A friend of mine requested that I write a post on sweeteners , and as someone with a sweet tooth, this is something I have thought a lot about! While this is by no means an exhaustive post, I hope it offers a brief guide to the sweeteners that are often used as alternatives to sugar, and what their potential health benefits/risks are, as well as discussion on which ones I personally use.
Let’s start with the sweeteners that include sugar, and those most similar to sugar (often called nutritive sweeteners because they provide calories).
Refined sugar – the chemical structure of sugar (sucrose) is a glucose and fructose molecule joined together. Sugar is widely known as being harmful and addictive, so I don’t think I need to add much here. But as a reminder, high sugar intake is implicated in everything from cancer to metabolic syndrome to heart disease. For a deeper dive into sugar see Dr Robert Lustig’s work. Most of the sugars mentioned below have the same basic chemical structure but may have other properties that make them healthier (see honey and maple syrup)
Unrefined sugar – This is often used in “health food products” but I think it is fairly equal to refined sugar in terms of health effects. It may contain slightly more minerals, but not enough to cancel these harmful effects. I avoid this equally
Coconut sugar – A very dark, brown sugar that is similarly unrefined, and has more minerals. Again, it is very similar to regular sugar in terms of the health effects, but I do occasionally eat things sweetened with coconut sugar, especially as it has a really pleasant caramel taste
Maple syrup – Comes from the sap of the maple tree which is boiled down and concentrated. Darker maple syrup seems to have certain antioxidants and phytochemicals that may be beneficial, for example potentially having anti-cancer effects. As such, I use maple syrup a bit more often than the above, also because it tastes good and is common used in paleo dessert recipes.
Raw honey – out of all the sweeteners mentioned, I like this the most. Raw honey has many health benefits, for example, it has been shown to lower average glucose levels, blood lipids and markers of inflammation in both healthy and diabetic people. This is the opposite effect of regular sugar even though they both have glucose and fructose. I like to keep it raw (for example i use it in homemade icream along with monkfruit), mainy to keep the benefits of enzymes, antioxidants and probiotics.
Sugar alcohols, such as erythritol and xylitol.
These aren’t sugar or alcohol but rather compounds derived from sugar that are naturally produced by certain plants or made industrially. I think these are generally safe, and xylitol has added benefits for dental health. Erythritol suffered a setback to its reputation after this study was published and widely publicised. I liked Peter Attia’s take on it which is less alarmist than some other takes. In summary, the paper found that high circulating erythritol levels was linked to increased risk of serious cardiovascular disease, however erythritol is produced in our bodies and is higher in metabolic syndrome, diabetes etc and therefore is likely a marker than a cause . As such, we can’t really tell with any certainty whether dietary erythritol intake causes heart disease. They also theorized erythritol could increase blood clotting by injecting it into mice, but as Attia explains you can’t translate these findings to humans. This was just one study, and I hope more research is done, but in the meantime I am generally cautious about these things so I tend to use xylitol, and only in small amounts (though a similar study hasn’t been done on xylitol so it may also have potential problems). Other sugar alcohols include maltitol, lactitol, and isomalt. I don’t consume them, mostly because they can cause GI distress.
Non nutritive sweeteners
These are a different category because they don’t actually provide calories. I usually use the natural ones combined with some of the sweeteners above in baking.
Monkfruit – this is my favourite out of the non nutritive sweeteners. It is an extract derived from a fruit native to China. While it’s health benefits haven’t been extensively studied, it may have anti cancer and anti-inflammatory properties. I get a brand that is just pure organic powdered monkfruit, and it works well combined with honey or maple syrup as a sweetener.
Stevia – This is a sweetener derived from the plant Stevia rebaudiana native to Brazil and Paraguay. It seems to have many potential health benefits including anti-diabetic effects, anti-microbial effects, and anti-inflammatory effects. It may also have beneficial impacts on the gut microbiome.
Allulose – This is a rare sugar found in small amounts in foods like figs and raisins. This has also ben shown to have some potential health benefits in rat studies like improving glucose sensitivity and reducing abdominal fat and liver fat.
Artificial sweeteners – I’ve lumped these in a group, but this includes common sweeteners such as aspartame and sucralose. saccharin and acesulfame K. I avoid all artificial sweeteners out of principle but also because of potential concerns, for example potential increase in cancer risk, weight gain and cardiometabolic disease. as well as effects on the microbiome which may be negative.
Are sweeteners without calories a problem?
A key question is whether having a non caloric sweetener can affect weight gain and energy balance because of the possibility of confusing the brain – i.e you taste something sweet but don’t get the calories that normally come with sweet foods. And indeed diet soda has been linked with weight gain and cardiometabolic disease. This may be because a sweet taste stimulates the production of insulin, which itself is a risk factor, and may confuse metabolic processes, or because the sweet taste means you crave other sweet things which are calorific, potentially because the diet drink doesn’t fully activate the food reward pathways. In fact one study showed that glucose does have a different effect on the brain than aspartame, because of the combination of sweet taste and energy content. I am not sure how big a deal this is, but to be cautious I never have non-nutritive sweeteners in drinks/non caloric foods, and usually combine them with natural sweeteners (eg maple syrup, honey) in recipes.
Closing thoughts
Alternatives to sugar are a growing market, with new ones coming out all the time. Personally, I try to eat a healthy optimised diet 90% of the time, with some space for treats which I usually make myself. I try to limit fructose to that which is in fruit, and generally try to keep carbohydrate intake to low-moderate levels, so I have found a great balance in using a mixture of honey/maple syrup and monkfruit/xylitol. It takes some practice to find what quantities work and how to adapt recipes but it’s worth it to be able to have delicious desserts I can feel good about!
MODERN PRIMAL 