Much of the fatigue many of us regularly experience is thanks to sugar. It’s a subtle poison that’s part of our daily lives. So innocuous, it can be found in everything from baby food to toothpaste and its effects are as rampant as its sources. We’re exposed to it from infancy, even encouraged to have it.

Concentrated sugars were essentially absent from human diets until the invention of agriculture 10,000 years ago. The U. S. Department of Agriculture reports that each American currently ingests about 63 pounds of refined sugar and 59 pounds of high fructose corn syrup (the worst kind of sugar!) a year. That’s 122 pounds of added refined sugars.

The adverse effects of sugar are well known. Nearly all simple sugars are metabolized quickly and disrupt insulin levels, contributing to most chronic illness. Sugar suppresses the immune system, is addictive, a common allergen and a significant cause of obesity.

In foods, hidden sugars may appear under a variety of names on a label. Ingredients are listed in order of volume. Look for the following ingredients. If any of these appear at the top of the list, the food is most likely high in sugar: ingredients that end in “ose”; brown sugar; corn syrup, corn syrup solids; dextrose; fructose; glucose; grape juice; high-fructose corn syrup; honey; malt syrup; maltodextrin; mannitol; maple syrup; molasses; raw sugar; sorbitol; sorghum; sucrose; and turbinado xylitol.

As efforts to find (or create) the best tasting but least problematic sweet flavors continue, the business of sugar and its substitutes is as confusing as it is competitive. Alternative sweeteners have been in and out of our grocery stores for decades, many creating deleterious effects worse than sugar itself. Here’s a look at some of the sugar products and substitutes currently available:

Aspartame

Also marketed as Nutra-Sweet and Equal, aspartame is 180 times sweeter than sugar. Since its approval in 1981, aspartame has been used in beverages, yogurts, breakfast cereals, desserts and chewing gum, and also as a tabletop sweetener.

Close to 170 documented symptoms, most of them related to the nervous system, are associated with the use of aspartame. In 1996, a study raised the issue that aspartame consumption may be related to an increase in brain tumors following the U. S. Food and Drug Administration’s approval of the sweetener in 1981.

The National Cancer Institute is currently is studying aspartame and other dietary factors as part of a larger study of adult brain cancer. Research shows that aspartame may induce sugar cravings and does not promote weight loss.

Sucralose

Also known by its trade name, Splenda, sucralose is 600 times sweeter than sugar. In the five-step process of making sucralose, three chlorine molecules are added to sucrose (sugar molecule).

In 1998, the FDA approved it as a tabletop sweetener and for use in products such as baked goods, nonalcoholic beverages, chewing gum, frozen dairy desserts, fruit juices and gelatins. The FDA recently allowed sucralose to be used as a general-purpose sweetener for all foods. Because sucralose is so much sweeter than sugar, it is bulked up with maltodextrin, a starchy powder, to measure more like sugar.

Some research suggests that sucralose may cause thymus shrinkage, damage to kidneys and liver, decreased red blood cell production, and other health problems. The safety of sucralose is still in question. Until further testing, use with caution.

Acesulfame potassium

First approved in 1988 as a tabletop sweetener, acesulfame potassium, also called Sunett, is now approved for products such as baked goods, frozen desserts, candies, and, most recently, beverages. More than 90 studies verify the sweetener’s safety.

Unfortunately, several potential problems associated with the use of acesulfame have been raised. They are based largely on animal studies since testing on humans remains limited. The findings showed that Acesulfame K stimulates insulin secretion in a dose-dependent fashion thereby possibly aggravating reactive hypoglycemia (low blood sugar). Acesulfame K apparently produced tumors of the lung and breast, several forms of leukemia, and chronic respiratory disease in several rodent studies, even when less than maxi-mum doses were given.

According to the Center for Science in the Public Interest, it was petitioned on Aug. 29, 1988, for a stay of approval by the FDA because of “significant doubt” about this product’s safety. Worldwide, the sweetener is used in more than 4,000 products.

Stevia

Stevia is a natural sweetener that sweetens with almost no calories, does not encourage cavities, is nonglycemic, and may even strengthen the pancreas. The sweetness of stevia is due to phytochemicals called glycosides. The most abundant of these, stevioside, is over 200 times sweeter than sucrose.

Unlike aspartame or sugar, to date no negative health effects have been reported with extensive use of stevia; some people, however are disappointed by the mild aftertaste.

HealthE Sweet

Another safe and natural sweetener, HealthE Sweet contains a unique complex of nonglycemic sweeteners including tagatose, a natural ingredient found in dairy products, erythritol — naturally found in many fruits and vegetables, and Fiberrific, an excellent soluble fiber source.

HealthESweet measures spoon for spoon, cup for cup like sugar. It can be used everywhere sugar is used (even in cooking and baking), has no calories or aftertaste, and is safe for diabetics and hypoglycemics. It is also 100 percent kosher and vegan.

Erythritol

Erythritol is a low calorie (0.2 calories per gram) sugar alcohol. About 75 percent as sweet as table sugar, it looks like sugar, tastes like sugar, has no aftertaste, and does not cause tooth decay. Erythritol is safe for diabetics since it doesn’t affect blood sugar. Like other sugar alcohols, it can cause diarrhea if used in excess.

Honey

Raw honey is one of the safest natural sweeteners to use. Honey is a delicious sweetener made naturally by bees for their own nourishment. The natural process of making honey begins when the bees feast on flowers, collecting the flower nectar in their mouths. This nectar then mixes with special enzymes in the bees’ saliva, an alchemical process that turns it into honey. The bees carry the honey back to the hive, where it is deposited into the cells of the hive’s walls.

The fluttering of their wings provides the necessary ventilation to reduce the honey’s moisture content, making it ready for consumption. Some commercial honey makers feed bees sugar to speed up production.

Studies show that using natural honey can have positive health benefits, while unnatural honey may produce adverse effects. Honey has been shown to have an antimicrobial effect. A number of studies have found that honey can help heal ulcers, sore throats and offer relief from diarrhea, insomnia and sunburn.

Although honey is not a dense source of nutrients, it provides some vitamin B2, vitamin B6, iron and manganese.

Agave

There are over 100 species of Agave cactus in Mexico. Blue Agave is higher in fructose-producing carbohydrates than other types of agave and is considered to be the finest agave in the world.

To produce organic agave syrup, juice is expressed from the core of the plant, and finely filtered to create a light-colored syrup. Tasting like a cross between honey and maple syrup, it dissolves easily and is the perfect sweetener to naturally enhance any food or beverage. It can be used to replace dates, honey, sugar, maple syrup, or other ingredients.

Because of its low glycemic index, agave is acceptable for people with diabetes and hyperglycemia. As with all sugars, use in moderation.

Sucanat

Sucanat is the most natural form of sugar derived from sugar cane. Short for Sugar Cane Naturally, Sucanat is made by crushing the sugar cane, extracting its juice and heating it in a large vat. Once the juice is reduced to a rich, dark syrup, it is hand-paddled. Hand paddling cools and dries the syrup, creating the dry porous granules.

Sucanat contains about 13 percent molasses and 87 percent sugar and retains most of the nutrients of the sugar cane plant. Sucanat is high-glycemic and therefore unsafe for diabetics.

Remember to use all sweeteners in moderation. If you have trouble knocking out the sweet tooth, try eating every 3 to 5 hours, and rather than eating carbohydrates alone combine carbs with plenty of fiber and/or some protein.