Agave syrup comes from a succulent plant that grows in warm climates. It has a lower GI index than most sweeteners.
Unfortunately, that's exactly what it is. Agave is not a good alternative sweetener for people with diabetes.
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Is agave a good alternative sweetener?
Agave is a group of succulent plants that grow in warm climates, particularly the southwestern United States and Mexico.
Although it can be used as a sweetener, blue agave is high in carbohydrates, and produces nectar that is high in a type of sugar called fructose.
Some people in the alternative health community have turned to agave as a potential alternative to table sugar and other sweeteners. Support for agave stems from it being a vegan sweetener as well as its glycemic index (GI).
The higher a food's GI, the more it increases levels of glucose in the blood. Agave boasts a lower GI than most other sweeteners, which means that it is less likely to cause blood sugar spikes.
GI, however, is not the only - or the best - way to assess whether a food is healthful for people with diabetes. A 2014 study suggests that low-GI foods may not improve how the body responds to insulin.
For people already eating a healthful diet, the study also found that low-GI foods produced no improvements in cardiovascular health risk factors, such as levels of fats called triglycerides in the blood.
Agave contains higher levels of fructose than table sugar and most other sweeteners. The body releases less insulin in response to fructose. This means that blood sugar may remain higher after eating agave than other sugars.
A 2014 study of mice suggests that agave syrup might be a healthful alternative to table sugar. Mice who consumed agave nectar had lower blood glucose levels compared with mice that consumed table sugar. They also gained less weight.
However, not all research conducted on mice applies to humans. The study also only compared agave to table sugar, which is already known to be harmful to people with diabetes. Agave may be marginally better than table sugar, but this does not make it healthful.
More importantly, agave is still a sugar and, like table sugar, high-fructose corn syrup, and the other sugars, people with diabetes should avoid it.
People following a healthful diabetic diet should reduce the use of sugar rather than switch one type of sugar for another.
A high-calorie alternative to table sugar
For people with diabetes who are tempted to try agave instead of table sugar, there is another reason to avoid the switch. Agave is a higher calorie sweetener than table sugar. It contains 21 calories per teaspoon, compared with 16 calories per teaspoon.
Supporters point out that agave is sweeter than table sugar, potentially enabling a sweeter taste with a smaller quantity. However, this potential benefit is small when compared with its potential negative health consequences.
Other health risks
In addition to its high fructose content, agave poses other risks to people with diabetes. A number of studies have looked at high-fructose sweeteners. Fructose usually produces worse effects than another type of sugar called sucrose, which is found in table sugar.
Consuming too much fructose can cause liver damage.
Fructose is broken down in the liver, so consuming too much can cause liver damage. People with diabetes already face a heightened risk of liver disease, making agave a high-risk sweetener.
In 2017, a study of mice linked fructose to liver damage, including fatty liver disease and liver cell death. The study also found a link between fructose consumption and inflammation, which is linked to a wide range of illnesses.
Another 2017 study also linked fructose consumption to fatty liver disease. The study emphasizes that fatty liver disease that is not linked to alcohol consumption has increased over the past decade.
According to research from 2013, high levels of fructose consumption have been linked to metabolic problems in a number of animal studies. This can lead to weight gain, unhealthy levels of fat around the waist, and oxidative stress.
A 2005 study linked fructose to insulin resistance. Researchers also found that high fructose consumption could trigger dyslipidemia, a syndrome marked by high cholesterol and triglycerides. This suggests that eating agave syrup, as well as high-fructose corn syrup and other fructose-based sweeteners, could lead to heart disease.
However, the study cautions that the link only applies when fructose-based foods constitute 20 percent or more of caloric intake. This suggests that fructose-based sweeteners may be acceptable in moderation, but there's no reason to actively seek them out.
Safe alternative sweeteners for people with diabetes
People with diabetes should work to avoid all added sweeteners, as well as sugar-rich processed foods.
Lifestyle and dietary changes are effective ways to fight diabetes. Even though giving up sugar may be hard, it offers many health benefits.
While maple syrup is a great natural sweetener, it still contains sugar and should be used in small doses.
Those who are seeking a sweet treat should choose their sweeteners carefully. Since artificial sweeteners contain no, or few, calories, doctors once thought that they might be a safe alternative to traditional sugar. New research undermines this recommendation.
A 2015 study found that artificial sweeteners alter the bacteria that live in the gut, which could trigger insulin resistance.
While honey and maple syrup may be safer alternatives for people with diabetes, both are still sugar in the body.
A 2009 study linked 8 weeks of honey consumption to a reduction in weight and blood fat levels. However, blood sugar levels increased, suggesting that honey should only be used sparingly and certainly not as a remedy for diabetes.
Maple syrup has antioxidant and anti-inflammatory properties, which could make the effects of other sweeteners less harmful. Used in small doses, this may make it a good alternative to traditional sweeteners.
Whole fruit is the ideal way to sweeten foods since the sugars are packaged along with fiber, antioxidants, and other nutrients that can benefit health. Try fresh or dried berries mixed into oatmeal, unsweetened applesauce in plain Greek yogurt, or frozen bananas blended with cocoa powder to replace ice cream.