Lactose intolerance do’s and don’ts

A new report on the digestive issue holds a few surprises for sufferers: Yes, you really can drink milk!

By Ayala Laufer-Cahana, M.d.

Topics:Nutrition, Food

A version of this post first appeared on Dr. Ayala’s Open Salon blog.

Are most Americans lactose intolerant? Do all dairy products contain lactose? How critical is it to stick to a lactose-free diet?

Although most of us know someone who is lactose intolerant, and “lactose intolerance” frequently comes up in health-related conversations, there are many myths and misconceptions regarding this common digestive issue. I’d like to take a look at this malady and at the findings of a recent National Institutes of Health (NIH) consensus conference on lactose intolerance, where experts in many medical fields pored over the relevant medical literature, discussed findings and developed a state-of-the-science statement that includes a few surprises.

(This post is about the common form of lactose intolerance — primary lactose intolerance — and is not about lactose intolerance that arises from illness or intestinal injury, or the rare cases of babies born unable to digest lactose.)

Lactose and lactose intolerance

Chemistry moment (this won’t take long): Lactose is a two-molecule sugar (or disaccharide) made up of one molecule of glucose and one molecule of galactose. In order to absorb lactose our body needs to break the bond between the two simple sugars using the enzyme lactase.

Lactase is abundant in the human intestine in infancy, but its level declines with age in many people. Lactase production is a fascinating example of our body’s ability to turn genes on and off; while the genetic code for producing lactase is in the cell, the cell can turn off production partially or completely.

Those of us with lower levels of lactase don’t break up some or all of the dietary lactose, which will reach the large intestine undigested; there, bacteria will happily feast on the sugar and produce gasses: carbon dioxide, hydrogen and methane. Undigested sugars can also draw water from the intestinal walls, causing bloating and diarrhea.

But low lactase by itself doesn’t define lactose intolerance; most people who have low lactase don’t experience signs and symptoms (the common ones being diarrhea, abdominal pain, gas, bloating or nausea). Only people with both low-lactase levels (measured by a health professional) and associated signs and symptoms have, by definition, lactose intolerance.

How common is it?

Surprisingly, the NIH panel concluded that we don’t really know.

Many people with low levels of lactase have no symptoms. Many people with gastrointestinal symptoms attribute symptoms to lactose intolerance even if they haven’t demonstrated deficiency of lactase; their symptoms may very well be due to other reasons.

What we do know is that low lactase varies across ethnic groups, occurs less frequently in European Americans and more frequently in African-Americans, Asian Americans and Native Americans.

Do people with lactose intolerance need to avoid lactose?

Let’s start with an explanation of the big difference between lactose intolerance and serious food allergies or gastrointestinal immune diseases such as celiac.

Food allergies can cause life-threatening systemic reactions after exposure to minute amounts of the offending food. Likewise, the intestine of a celiac patient suffers changes to its surface — changes that can lead to malabsorption, anemia and even cancer — even if exposed to very small amounts of gluten.

But not absorbing some of the sugars in our food is part of everyday life for all of us.

Beans, for example, contain sugar chains — called raffinose oligosaccharides — which no human can break down. The sugar polymers are digested by bacteria in the gut resulting in the well-know bean-related flatulence — the butt of many jokes — and can also cause symptoms resembling those of lactose intolerance.

Some people experience no discomfort after eating beans while others limit their intake of beans because large amounts cause them symptoms. There are even individuals who experience such great discomfort that they choose not to eat beans at all. Our individual anatomy and physiology, our intestinal microbial flora, as well as the way we perceive pain and social awkwardness differs a lot. And by no means are beans unhealthy — they are in fact very good to eat!

Milk contains a considerable amount of lactose, much more than the undigested sugars in beans, but the bean analogy can perhaps explain some of the symptom variability we see with lactose intolerance.

Lactose sources

Milk products vary greatly in their lactose content.

Milk itself has a lot of lactose, but aged cheeses have very little (most of the lactose is drawn away in the whey, and what’s left in the curd is fermented by bacteria and mold). Yogurt with live cultures contains bacteria that break down lactose, and therefore causes fewer symptoms. Butter and full-fat cream cheese contain almost no lactose.

So how much milk can people with lactose intolerance tolerate?

The NIH panel looked at the best studies, and concluded that most lactose-intolerant individuals can take in 12 grams of lactose (the equivalent of one cup of milk) in a single sitting with minimal or no symptoms and can tolerate larger amounts if the lactose if ingested with meals or spread over the day. A quart of milk (50 grams of lactose) ingested without food in one sitting will induce symptoms in most lactose-intolerant people. There’s also some evidence showing that the body gets used to lactose, and can tolerate more lactose if routinely exposed to it.

The most important long-term health consequence of lactose intolerance may be calcium deficiency

There are many ways to eat healthy, and dairy is by no means necessary for a balanced diet. Balanced Asian-type and vegan diets are perfectly healthy with little or no dairy. Calcium sources — both naturally occurring or in supplements — are plentiful. (Foods rich in calcium include collard greens, turnip greens, kale, bok choy, soybeans, okra, broccoli, some fish, cultured soy yogurt, tofu, almonds, and calcium-fortified orange juices, soy milks and cereals.)

But dairy products are by far the most prevalent — and least expensive — source of calcium in the Western diet. Since many people with real or perceived lactose intolerance avoid dairy products, they may consume inadequate amounts of calcium and vitamin D (which is added to milk), leading to weaker bones and osteoporosis.

Therefore the diagnosis of lactose intolerance should be made judiciously, and the treatment plan should include assuring that dairy avoidance, if necessary, won’t lead to nutritional deficiencies.

Practical tips:

If you think you have lactose intolerance:

Talk it over with your doctor; getting an accurate diagnosis for your symptoms can be important. Some of the causes of recurrent abdominal pain are treatable and it’s not a good idea to commit to an elimination diet for the wrong reason.

If you do have lactose intolerance:

Find a reduced-dairy eating plan that controls your symptoms, while enabling both good nutrition and enjoyment of food.
Eat dairy products with less lactose (cheese, yogurt) and spread your dairy consumption throughout the day. Consume dairy as part of a meal.
Make sure you get enough of the nutrients usually found in dairy, especially calcium.
Consider using lactase products; these are dietary supplements that help digest lactose.
Above all, listen your body — treatment and diet plans can’t ever be one size fits all. Find what works for you and stay healthy!

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The triumph of Jamie Oliver’s “nemesis”

The culinary crusader barged into West Virginia for a reality show. Now his on-screen rival is making her own magic

By Jane Black, Gilt

Alice Gue (center) and Jamie Oliver (right)

Topics:Reality TV, Nutrition, Food

It was all I could do not to scarf the entire stromboli, neatly packaged for me in a Styrofoam clamshell, while in the car. The dough was soft. The balance of ham and mozzarella, just right. And so, only about half was left when I parked on Third Avenue, the main drag in Huntington, West Virginia, and offered a bite to some friends.

“Wow. That’s great,” said one.

“Yeah, where’d you get that?” asked another.

“You’ll never believe it,” I told them. “This is school lunch.”

Times have changed since celebrity chef Jamie Oliver broadcast startling and deliberately inflammatory—this was reality TV, after all— images of kids here dumping trays of fresh food untouched into the trash. For those of you who missed, Oliver’s prime-time program, “Food Revolution,” the British chef arrived in Huntington in 2009 after it was named the most unhealthy metropolitan area in America and went to work ousting greasy burgers and pizza in favor of from-scratch meals made with fresh ingredients. Two years later, on the first week of school, which began in mid-August, students in Cabell County sat down to meals of from-scratch chicken quesadillas and brown rice and, on the day I visited, creamy chicken and noodles served with freshly made coleslaw, steamed broccoli with parmesan, an orange and hot rolls, the smell of which floated enticingly through the halls.

And that stromboli? Well, it’s not one of the meals that the school district is most proud of. The dough is made from scratch, of course. But school cooks would be happier if they actually made the ham or cheese. As I said, times have changed.

School officials repeatedly point out that the county’s food already was 50 percent made from scratch before Oliver rolled into town. And you can’t blame them for wanting a little credit. The culinary crusader may have focused the national klieg lights on this otherwise quiet Appalachian city, but it’s local officials that have done the real work of overhauling school food. Over the last two years, Rhonda McCoy—the school food service director who was portrayed on the show as an aloof bureaucrat more concerned with budgets and caloric counts than kids’ health—has redeveloped recipes, held after-hours taste tests, sourced fresh and unprocessed ingredients at affordable prices, bought new equipment and trained school cooks. She also endured an unprecedented four regulatory audits to ensure that the new meals met federal nutritional and caloric standards. She passed.

McCoy hasn’t stopped there. This year, she introduced free meals for all low-income students and free meals for all students at one county elementary school. She also plans to introduce lower-sugar flavored milk, and to buy a projected 12,000 pounds of sweet potatoes for the district, grown by a county high school’s vocational agriculture students.

Now, deservedly, McCoy’s county is a model in the state. Last spring, Dr. Jorea Marple, the state schools superintendent, visited Cabell County and decided that other districts need to follow its path. As a result, eight counties—most of which are in the poor, southern coal fields— this fall will introduce 100 percent from-scratch meals at breakfast and lunch – and provide them to all students, regardless of their family’s income, free of charge.

It’s easy to imagine how this kind of warp-speed transition might be painful for those eight lucky counties. My husband and I spent six months in Huntington researching a book about how and if the town can change its food culture, and in meeting after meeting, McCoy told me that she never objected to the changes that Oliver suggested, just the way and speed at which she was forced to implement them.

But this new set of cooks won’t be starting from scratch. McCoy provided a binder full of USDA-approved recipes and order forms with all the ingredients they need to purchase. She also organized a two-day training where the now-experienced Cabell County cooks demonstrated recipes: rotisserie chicken, roasted potatoes, sugar snap peas, pizza sauce and homemade salad dressings and croutons, among others. They also imparted tips and techniques for, say, quickly chopping dozens of heads of romaine lettuce or cabbage for coleslaw rather than just opening a bag.

Alice Gue, the school cook who “Food Revolution” viewers will remember as Oliver’s grumpy nemesis, was one of the trainers. (And, for the record, she’s one of the warmest, cuddliest school cooks I’ve met in years of covering the subject.) “It’s a lot for them to take on but most were really excited,” she told me after serving stromboli to almost 200 students. “You always get some people who will say, ‘I can’t do that. We have no time. We don’t this or we don’t do that.’ Just like you get some people who say: ‘Well, why do the extra work when the kids are just going to throw away the food?’ And sure, some of them will. And if they don’t eat it today, okay they didn’t today. But down the road they will. You have to take pride in what you do and what you put out there for these kids.”

Pride is one thing. Money is another. And a lack of federal funds is the perennial reason for the piles of cheap, processed food that end up on children’s trays. And so I asked McCoy: Where would West Virginia get the money for new equipment, better ingredients and free lunches for all low-income students?

“I don’t know,” she said. “They’re just going to find it.”

It’s a non-answer. But, in a way, it doesn’t really matter. What does is that state and county leaders in West Virginia now agree that good food in schools is so important that they’ll find some way to put it on students’ plates. Or, to put it another way, remaking school food is more about leadership than cash. While chef-advocate Alice Waters and others would like to see the federal government spend $5 per student for organic, sustainable and local school lunch, the Cabell County school district is proving that it’s possible—with dedication and a little ingenuity— to put out tasty, from-scratch meals that both kids and a discriminating food writer will happily eat.

That’s not to say that more money wouldn’t help. Doling out money is how Congress leads. And school food would be a popular cause if children suddenly got the vote. But the experience in Cabell County proves that sometimes what schools need most is a push to change. “If I had to do it my way, we would have gone slower,” McCoy told me. “But now that it’s all done, I think, yes, it was worth it.”

Jane Black is a Brooklyn-based food writer who covers food politics, trends and sustainability issues. Her work has appeared in the Washington Post (where she was a staff writer), the New York Times, Slate, New York magazine and other publications. To read more, visit www.janeblack.net.

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The right’s weird Michelle Obama problem

They hate her because she ate a hamburger even though she wants children to be healthy

By Alex Pareene

Two separate Drudge Report headlines, from July 11 and July 12

Topics:Michelle Obama, War Room, Matt Drudge, Nutrition, Obesity

It was just stupid when the Washington Post’s 44 blog (“Politics and Policy”) “reported” that Michelle Obama ate a hamburger. (Or, as Ta-Nehisi Coates said, it was “the dumbest story ever written in all of human history.” He’s not wrong!) After the right-wing blogs all picked it up, as they were always going to because of their seething, inexplicable hatred for the first lady, though, it became something darker than stupid.

After everyone else began calling the story dumb and pointless and inane, the Post… ran a poll. Now the people can decide if Michelle Obama is “a hypocrite” for eating a hamburger! In order to justify the newsworthiness of “Michelle Obama eating a hamburger,” the Post’s Tim Carman Googled “Michelle Obama” and “hamburgers,” and discovered that she has eaten at least five hamburgers in the past.

Type in “Michelle Obama and salads” into Google, and you gets tons of hits about her introducing salad bars into schools. But few hits of her ordering salads in public.

It’s not actually an example of hypocrisy for someone who advocates a healthy lifestyle to eat a hamburger. And a shake. If you eat a balanced diet and get some exercise, a hamburger and shake every now and then is fine. Any educated adult understands this. The Washington Post understands this. But because the conservative movement has decided that the first lady’s anti-childhood obesity campaign is actually an attempt to ban all delicious food in order to force-feed your child organic arugula, this was presented in the original item as a “gotcha.” Michelle Obama says kids shouldn’t eat garbage all day, every day, but she ate a meal that has a bunch of calories! What a “mixed message.” She should eat only carrots in public, or else children will think it is OK to have a bowl of “Tacos After Midnight” Doritos for breakfast and then play Xbox games for 18 hours straight. (Plus, Jesus, people, this is Shake Shack we’re talking about — the vegetables are all fresh and organic and the cow was fed better than kids on school lunch programs.)

The Post probably just ran the stupid story to begin with because they know Obama’s anti-childhood obesity campaign is catnip for the right wing. Matt Drudge is obsessed with Michelle Obama and his weird fantasy idea of her as a threatening, angry, anti-white black woman (who is also a liberal nanny-state tyrant). Glenn Beck’s “The Blaze” quickly picked it up.

Fox Nation, too, jumped on the story. Their comments section is a mostly unfiltered (the most blatantly racist comments, of which there are plenty, are eventually flagged and removed) peek into the hatred and resentment that feeds Michelle Obama stories on the right-wing Web:

What’s especially insane about this is that Michelle Obama has worked very hard to not give people any reason at all to hate her. She made one ill-advised statement on the campaign trail — the misinterpreted bit about being proud of her country for the “first time” in her “adult life” — but since then she has been precisely as “controversial” a first lady as Laura Bush. She entertains. She travels. She wears nice clothes. Her sole policy issue is healthy children.

She’s a well-educated, successful woman from a blue-collar background who took a break from her successful career to basically raise their adorable children while her husband is president. She is not “threatening” like Hillary Clinton, who actually wanted to be president herself. Or, at least, she’s not “threatening” unless you’re just “threatened” by… successful, powerful, black women. (I’m sorry, I meant to say “uppity.”)

The clue that this is not related at all to anything Michelle Obama has actually done (or said), but rather who she is, is the legend of the old “Whitey” tape, which various right-wingers promised to produce, and which I, for one, still cannot wait to hear.

Sure, the right-wing Internet nuts and their enablers at every industry-funded think tank in Washington would turn a “kids should exercise” program into a full-on assault on liberty under any Democratic president — it’s what they do! — but the tone of the Michelle Obama coverage, and the commentary it generates, is pretty unmistakably racially tinged. (In addition, obviously, to being usually blatantly sexist.)

But as long as the Post continues policing Michelle Obama’s public appearances for imaginary hypocrisies, and then conducting polls about them, it can either absolve itself of responsibility or congratulate itself for the fuss it kicked up.

: Alex Pareene writes about politics for Salon. Email him at apareene@salon.com and follow him on Twitter @pareene More Alex Pareene

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Beck site: Huckabee does literally want the government to take candy from babies

Another round in the fight over the former governor's supposed "progressive" tendencies

By Alex Pareene

Glenn Beck and Mike Huckabee

Topics:Glenn Beck, War Room, Fox News, Michelle Obama, Mike Huckabee, Nutrition

Outgoing Fox host Glenn Beck recently attacked ongoing Fox host Mike Huckabee for supporting first lady Michelle Obama’s anti-childhood obesity campaign (fighting childhood obesity is an attack on our fundamental right to feed children garbage). Huckabee, Beck argued, is a “progressive,” and progressives, in Beck’s world, are the intellectual descendants of the Nazis themselves.

Huck struck back with an entertaining, unedited blog post calling Beck a conspiracy theorist looking for “boogey men” that “he and only he can see.” “The First Lady’s approach is about personal responsibility,” Huckabee wrote, “not the government literally taking candy from a baby’s mouth.”

On the Blaze, Beck’s news website, Kevin Balfe, Beck’s primary ghostwriter, has responded today by calling Huckabee a liar. Because, he argues, Michelle Obama and Mike Huckabee do want to literally take candy from babies’ mouths:

Michelle Obama is heading up an effort to combat childhood obesity. One of the first major initiatives of this campaign was the “Healthy, Hunger Free Kids Act of 2010.” Here is what Huckabee said about it at the time: “By passing a bill that addresses the nutritional quality of school lunches, an important step is being taken to give children choices that will make them healthier and more productive.”

Ok, great, so he likes the law…but what does that law actually do? Well, according to USA Today: “it gives the USDA the authority to set nutritional standards for all foods regularly sold in schools during the school day, including vending machines…”

To translate, the FEDERAL GOVERNMENT will have DIRECT CONTROL over whether or not certain foods–say a Milky Way bar–can be put into a vending machine at a public school.

With me so far?

Ok, so now for the big reveal…the Huckabee Lie. In his public statement attacking Glenn, here’s what he claims:

“I’m no fan of [Michelle Obama's] husband’s policies for sure, but I have appreciated her efforts that Beck misrepresented—either out of ignorance or out of a deliberate attempt to distort them to create yet another ‘boogey man’ hiding in the closet that he and only he can see. The First Lady’s approach is about personal responsibility—not the government literally taking candy from a baby’s mouth.”

Actually, Governor, no. I know you‘re so immune to political spin that you probably don’t even recognize it anymore, but THAT’S EXACTLY WHAT THIS ACT THAT YOU SUPPORT DOES.

I know the definition of the word “literally” has drifted a bit since Joe Biden took office, but unless this bill calls for jackbooted USDA thugs to storm into public schools and rip Milky Ways directly from the mouths of … babies who are in school for some reason, then no, this act does not actually take candy from babies.

There is, in fact, absolutely nothing in this bill stopping any public school student from bringing an entire crate of delicious candy bars to school and eating each and every one of them during recess. Our freedom to begin the process of eating ourselves to death as early as possible is still safe!

While Balfe characterizes the bill, and Obama’s campaign in general, as “federal intervention in local issues like school lunch nutrition,” the USDA already “intervenes” in school lunches (the National School Lunch act is more than 60 years old) and sets nutritional standards for government-subsidized meals. (Of course, demanding healthier school lunches without giving schools a lot more money to spend on food is pretty unrealistic but on the other hand LIBERTY DON’T TREAD ON ME FOUNDERS FREEDOM etc. etc.)

: Alex Pareene writes about politics for Salon. Email him at apareene@salon.com and follow him on Twitter @pareene More Alex Pareene

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Is the rise of food prices all bad?

Outrage abounds over a report that companies are shrinking portions but not prices, but it might be good for us

By Francis Lam

(Credit: Willie B.thomas)

Topics:Food Business, Food Psychology, Nutrition, Food

Slayers of elitists and other warriors of the downtrodden: Look! I bare my throat to you, fleshy and fat and ripe for the kill. But before you draw your blade, let’s talk about this for a minute. Is the increasing cost of food in America an entirely bad thing?

A recent report in the New York Times announced that American grocery store “shoppers are paying the same amount, but getting less,” and proceeded to quote a woman whose three-box pasta dinner for her large family didn’t quite satisfy. She only later realized it was because those boxes now contain 13.5 ounces of noodles, not 16.

The report goes on to catalog other shrinkages: cans of tuna going from 6 ounces to 5; buckets of ice cream going from 2 liters to 1 ½; orange juice from 64 ounces to 59, et cetera, et cetera, et cetera.

An immediate and obvious reaction is that this is an outrage — a problem that really puts the screws on people who already have trouble affording enough food to feed their families. Hunger — and the threat of hunger that policy wonks call “food insecurity” — is no joke. (Even if we’re not entirely clear on how many people are truly hungry, and what food insecurity really means.) My point is not to minimize the difficulty this kind of price inflation will create for people truly struggling to eat.

But there is something else that struck me when reading the report. It was the ice cream. And then the Reese’s mini peanut butter cups. These, and presumably many other processed and junk foods, are among the items “shrunken” this way.

Is that really so awful?

First, Americans spend a smaller percentage of their income on food than anyone, ever. In 2008, during the economic crash, we spent an average of 5.6 percent of our income to feed our families, the lowest since 1929. At this point, overeating affects many more Americans than chronic hunger, by far. (Perversely, obesity and diet-related diseases like Type 2 diabetes are actually much more common in lower-income communities, which speaks to a prevalence of junk food that confuses the line between “hunger” and “malnutrition.”) And if current trends continue, over 40 percent of Americans will be obese within the decade.

So how do we deal with this? Anyone who tells you they have a clear answer is selling you snake oil. But a big part of it has to be eating more smartly, and yes, eating less. It’s weird to say this, but maybe food should cost more. Not because we should be poorer, certainly not because we need to be protecting the profits of corporations, but because we have real trouble valuing what’s cheap.

Food, for most of us, is blessedly and cursedly cheap. It’s plentiful. And so we plow through huge dinners nightly. And so we mow down whole containers of ice cream. It’s in our nature to want to eat more. Our bodies and brains have descended from animals that have struggled, really struggled, to get enough food to survive forever. We want to pack as many calories into ourselves as humanly possible, for when the lean times inevitably come. Only we’ve engineered and marketed away most of the lean times, and yet we keep gorging.

So there may be something significant and strangely hopeful about how this food inflation is manifesting. It’s not that prices are rising per se, but that portion sizes are shrinking. That means that if you could afford a box of pasta or a bag of chips before, you can still afford one now; no one is taking all your chips away from you. But the limiting of portion size might do us some good.

Studies by Dr. Brian Wansink at the Cornell University Food and Brand Lab regularly show that people keep eating not until they feel “full,” but rather until there is some external signal to tell them to stop. In one notable experiment, Wansink’s team rigged a bowl of soup to secretly keep refilling itself. Without realizing it, diners eating from that bowl ate 50 percent more soup on average, and some ate three times the amount of soup they might have otherwise. We eat mindlessly, as a function of habit and instinct, and so with a surplus of food, we are constantly overeating. Knowing that, maybe we don’t have to begrudge that extra couple of ounces of food companies are saving for the next bag.

: Francis Lam is Features Editor at Gilt Taste, provides color commentary for the Cooking Channel show Food(ography), and tweets at @francis_lam. More Francis Lam

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How do “natural” non-sugar sweeteners stack up?

With Nutrasweet and Splenda taking a hit, we look into -- and taste -- trendy alternatives like agave syrup

By Aviva Shen

How do "natural" non-sugar sweeteners stack up?

Topics:Faddy foods, Food Advice, Nutrition, Food

Now that the artificial sweetener aspartame (Nutrasweet) has attracted suspicion, you might be thinking twice about that daily Diet Coke or Splenda (sucralose) in your coffee. Not that this is surprising; even without the stroke and cancer warnings, the word “artificial” alone conjures up images of shadowy figures in lab coats concocting solutions destined for your stomach. Much more reassuring are images of freshly plowed farms tucked in the mountains, like the one on the jar of Lundberg Family Farms’ organic brown rice syrup.

Brown rice syrup is just one of many “natural” sweeteners that have taken off in the wake of the backlash against artificial sweeteners like aspartame and sucralose, which, of course, were invented to defeat the dietary axis of evil — refined white sugar and high fructose corn syrup. Once confined to Berkeley communes, these not-refined-sugar, not-man-made substances pose a huge marketing opportunity, since most people who avoid sugar don’t want to get cancer but also aren’t ready to commit to a joyless, dessert-free existence. Natural sweeteners are the perfect answer to this conundrum. Right?

The biggest problem is that the term “natural” is a slippery one. Unlike with organic foods, there are no official standards in the U.S. to determine a natural versus unnatural food. Essentially, it’s a word that promises a lot — those wholesome fields — but can mean nothing.

The potency of that promise depends on the leap people make from “natural” to “healthy.” But because the popularity of alternative sweeteners is relatively new, there’s no definite consensus on their long-term risks and benefits. Plus, there’s no telling what unholy quantities Americans will consume of a sweetener with no yet-known health consequences whatsoever.

Then there’s the issue that sugar, in all its caloric and cholesterol-boosting splendor, is just so damn delicious. For one thing, sugar is more than just a sweetener; in baking, it’s a structuring agent that resists lumping and introduces air into batter as it creams, creating a fluffy and even texture. It also caramelizes when heated, developing a flavor much more complex than mere sweetness. How can you beat that? For people with diabetes or sugar allergies, natural non-sugar sweeteners can be a godsend. But those seeking a consequence-free sugar fix, beware: not all sweeteners are created equal. We took a standard sugar cookie recipe — flour, eggs, vanilla extract, butter — and subbed in a different sweetener for each batch to find out what works, what doesn’t, and what actually tastes good.

Agave syrup

The facts: Beloved by raw food enthusiasts, agave syrup has become one of the easiest alternative sweeteners to find in grocery stores. It’s derived from the Mexican succulent plant agave, of which there are several varieties. It has to be processed to become sweet, and depending on that process, it can be comparable in composition to the dreaded high fructose corn syrup. True, agave has a low glycemic index — meaning it releases glucose into the blood stream at a slower rate than refined sugar — so it can help keep blood sugar levels stable. Eating agave as a “healthy” alternative to sugar, however, is pointless; the two have the same number of calories, no nutritional value whatsoever, and, even though it doesn’t spike blood sugar, the primary sugar in agave, fructose, has been linked to cancer and cholesterol problems when consumed in large quantities.

The experience: Agave syrup is very similar to honey or maple syrup in terms of consistency, though it has a distinctly deeper, cleaner sweetness than either, without as assertive a flavor. Subbing agave for sugar is relatively simple; because it’s sweeter than sugar, a cup of sugar should be replaced by ¾ cup of agave syrup. Don’t expect an identical product, though — our crack team of Salon taste-testers noted that cookies made with agave syrup became “densely chewy” and “raisin-like” in taste, with a “nice complexity.”

Brown rice syrup

The facts: Brown rice syrup is what happens when cooked brown rice meets barley malt enzymes. The sweetness comes from starchy complex carbohydrates, which take a couple of hours to digest. As a result, the glucose is released gradually into the bloodstream, providing a steady supply of energy rather than the rush — and crash — of cane sugar. Plus, the syrup maintains some of the nutrients in brown rice, like protein, so it’s not a total nutritional bust like most sweeteners are.

The experience: Although nutritionally, brown rice syrup is the best you could hope for, it certainly doesn’t taste like table sugar. Maltose (the kind of sugar in brown rice syrup) is not as sweet as sucrose, so you’ll need about 1¼ cups of syrup to replace a cup of sugar. By itself, brown rice syrup is similar to butterscotch in taste and consistency. Baking it into cookies, though, resulted in an “unpleasantly gummy” texture, and made one tester feel “like I just woke up from a nightmare where I was stuck in a San Francisco commune in 1971, only to find out that it wasn’t a dream.” The mild butterscotch taste has potential, though, and could work well as a complementary flavor in bread or a savory dish.

Stevia

The facts: Stevia’s not technically a sugar; it’s extracted from a sweet herb of the same name. Therefore it has no calories and doesn’t raise blood sugar. Though the FDA labeled it a “dangerous food additive” in 1991 after an “anonymous industry complaint” (read: shadowy figures in lab coats), stevia is now back on the market as a “dietary supplement.” In the rest of the world, particularly Japan, widespread use of stevia has been going on for decades.

The experience: The biggest drawback of this seemingly perfect sweetener is that it has an “odd chemical aftertaste” that is not weakened in the baking process; one tester described the aftertaste of the cookie as “psychological torture.” It’s a pleasant, pure sweetness at first that just keeps on going … and going … and going, long after you are ready for the taste to end. If you can get used to that, you only need a teaspoon of the powder to replace a cup of sugar. Keep in mind, though, that sugar is more than just a flavoring; take away its structural properties from a recipe and you’re left with one crumbly cookie. To adjust, we added in more butter, resulting in a shortbread-like consistency.

Date sugar

The facts: Date sugar is so low-tech it’s kind of funny — it’s just dehydrated dates that have been ground into a powder. That means it’s completely unprocessed and retains all the nutrients in dates. It’s high in fiber and protein, and has lots of vitamins and minerals like iron and potassium. Plus, it qualifies as a raw food. It still contains sucrose, fructose and glucose, so it’s not a good alternative for diabetics or people looking to control their blood sugar.

The experience: Date sugar seems to be the Salon staff’s favorite sweetener of the bunch. It has a very subtle sweetness that evoked almonds for one tester. Another described it as “nutty, not super sweet.” The cookie’s texture turned out to be “very crumbly” and “chalky” but not unpleasant. Date sugar’s not soluble, so don’t try to put it in tea or coffee. It is, however, simultaneously delicious and nutritious, which is no small feat.