Kristie Leong M.D. is a family practitioner who believes in the power of nutrition and a healthy lifestyle to prevent and fight illness.
Most Americans have a sweet tooth, but no one wants the tooth decay, calories, and health risks that go along with a diet high in sugar. That’s why some people turn to sugar substitutes, especially natural ones, as an alternative to sugar.
One example of a natural sweeter that shoppers are dropping in their grocery carts is agave nectar. Agave nectar or agave syrup is popular for sweetening everything from coffee to pancakes. But exactly what is this substance—and is it a healthy sweetener alternative?
Where Agave Nectar Comes From
Agave nectar is produced from one of over 100 varieties of agave plant grown in Mexico. It's made by pressing and concentrating the juice from the agave plant. This process releases natural sugars in the form of complex carbohydrates called fructosans.
When fructosans are heated and concentrated, they break down into smaller units made of fructose, the sweetest of all natural carbohydrates. It’s the fructose that gives agave nectar its sweet taste.
Unfortunately, some experts are unconvinced that agave sweeteners are safe due to their high fructose content. When fructose is absorbed and released into the bloodstream, it heads straight to the liver where it is converted into triglycerides, a type of fat. Some experts believe the metabolism of fructose by the liver places added stress on the liver.
Fructose Contributes to Non-Alcoholic Fatty Liver Disease (NAFLD)
According to the National Institutes of Health (NIH), research shows a diet rich in fructose contributes to non-alcoholic fatty liver disease. (NAFLD), a condition in which fat builds up in the liver. This disease can lead to cirrhosis, a serious condition in which scarring of the liver occurs and reduces its function.
NAFLD is the most common form of liver disease in the United States. The cause is not known but it's linked to obesity and insulin resistance. Treatment for this disease includes weight loss, exercise, and a healthy diet
In addition, some studies show that fructose contributes to insulin resistance, a forerunner to heart disease and type 2 diabetes. Recent studies have linked drinks containing fructose to gout in women, because fructose raises blood uric acid levels.
Agave Nectar May Contain More Fructose Than High-Fructose Corn Syrup
You’ve probably heard about the risks of consuming high fructose corn syrup. This is a processed product that contains a higher percentage of synthetic fructose. Manufacturers add it to ultra-processed foods and beverages for sweetness and texture.
The advantage is that high fructose corn syrup is cheaper than sugar. However, some versions of agave nectar contain more fructose than high fructose corn syrup and table sugar.
The Pros and Cons of Agave Sweeteners
Agave nectar has some advantages over table sugar. Although it contains a similar number of calories, it’s 1.5 to 1.8 times sweeter than sugar, which means you need less of it to sweeten your food or drink. So, you may be able to save a few calories using agave nectar in place of sugar.
It also has a lower glycemic index, which means it doesn’t raise blood glucose or insulin levels as rapidly as sugar does—although this benefit may still come with an increased risk of fatty liver and elevated triglycerides.
Plus, research shows fructose is harmful to metabolic health and contributes to insulin resistance, weight gain, and type 2 diabetes. In addition, there’s evidence that concentrated sources of fructose contributes to belly fat.
Agave Nectar Has Downsides
Agave nectar offers few advantages over sugar except for a small calorie savings, because you need less. When you consider the controversy surrounding fructose as a sweetener, it’s smarter to cut back on all sweeteners.
The way to do this is to slowly reduce the amount of sugar you add to coffee and tea by a small amount each week and substitute fruit for the sweet items you currently eat.
Gradually, your taste buds will adapt to less sugar and you’ll be satisfied with less sweetness. After a while you may even discover that sweetened beverages and foods you once loved, taste too sweet.
- "Agave Nectar: A Sweetener That’s Even Worse Than Sugar? - Healthline." 25 Jun. 2020, https://www.healthline.com/nutrition/agave-nectar-is-even-worse-than-sugar.
- Bray GA. How bad is fructose? Am J Clin Nutr. 2007 Oct;86(4):895-6. doi: 10.1093/ajcn/86.4.895. PMID: 17921361.
- Ter Horst KW, Serlie MJ. Fructose Consumption, Lipogenesis, and Non-Alcoholic Fatty Liver Disease. Nutrients. 2017 Sep 6;9(9):981. doi: 10.3390/nu9090981. PMID: 28878197; PMCID: PMC5622741.
- "How high fructose intake may trigger fatty liver disease." https://www.nih.gov/news-events/nih-research-matters/how-high-fructose-intake-may-trigger-fatty-liver-disease.
- Agave syrup (sweetener; Full report, all nutrients)". USDA National Nutrient Database. 2016.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.