The Truth About Agave Nectar and Diabetes

Agave syrup

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Agave nectar, also called agave syrup, is a sweetener often recommended for people with diabetes. It is made either by heating extracts of the succulent Agave salmiana plant or by breaking them down with water in a process called hydrolysis. The resulting liquid is processed with enzymes derived from a mold called Aspergillus niger.

Agave is also fermented to make tequila.

It's easy to see why agave nectar appears to be a smart alternative to table sugar, as it's lower on the glycemic index (GI)—one indication of how a given carbohydrate is likely to affect the levels of glucose (sugar) in the blood.

However, this assessment isn't as cut-and-dried as it may seem. If you have diabetes, you'll want to understand how agave sugar really stacks up to sugar before working it into your diet or that of someone with the disease you care for.

Agave Nectar vs. Table Sugar

The differences between agave nectar and table sugar are negligible when it comes to calories, carbs and total grams of sugar. They diverge in terms of type of sugar and where each ranks of the glycemic index. It is these two factors that make agave nectar a questionable alternative to sugar.

1 Teaspoon Table Sugar
  • 16 calories

  • 4 grams carbohydrates

  • 4 grams sugar

  • 50% sugar from fructose

  • GI rank: 60 to 65

1 Teaspoon Agave Nectar
  • 20 calories

  • 5 grams carbohydrate

  • 4.7 grams sugar

  • 90% sugar from fructose

  • GI rank: 20 to 30

Fructose

Fructose is a simple sugar (monosaccharide) found naturally in fruits and vegetables. It is relatively low on the glycemic index. However, when fructose is highly processed—as is the case with agave nectar—it can become problematic if consumed in excessive amounts. 

Fructose is metabolized in the liver, which turns excess fructose into triglycerides—a type of fat—some of which can become trapped and lead to any of a number of chronic medical conditions. For example, large amounts of high-fructose corn syrup have been linked to non-alcoholic fatty liver disease, insulin resistance, metabolic syndrome, obesity, and type 2 diabetes.

What's more, although agave is one and a half times sweeter than table sugar—meaning you may be able to use less of it—some researchers believe it's easy to eat too much fructose as it seems to bypass the body's satiety signals. Agave contains more fructose than high-fructose corn syrup, table sugar, and fruit.

Food Fructose Percentage  
Agave Nectar 90%  
High Fructose Corn Syrup 55%  
Table Sugar 50%  
Whole, Fresh Fruit 5 to 6%  

Glycemic Index

Foods and beverages that are low on the glycemic index, typically defined as those with a score of less than 55, are less likely than higher-ranking foods and beverages to cause spikes in blood sugar levels.

Agave's ranking of 20 to 30 certainly places it in the category of low glycemic foods. However, there is some controversy regarding the usefulness of the GI for controlling blood sugar. This is because the index doesn't account for portion sizes of foods. What's more, many of the factors that determine a food's GI score (how the food is prepared, for example, or the laboratory in which it is measured) can be inconsistent.

In other words, the fact that agave nectar is a highly processed sweetener containing a high percentage of fructose, paired with the possible inaccuracy of the Gi for determining a foods true potential affects on glucose levels, makes it a less viable alternative sweetener for people with diabetes than it appears to be at first glance.

A Word From Verywell

If you have diabetes, it is advisable to reduce your intake of all types of sugar, including agave. If you really want to use a sweetener, try honey or maple syrup, which contain beneficial vitamins and minerals, or no- or low-calorie natural alternatives, such as stevia or monk fruit.

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Article Sources
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  1. Chung, et. al. Fructose, high-fructose corn syrup, sucrose, and nonalcoholic fatty liver disease or indexes of liver health: A systematic review and meta-analysisAm J Clin Nutr. 2014 Sep; 100(3): 833–849. doi:10.3945/ajcn.114.086314

  2. Lowette K, Roosen L, Tack J, et al. Effects of high-fructose diets on central appetite and cognitive function. Front Nutr.2015;2:5. doi:10.3389/fnut.2015.00005

  3. Vega-Lopez S, Venn BJ, Slavin JL. Relevance of the glycemic index and glycemic load for body weight, diabetes, and cardiovascular disease. Nutrients 2018, 10(10), 1361. doi:10.3390/nu10101361

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