Sugar substitutes and a low-histamine diet: What should you be aware of?

Common household sugar (sucrose) consists of the simple sugars fructose and glucose. It is produced from local sugar beet or sugarcane, is high in calories, and completely devoid of nutrients. Too much sugar promotes tooth decay, obesity, diabetes mellitus, and cardiovascular diseases. According to the DGE (German Nutrition Society), total energy intake from free sugar should be less than 10%. This includes naturally occurring sugars in fruit juices, honey, and syrup, in addition to sugar in foods and beverages. Although household sugar is low in histamine, it contributes to the formation of bad gut bacteria, which can lead to intestinal problems. So, are there low-histamine alternatives to sucrose?

Natural Sugar Alternatives

There are several natural alternatives to household sugar. These also contain little to no histamine. The most natural and healthiest option is the fructose found in fruit. Dried dates, for example, can be wonderfully used as a natural sweetener. We have also leveraged the sweetness of dates in our delicious Organic Seed Muesli and our tasty Organic Seed Bar. Other low-histamine options include:

• Coconut blossom sugar: Sugar from the nectar of the coconut blossom
• Honey: contains various nutrients and fructose
• Dextrose/Glucose: Grape sugar, a naturally occurring carbohydrate form
• Maple syrup: Sap from the trunk of the sugar maple
• Agave syrup: extracted from agave
• Rice syrup: syrup made from rice flour
• Tapioca syrup: extracted from the cassava root

Aside from fruit sugar, maple syrup is the healthiest alternative. However, for people following a low-fructose diet, only dextrose, rice syrup, and tapioca syrup are suitable. The latter is easily digestible, contains fewer calories than sugar, and is perfect for allergies.

If you want to avoid refined household sugar as much as possible in your diet, it's worth checking the ingredients of ready-made foods. Our Organic Seed Muesli contains no refined sugar and is exclusively naturally sweetened with dates. It is suitable for a low-histamine, gluten-free, and lactose-free diet and is ideal for a balanced start to the day. Additionally, it is vegan and consists of 100% natural organic ingredients.

Artificial Sugar Substitutes

In addition to synthetic sweeteners like aspartame, there are also synthetic sugar substitutes. There is no maximum limit for these, which is why they can be added to foods in unlimited quantities. However, a warning is mandatory on the packaging if the amount contained exceeds 10%, alerting customers that the product may have a laxative effect if consumed excessively. Diarrhea, abdominal pain, and bloating are possible side effects. According to the European Food Safety Authority (EFSA), the following sugar substitutes are harmless to health and therefore approved in the European Union:

• Sorbitol (E 420)
• Mannitol (E 421)
• Isomalt (E 953)
• Stevia extract/Steviol glycosides (E 960)
• Polyglycitol syrup (E 964)
• Maltitol (E 965)
• Lactitol (E 966)
• Xylitol (E 967, birch sugar)
• Erythritol (E 968)

Sugar substitutes are generally low in fructose and thus tolerable for people with fructose intolerance. However, caution is advised with sorbitol, as people with fructose intolerance often also have sorbitol intolerance. This is because the human body metabolizes sorbitol into fructose. Stevia is the most suitable option among sugar substitutes for a low-histamine diet. The remaining sugar substitutes belong to the group of sugar alcohols. These generally do not contain histamine but can still lead to digestive problems as they are broken down by enzymes. Xylitol and erythritol are the most tolerable. Attention should be paid to individual tolerance limits.

The Sweetener Stevia

Stevia is extracted from the Stevia Rebaudiana plant, which originates from South America. However, Stevia products do not contain Stevia leaves, but rather Steviol glycosides, the isolated sweeteners from the leaves. The disadvantage is that Stevia is highly processed, and environmentally harmful aluminum salts are used during processing, as the processing steps are chemical. Stevia products often taste slightly bitter. Due to long transport distances, the sugar substitute is also not recommended from an ecological point of view. However, the advantage of Steviol glycosides is that they have no calories, are not tooth decay-promoting, and do not cause blood sugar levels to spike. In addition, their sweetness is 200 to 300 times stronger, which reduces the required dose.

The Sugar Alcohol Xylitol

The dosage of the sugar alcohol xylitol is quite simple, as the same amount is needed for the same sweetness as regular household sugar. Xylitol belongs to the group of polyols and has 40% fewer calories than sugar. Xylitol has no effect on blood sugar levels and significantly reduces the risk of tooth decay. This is because tooth decay bacteria cannot use the sugar substitute as a food substrate. In addition, xylitol stimulates saliva production, which contributes to the stabilization of calcium in saliva and the remineralization of tooth enamel. Although the name birch sugar sounds like a natural sugar alternative, xylitol is a synthetic substance, as birch sugar is obtained from residues such as corn cobs, straw, and other types of wood. This requires a lot of energy. In addition, sulfuric acid and caustic soda are used.

The Sugar Alcohol Erythritol

The sugar alcohol erythritol can be used for cooking and baking as well as for cold dishes. Since erythritol has about 40% less sweetness than regular household sugar, more of it is needed. However, the sugar substitute has hardly any calories and tastes similar to sugar. If organically grown corn and dextrose are used for production, erythritol is certified organic. Erythritol does occur in foods, but only in small amounts. This means that only products from industrial production are available in retail. Erythritol is obtained from sucrose and glucose in a complex process with the help of yeast and fungi.

All Key Information at a Glance

All sugar alternatives are suitable for both cooking and baking. Generally, all varieties can also be used for cold dishes. For sugar substitutes, a dosage recommendation on the product is mandatory, as an overdose can cause gastrointestinal complaints. However, they have the advantage that they do not cause blood sugar fluctuations and are low in calories. Although fruits are the most natural form of sweetness, sugar substitutes like stevia can be good low-histamine alternatives, especially if other intolerances such as sorbitol and/or fructose intolerance are present. Sugar alcohols like xylitol and erythritol are low in histamine but are broken down by enzymes. Therefore, digestive problems may occur with histamine issues.

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