The average American eats around 77 grams of sugar per day, or 60 whopping pounds per year. Let that sink inits a lot of sugar! If youre trying to cut back on the sweet stuff, it only gets tougher during the holiday season. Grocery shelves are stocked with sugar cookies, coffee shops dole out sweet seasonal drinks, and pumpkin pie is top of mind on most Thanksgiving menus.

But not every dessert contains natural sugar. You can order a skinny peppermint mocha at Starbucks with sugar-free syrup or bake gingerbread men with Stevia. Are these sweetener alternatives healthier than plain-old fashioned Domino? According to a new study in Journal of the American College of Cardiology, artificially sweetened beverages are no better than sugary drinks as far as long-term implications for cardiovascular disease.

But what about people with blood sugar issues, or folks who just want to keep their caloric intake down? We wanted to know more about which sweetener is better, so we dove into the research. And, well its complicated, and pretty much depends on your specific health goals.

When you eat a donut (or any sugary food item), your body immediately gets to work breaking it down. Sugars have calories, so they are metabolized and provide energy, says Chris DAdamo, Ph.D., director of the Center for Integrative Medicine at the University of Maryland School of Medicine in Baltimore. But depending on the type of sugar, they are metabolized differently. Natural sugar occurs as one of two types of monosaccharides, a.k.a. simple compounds: glucose and fructose. Both are found in a variety of foods like fruits, vegetables, and starches. Sucrose, or table sugar, is made up of both glucose and fructose. Let's take a closer look at these two forms of sweetness.

Now lets dive into sugars number one rival: Artificial sweeteners. Many are non-nutritive, or zero-calorie, making them an appealing alternative for someone trying to cut back on calories. They tend not to increase blood sugars the way sugars do, DAdamo explains.

These calorie-free or low-calorie compounds are as much as 700 times sweeter than regular table sugar, so a little goes a long way. Youll see them in stores under names like Sweet & Low, Nutrasweet, or Splenda, or in ingredient lists under names like saccharin, aspartame, or sucralose. Theyre non-nutritive, no-calorie sweeteners, so theyre really not causing the same metabolic derangements in the liver that fructose does, Dr. Aspry says.

That said, there has been controversy over whether these sweeteners are really the healthy option theyre advertised to be. DAdamo explains that artificial sweeteners can trick the body into thinking it is eating calories, which may ultimately lead to an increased hunger response that leads to weight gain. This real sweet taste with no calories can derange the appetite system, he says. A study in Cell Metabolism found that frequent consumption of sucralose can increase the motivation to eat. They may make people want to eat more sweets because the brain is sort of tricked into liking sweets, Dr. Aspry notes. (Research also shows that the more often you eat sweet foods, the more you crave them.)

However, Dr. Aspry points out that other studies have shown the opposite effect. A study in the American Journal of Clinical Nutrition found that drinking diet beverages, as opposed to sugar-sweetened beverages, did not lead participants to eat a higher-calorie diet.

DAdamo says that for some people, artificial sweeteners can mess with the delicate balance of their gut bacteria or cause other side effects like migraine or skin issues. There has also been evidence that artificial sweeteners like aspartame could increase cancer risk, but thats really only when consumed in mass quantities (like drinking six sodas per day). I dont think cancer is really the main concern, DAdamo says. I think more its that this disrupts our appetite symptoms and may have some of these other issues in susceptible people who are already prone to digestive issues or headaches.

Sorry to say this, but there is no clear-cut answer. My recommendation for most people who are pretty healthy, is just not to overdo it, DAdamo suggests. Aspry echoes this general advice: If I had to choose between one or if I was counseling folks, I would say choose the non-nutritive one, she says. Does that mean that theres no risk associated with the artificially sweetened beverage? I dont think we know the answer to that yet, but may over time.

If you struggle with insulin sensitivity, weight gain, or diabetes, its probably better to reach for that diet soda that wont spike your blood sugar. But if you find that artificial sweeteners make you want to eat more, or if they mess with your gut, stick with table sugar. Having a little bit in a coffee is going to be okay, DAdamo says. As the saying goes, the poison is in the dose.

Just dont go about thinking that artificial sugars are the cure-all for your health goals. We cant think that we can replace drinking four cokes a day with four diet cokes and not have an issue, DAdamo says. Instead, limit sugary treats and use artificial sweetners in moderation. Think of that sugary peppermint mocha as a special occasion to savor once in a while, not every day. I really encourage people to drink mostly water, flavored water, tea, or homemade lemonade without a lot of sweetener, Aspry says. Consider a plain, unsweetened chai tea next time, for balances sake.

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Sugar vs. Artificial Sweetener: Which Is Healthier? - HealthCentral.com