Is Agave Nectar Healthy for People With Diabetes?

Agave nectar (or syrup) is an all-natural, plant-derived sweetener made from the agave plant native to Mexico. Agave nectar is commonly used by people with diabetes and others who are interested in sugar alternatives, although it may not be the safest choice for those hoping to keep blood sugar balanced.

The agave plant is a succulent indigenous to Mexico and comes in many varieties. Blue agave is fermented and used to make tequila. The least manipulated commercial form of agave nectar is made from extracts of the Agave salmiana plant and is processed with enzymes derived from a mold (Aspergillus niger) in a process "generally recognized as safe" by the FDA.

Agave nectar is made by heating or hydrolyzing the juice of the agave plant. When making raw versions of nectar, the heat is lower and slower than in the processing of regular nectar or syrup.

Agave nectar saw a surge in popularity thanks to its low ranking on the glycemic index (GI) as compared to other sweeteners. Agave's GI ranks between 20 to 30, versus table sugar which has a GI of 60-65. A lower GI means that the food should raise blood sugars at a slower pace, and are thought to be better choices for people who are working to manage their blood sugar. However, it's now well-known that the glycemic index value is misleading: the ranking system doesn't take into account the healthfulness of a food or the quantity of food eaten (for example: ice cream and chocolate have lower GIs than pineapple and watermelon!).

One teaspoon of agave nectar contains 20 calories, 5g carbohydrates, and 4.7g sugar, 90 percent of which is derived from fructose. In comparison, one teaspoon of table sugar contains 16 calories, 4g carbohydrates, and 4g sugar, 50 percent of which is derived from fructose. Often lauded for not raising blood glucose (blood sugar), fructose is metabolized directly in the liver instead of the bloodstream.

Agave contains even more fructose than high-fructose corn syrup. Let's look at a few other fructose-containing foods:

Fructose is a simple sugar (monosaccharide) naturally found in fruits and vegetables. It is known to have a low glycemic index. However, when fructose is highly processed to create sweeteners such as high-fructose corn syrup and agave nectar, it can become problematic if consumed in excessive amounts. 

Some researchers believe that it is easy to eat too much fructose as it seems to bypass the body's satiety or fullness signals. This may lead to weight gain and the development of insulin resistance (which may cause blood sugars to increase and is a contributing risk factor for type 2 diabetes).

Although fructose may not raise blood sugars as quickly as glucose, increased intake of fructose can elevate triglycerides, a type of fat in your blood that is associated with an increased risk of diabetes, metabolic syndrome, and heart disease.

Therefore, if you already have high triglycerides or other risks of heart disease (which many people with type 2 diabetes do), it is wise to choose a different alternative sweetener than fructose-based agave nectar. Also, if you are trying to avoid high-fructose corn syrup, you may want to avoid agave syrup too, as it is nearly 100 percent fructose.  

Agave nectar is often marketed as a "healthy and natural alternative" to artificial sweeteners or sugar. It can lend a nuanced flavor in cooking or baking and is slightly more concentrated than table sugar.

In fact, agave is 1.5 times sweeter than table sugar (sucrose), hence some believe that using it helps them to decrease the amount of sweetener added to foods or drinks and perhaps even enables some calorie-cutting. 

When using any sweetener, it's important to remember that additional calories may result in weight gain, which is an independent risk factor for diabetes and heart disease.

Using one tablespoon of agave nectar (the equivalent of three teaspoons) means you are consuming 60 calories and 15 grams of carbohydrates—the same amount of carbs in one serving of fruit or one piece of bread, without the added benefits of fiber, vitamins, and minerals.

If you have diabetes and are looking to lose weight, it is best to avoid all calories from sugar, including sugary beverages and condiments, like agave, table sugar, and maple syrup. If you must use sweeteners, you may want to try stevia, a plant-based sugar alternative with zero calories. Studies have shown that reducing the consumption of sugar (which lowers calorie intake and promotes weight loss) can improve blood sugar and weight control.

Agave nectar isn't necessarily a better alternative to table sugar and other sweeteners. When it comes to weight and blood sugar control, all sugars should be taken into consideration. Weight loss can improve your blood sugars and lower your chance of heart disease. If you prefer to use sweeteners, you may want to try no- or low-calorie alternatives, such as stevia or monk fruit. If, on the other hand, you decide to use agave or other types of sweeteners, practice portion control.

The American Heart Association recommends that men limit their daily intake of added sugars to 150 calories (about 37 grams), and women limit their daily intake of added sugars to about 100 calories per day (about 25 grams). Whether you are looking to lose weight, prevent disease or simply feel good, limiting all types of added sugars in the diet is important.