Ask the RD | September
Our registered dietitian, Jamie, offers answers to nutrition-related questions our community have submitted over the past month.
The information shared within this blog is meant for informational purposes only and should not be received as medical advice.
If you have a question to submit, please click the button and watch for a response the following month. Before submitting a question, we invite you to visit the main page for Ask the RD and enter a keyword into the search box — your question may already be answered!
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Ahead of discussing the variety of sugars (natural and added) available, let’s first review the related nutritional approach. We know that we want to minimize added sugars in the diet, as excess intake of these simple carbohydrates can lead to increased risk for obesity, diabetes, cardiovascular disease, and even cancer. The daily recommended limit for added sugars is 6 teaspoons (24 g) for women, and 9 teaspoons (36 g) for men, which is approximately 10% or less of the daily caloric intake; this amount may fluctuate for someone with underlying health concerns.
When trying to decide which form of sugar to use, the variety of available options can make this choice a bit confusing. Is maple syrup, honey or agave better than regular table sugar? Is cane sugar better than high-fructose corn syrup? Or are artificial sweeteners a better choice than natural sweeteners? Ultimately, all added sugars are processed the same way by our bodies resulting in negligible differences in their nutritional impact.
To better understand the difference in types of sugars, below is a breakdown of common natural sweeteners, artificial sweeteners, sugar alcohols, and novel sweeteners.
Natural sweeteners: Granulated sugar (cane/beet), brown sugar, coconut sugar, maple syrup, honey, agave, molasses, and fruit/fruit juice
Naturally derived
Contains 15-20 calories per teaspoon
Baseline sweetness index (taste 1-1.5x sweeter than standard sugar)
Impact blood sugar response
Artificial sweeteners: Aspartame (NutraSweet, Equal), Saccharin (Sweet ’N Low), Sucralose (Splenda)
Chemically derived
Contains 0 calories (Artificial sweeteners do not count as “added sugars” as they do not contain calories.)
Higher sweetness index (taste 100-700x sweeter than standard sugar)
No impact on blood sugar response
A daily recommended limit of artificial sweeteners has yet to be established, however, it is best to use in moderation.
Sugar alcohols: Erythritol, Sorbitol, Xylitol
Synthetically derived from sugars
Contain 7-10 calories per teaspoon (or about half the calories of standard sugar)
Lower sweetness index (.25-1x sweeter than standard sugar)
Minimal impact on blood sugar response
Novel sweeteners: Monk fruit, stevia, allulose, tagatose
Derived from natural sources, though require chemical synthesis, extraction, and refinement
Contain 0-6 calories per teaspoon
Varying sweetness index (taste .75-.9x to 100-400x sweeter than standard sugar)
Less impact on blood sugar response
As far as safety is concerned, most sugar substitutes are considered safe when consumed in moderation. Emerging research shows sugar substitutes may alter our body’s taste perception, feelings of hunger, and metabolic response to consuming sweet foods and beverages. As a result, this could lead to increased sweet cravings and even alter the gut microbiome. Some studies have also found connections between regular use of artificial sweeteners and increased risk for heart disease, stroke, and overall death. This is not to say that artificial sweeteners cause these serious health problems, but there is a possible association.
The important takeaway is to consume less added sugar, as well as sugar substitutes. Instead rely on naturally occurring sugars in their whole food form such as those found in fruits, vegetables, grains, and dairy. This helps ensure your consumed simple sugars include redeeming nutritional qualities such as vitamins, minerals, and fibers. When choosing added sweeteners, choose the one that you prefer the taste of and work on gradually using less to stay within your recommended limitations.
If learning more about sugars and how our bodies process them is of interest to you, our In the Kitchen nutrition series covers topics such as this each month. You can register for free to begin receiving the helpful information and recipes, plus you can access past topics to review the detailed highlights.
Previous related Ask the RD posts:
Please share thoughts on date sugar and Xylitol as sugar alternatives. (July 2025)
When baking, are there sweeteners or non-sugar alternatives you recommend? (December 2023)
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Maintaining a healthy and balanced diet can certainly be challenging when dealing with food intolerances and/or food allergies. It is important to differentiate food intolerances versus food allergies. Food intolerances often cause delayed symptoms such as digestive issues (bloating, gas, abdominal pain, or diarrhea), where food allergies cause a rapid immune response in the body which can cause symptoms such as hives, swelling, vomiting, diarrhea, and even anaphylaxis. Though both are uncomfortable, food allergies are certainly more severe and more dangerous than food intolerances. The most common food allergies, known as the “Big 9” are milk, eggs, peanuts, tree nuts, wheat, soy, fish, shellfish, and sesame as these foods account for over 90% of food-related allergic reactions.
Some of these allergens, like peanuts and shellfish, are more often straightforward and therefore are more easily avoidable in a diet. Others like milk, eggs, wheat, and soy are frequently found in very small quantities in almost all food products, making them difficult to identify and avoid. For these types of allergies, it is best to limit processed foods – especially those with longer ingredient lists – as much as possible to minimize your risk. Choosing mostly whole foods and homemade meals, you can reduce the risk of cross-contamination and accidental ingestion of these allergens. You can also utilize a variety of smartphone apps to help navigate your food choices.
Unfortunately, there is limited testing to reliably determine food allergies. Many available tests are not accurate and often generate long lists of foods that should be avoided for no reason. A reliable option is consulting with an allergist who can perform skin prick testing, blood labs (IgE antibody testing), and/or medically supervised oral food challenges to better identify any true food allergies. Once you’ve identified your food allergies, the best next step is working with a dietitian to develop an individualized eating plan.
If you have food sensitivities or intolerances but not true allergies, consider meeting with a dietitian to assist with an elimination diet, such as a low-FODMAPs diet.
Additional Resources:
Foodallergy.org offers additional information and resources for those living with food allergies.
Previous related Ask the RD posts:
Please share alternatives to fish and eggs to achieve similar nutritional benefits. (April 2025).
Can you explain the various diets? Is there a best option? (January 2025).
What is a good milk substitute for lactose intolerance? Which is the healthiest option? (April 2024),
I have IBS-D and use a FODMAP diet to manage. How can I follow a healthy nutrition plan with so many food sensitivities? (October 2023).
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The priority when choosing any meat should be to keep it minimally processed. This means selecting fresh red meats, poultry, and seafood as opposed to processed versions. Processed meat “… has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavor or improve preservation.”* This includes bacon, ham, deli meats, jerky, sausages, pepperoni, corned beef, hot dogs, smoked meats, and fish, as well as canned meats such as pâtés and Spam. Also encompassed under the processed meats umbrella would be rotisserie chickens, reduced sodium deli meats, nitrate-free meat products, and to a lesser extent canned chicken and canned tuna.
We want to minimize processed meats due to their typically high amounts of sodium and fat, while also being considered a group one carcinogen due to their connection with increased cancer risk (specifically colorectal cancer).
When selecting meats, it’s best to stick with fresh, unprocessed meats:
Beef: ground beef, steak, roast
Pork: loin, chops
Chicken or turkey: breast, thighs, legs, whole, or ground
Fresh or frozen fish and seafood
All animal-based meats, poultry, and seafood contain high quality proteins and offer a variety of nutrients; therefore, it is best to vary your protein choices to achieve a balanced and nutrient-rich diet.
Keep your meat choices lower in fat by selecting lean or extra lean cuts like loin, round, or sirloin. You can also trim any visible fat, remove the skin, and use healthy cooking techniques.
Though red meats are a good source of protein and iron, they are also higher in saturated fat. Try choosing grass-fed options, or even game meats such as venison or bison for lower saturated fat counts.
More often, choose white meats, fish, and plant-based protein options such as beans, lentils, and tofu.
*Source: World Health Organization
Previous related Ask the RD posts:
Can processed meat be part of a heart healthy diet? (January 2024)
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Carcinogens are defined as any substance that can increase the risk of cancer formation. They come from a variety of sources in the diet including alcohol, heavy metals, pesticides, certain processed foods, and even through some cooking methods. Due to environmental contamination, heavy metals such as arsenic, lead, and mercury can be found in foods like brown rice, seafood, fruit juices, vegetables, and even water. Nitrates and nitrites can be chemically derived or naturally derived (using vegetable salts: celery salt) and are typically added in the processing and preserving of meats. Acrylamide is another carcinogenic compound that results from high-temperature cooking of starchy foods such as potatoes or bread. Additionally, heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) are formed when frying, grilling, or smoking foods at high temperatures.
Below are ways we can minimize these carcinogenic compounds in the diet:
Eat a varied diet, avoiding excessive intake of any one food. Choose mostly fresh and minimally processed foods for the best nutritional quality.
Buy organic foods, utilize local farmers’ markets when available, consider growing your own fruits and vegetables. Be sure to thoroughly wash all produce with clean tap water to reduce pesticide ingestion.
Utilize low to moderate heat cooking methods and consider limiting high-temperature cooking methods, such as stir-frying, deep fat frying, and charring. You can find helpful information on choosing cooking oils and smoke points by visiting the nutrition tips collection on our website.
Lastly, stay informed on food safety issues through reliable organizations such as FoodSafety.gov.
Previous related Ask the RD posts:
What are the health concerns with ingesting microplastics? (January 2025)
What are the best oils for cooking that are also healthy? (January 2024)
Jamie Libera, RD, LD, CCTD, is a clinical dietitian within the Providence health system. She works closely with the heart programs in offering consultations for heart failure patients, cardiac rehab patients, and serves as the nutrition consultant for Basecamp Prevention + Wellness. Jamie offers monthly nutrition-based classes and a monthly heart-healthy recipe as part of Basecamp’s free community programming.