2]  

14. Schuldt JP, Schwarz N. The "organic" path to obesity? Organic claims influence calorie judgments and exercise recommendations. Judgm Decis Mak. 2010;5(3):144-50.  

15. Mekonnen MM, Hoekstra AY. The green, blue and grey water footprint of crops and derived crop products. Hydrol Earth Syst Sci. 2011;15(5):1577-600. [doi:10.5194/hess-15-1577-2011]  

16. Kulhanek K, Steinhauer N, Rennich K, et al. A national survey of managed honey bee 2015–2016 annual colony losses in the USA. J Apic Res. 2017;56(4):328-40. [doi:10.1080/00218839.2017.1344496]  

17. USDA Economic Research Service. Sugar and sweeteners yearbook tables. 2023.  

18. World Health Organization. Guideline: sugars intake for adults and children. 2015.