Can Sweeteners Fit into a Healthy Diet?

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Over the past couple months, I’ve delved into the topic of sweeteners, hoping to shed some light on what can often be a controversial issue in the Paleo and ancestral health community.

So far, we’ve covered natural sweeteners, artificial sweeteners, sugar alcohols, and even refined sugar and high fructose corn syrup, and I’ve showed you why all sugar is not created equal.

For the final post in this series, I want to give you all some practical advice on how to incorporate sweeteners into a healthy, whole-foods diet. As with everything else, my recommendations are different depending on your health, both past, present, and hopeful future. I hope to give you some guidance on how to healthily and mindfully incorporate sweeteners into your diet.

Sugar and healthy eating: mutually exclusive?

If You Want To Lose Weight

As I’ve mentioned a few times in this series, one of the main problems with refined sugar (and sweeteners in general) is a tendency to promote overeating, which can lead to weight gain and inhibit weight loss. For this reason, I recommend that anyone trying to lose weight minimize or avoid foods that are sweetened, even with natural sweeteners.

And although artificial sweeteners are popular for weight loss and some trials have shown them to be effective, I recommend avoiding them in this case. Aside from the simple fact that they’re not real food, the mismatch between sweet taste and caloric load could potentially disrupt appetite regulation and metabolic response, which is counter to any goals of weight loss. If you want something sweet, stick with whole fruit, because the fiber and water in fruit make it more difficult to over-eat, while promoting healthy gut bacteria.

If You Have Diabetes or Insulin Resistance

For those with insulin resistance or diabetes, I have similar advice: avoid concentrated sweeteners as much as possible, whether natural or refined. Some studies have found that consuming whole fruit does not increase blood sugar or insulin even in people with type 2 diabetes, but I’ve found in my practice that this really depends on the individual. If you have a blood sugar problem and you’re wondering whether you can safely consume whole fruit, I recommend purchasing a glucometer and following the procedure I outline in this article to answer that question.

For those who can’t tolerate even whole fruit, stevia can be a good choice for when you want something sweet. Stevia has actually been used traditionally as a treatment for diabetes, and some studies indicate that it can have therapeutic effects in diabetic patients. (1)

Sugar alcohols are another viable option if stevia doesn’t work for you. They have fewer toxicity concerns than artificial sweeteners, and some preliminary research suggests that sugar alcohols (particularly xylitol and erythritol) might even be therapeutic for diabetic patients. (2, 3)

Sugar alcohols aren’t something I recommend consuming regularly, and I think stevia is a much better option since it has a long history of human consumption, while sugar alcohols are comparatively new. But if you can’t (or choose not to) use stevia, occasional use of sugar alcohols could help you not feel deprived. Just keep in mind that tolerance of sugar alcohols varies, both with regards to blood sugar control and digestion (sugar alcohols are high FODMAP) so be sure to test your own tolerance.

If You’re Dealing with Digestive Issues

People with IBS, reflux, or other digestive problems often have trouble with concentrated sweeteners. One reason for this is that large quantities of fructose can be difficult to digest and absorb, and undigested fructose can lead to unpleasant digestive symptoms. Additionally, sugar is a prime food for gut bacteria, so anyone with small intestinal bacterial overgrowth (SIBO) might experience gas and bloating from intestinal bacteria digesting the sugar before it can be absorbed.

My general advice on sweeteners for those suffering from digestive issues is to go with what your gut can tolerate. This usually means avoiding large amounts of any concentrated sweetener, and avoiding any sweeteners (such as agave nectar) that contain a high proportion of fructose. Raw honey may have some therapeutic properties for digestion despite having a high fructose content, and it’s definitely the most “Paleo” sweetener out there, so it’s a good option if you tolerate it well.

If You’re Prone to Sugar Cravings

As I mentioned earlier in the series, sugar can certainly be addictive for some people, and those who have strong cravings for sweet foods can find it difficult to incorporate sweeteners into their diet without crowding out other, more nutrient-dense foods. In this case, it’s probably best to avoid concentrated sweeteners altogether, but this is easier said than done when you have strong cravings!

If you struggle with sugar cravings or addiction, make sure you’re getting enough healthy non-sweet carbs – especially dense sources like potatoes and other root vegetables, plantains, and white rice (if you tolerate it). A simple need for carbs can often manifest as cravings for sweets, so making sure you get plenty of healthy carbs can prevent bingeing on sugary foods.

When you do want something sweet, just eat some whole fruit! (Are you sensing a theme here?) However, it can be helpful for some people to restrict your fruit consumption to meal times, especially if you find yourself mindlessly snacking on fruit all day instead of eating other foods.

Another trick for addressing sugar cravings is eating a teaspoon or two of coconut oil. Coconut oil has medium chain triglycerides in it, which are a type of fatty acid that is rapidly absorbed and turned into usable energy.

If You Just Want to Optimize Your Health

If you don’t have any particular health concerns or goals, a variety of sweeteners can fit well into a healthy diet. Natural, minimally-refined sweeteners are the best choices, and honey, stevia, and molasses might even provide some health benefits. Although other natural sweeteners such as maple syrup or coconut sugar aren’t significantly different from plain old white sugar on a nutritional basis, choosing natural sweeteners ensures that you avoid GMOs and possible contaminants introduced during processing.

And it’s always a good idea to eat foods that are as close to their whole, unrefined state as possible, even if modern research indicates that they affect the body the same way as more refined foods. That said, occasional consumption of refined sweeteners isn’t something to worry about.

Conclusion

When it comes to diet, a primary goal should definitely be to maximize nutrient-density and healthfulness, but actually enjoying your food is just as important. Humans are hard-wired to enjoy sweet foods, and for most people, excluding sweeteners from the diet in the name of health is unnecessarily restrictive. As we’ve seen, some sweeteners actually have health benefits, and even refined sweeteners aren’t as scary and harmful as they’re often portrayed to be.

Will you be changing your sweetener consumption after reading this series? Share your opinion in the comments below!

Previous articles in this series:

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Comments Join the Conversation

  1. Anna says

    Thank you for being so clearcut on the diabetes issue. There are so many differing recommendations (eat lots of fruit, agave nectar is good for diabetics, eat anything you want but just use enough insulin) that it gets frustrating. What you say is common sense.

  2. Farhd says

    Aren’t some of the sugar alcohols natural sweetener in many vegetables and fruits? If so, why do you consider them as a class as non-natural?

  3. Kelly says

    Thanks Chris.

    I have a question about Stevia… since this is a no-calorie sweetener, could it not in principle have the same confusing effect on hormones and metabolism as artificial sweeteners, with the body expecting a higher caloric load than it is getting due to the sweet taste?

    Also, are all stevias created equal? There is the white powdery stuff that you can get in a massive bag from grocery stores, and there are also drops, and maybe some other forms. Stevia may have been used since the dawn of man, but how do we know modern stevia is metabolically equivalent or as safe?

    Appreciate it! Love listening to your stuff and share your podcasts with friends.

    • Chris Kresser says

      That’s possible, but I have not yet seen any studies suggesting that stevia has that effect.

      I would suggest trying to obtain stevia closest to its natural form—but that’s true for just about any food.

      • says

        I thought about this metabolic disrupting effect of sweet taste without the caloric load to match. Maybe when making a sweet treat with stevia, including a small amount of raw honey or whole fruit just to satisfy the brain with a little caloric load. Would that work?

  4. Louise says

    You might have pointed out that for the most part, sweeteners are optional. Generally speaking, there’s no need to use them. For my part, I keep honey in the house only because sometimes guests come over who like it in their tea. I drink black, unsweetened coffee, which I find delicious. Except for a very occasional almond flour pancake or muffin that I sweeten with organic maple syrup, I consume no baked goods because I eat no grains. When else is a sweetener required? I can’t think of a reason.

    Some might find my position extreme, but I believe that our taste for very sweet things is conditioned and can be unlearned. Don’t get me wrong. I love fresh berries as much as the next Paleo person, but there’s no need to add sugar to them, or just about anything else for that matter.

    • Chris Kresser says

      Our taste for sweet things is not conditioned. It is evolutionarily hard-wired. Sweet taste = high energy density (typically) and in a environment where food is scarce eating foods with high energy density when they’re available would confer a survival advantage.

      Anthropologists who study hunter-gatherer populations have noted that they will basically gorge themselves on honey when they find it. This is not a conditioned response.

      • Louise says

        Even if we were evolutionarily hard-wired for sweets in the distant past, we are no longer hunting-gathering and facing environmental food challenges of the type you’re describing. On the contrary, we have more food, both healthy and junky, than we know what to do with. In this context, what’s the value of using sweeteners on a regular basis?

        I’m assuming (perhaps wrongly) that this article is designed to move people who have sweet cravings toward healthier options, understanding that they’re going to seek out sweets one way or another. But my point still stands: we almost never need to sweeten foods, and the fact that we continue to do so is a habit. People seeking “something sweet” often need to retrain themselves to choose an orange or berries over a cookie or a candy bar — I know I did — and this speaks to the psychological aspect of sugar ingestion.

        A craving for sweets can be unlearned and I think it’s worthwhile to mention that.

  5. says

    Great series Chris. I’ve been having a desert at night before bed made with a tablespoon of honey, cup of milk and a little cinnamon warmed in microwave.

    • sheila c. says

      Hi Aaron (Paleo Runner Podcast host!). Does this help with your sleep? I’ve heard good things about having honey before bed.

  6. Rick says

    Chris Please help me figure out what causes geographic tongue? Any advice would be great .. Thanks even if u don’t reply

  7. jenn says

    I love your series, Chris. I was already using stevia sparingly before reading it, but I feel better about that choice now. While I don’t eat much honey, I am thinking of it as a very calorie dense food now, rather than just another sweetener.
    Thank you

  8. Hélène says

    If anyone hates stevia with its aftertaste PLEASE *try the glycerite*. Stevia glycerite is great. Need very little and no funkiness. I have used NuNaturals & it was good, but I prefer NOW brand stevia glycerite, alcohol free. I get it in an 8 oz bottle and it has a dripper cap so you don’t have a mess using the droppers with other (smaller) bottles. You need very small amounts as glycerine is sweet in its own right & there’s no alcohol to overcome.
    The only powder I can tolerate is SweetLeaf, the white powder with inulin. And that just isn’t as “no-funk”/non-bitter as a glycerite. It’s fine for baked goods tho. I’m not sure which is cheaper to use, the powder or the glycerite I only use the glycerite in anything that’s not a baked good. I often use it in baked goods too, with erythritol. The 2 sweeteners give a better flavor profile than one alone.

  9. Joy says

    Chris,
    I am wondering about stevia if I have an autoimmune disease (in my case type 1 diabetes). Does it have disadvantages for autoimmunity?

    I can testify that stevia has no effect on blood sugar since I check my blood regularly and tested stevia.

    Also I assume you are referring to 100% pure stevia as apposed to stevia that are a mix of stevia and other sugars.

    As always I enjoy your POV on sugar and other subjects you write about.

  10. MR PALEO says

    As an addendum to the information Chris has provided, it is important to note:
    When buying xylitol, buy birch-bark derived and not from China,
    All rice in America tested positive for arsenic (both organic AND inorganic), except for the Lundberg brand (wish I got a kickback for every time I have mentioned this),
    Real “Manuka” honey from New Zealand has healing properties, but should be used judiciously, as it is still sugar, as is coconut sugar, which is gaining in popularity.

    • Hélène says

      Or just quit eating grains, including rice lol
      I only eat grain when I have my 2x month pizza and yes I go wheat even as it just bother me (but I know that wheat is just not good to eat nonetheless, 100% organic wholewheat included). But being grainfree the other meals 3x a day for the month doesn’t bother me. I’ve gotten used to it and use almond and coconut flour for baked goods. And GREENS for things most ppl eat grains for lol
      I dont think raw honey has rly any diff on metabs, nor coconut sugar. if you can’t have sweeteners, u just can’t.
      n=1 all the way, baby!

  11. Gina S says

    I love how you sectioned the article off into specific categories depending on your health issues. Awesome as always Chris!

  12. Tara says

    Hi Chris, I muscle test myself for my foods and products, and I find that I never test well for honey, which is just me I guess, but I always test well for coconut sugar. I was under the impression that coconut sugar is low glycemic, but above it was compared to white sugar, so I am wondering your take on this? I also use stevia mostly, but coconut sugar for baking, and dates to sweeten foods too, like when I make raw fudge (yum!). As far as fruit goes, what is your take on dried dates, as well?
    Thanks!

  13. chaitea says

    I recently came across the work of a nutritionist who is promoting eating / using regular white sugar in cooking (as long as it is paired with protein and fat). The work of this nutritionist also promotes eating other healthy sugars found in fruit and vegetables (as long as it is paired with protein and fat…this I understand). White sugar (along with other processed sugars) weren’t around when we lived in traditional hunter-gatherer societies, so I don’t see how someone could come to the conclusion that the body could prefer to use such sugar to convert to energy.

  14. John McDonell says

    Its strange that I thought a Paleo diet would resolve most of my issues. However, now I’m leaning more to aketogenic diet + added refinements like: Carb Backloading (timing of fat intake in daytime and carbs in evening long before sleep…. even junk and very sweet and even trans fatty acids have little negative health impact. All this has to do with cortisol spiking to ‘clean’ arteries. The ‘spike’ is very short, but changes metabolism for hours.
    Paavo Airola proposed (decades ago) to improve circulation by soaking feet in ice-cold water (another cortisol spike). for 5 minutes just before bed and first thing upon rising.
    Yesterday, I heard that if too much protein is consumed (>100g) then the body converts this excess into sugar.

    Sometimes the Paleo position does seem remote.

  15. Debbie says

    Chris, I have a question about your Prebiogen. How does it differ from potato starch; if one is taking 4 tablespoons of PS daily, would taking Prebiogen still be helpful?

    Thanks so much.

  16. says

    Great post Chris! As health and wellbeing bloggers following a paleo lifestyle we share quite a few sweet treat recipes (and eat them). Over the last year we have seen our tastes change dramatically when it comes how much natural sweetener we need and we continue to experiment with the different natural sweeteners to see the different effects. Our favourite sweetener is stevia as we get no racey feelings afterwards.

  17. says

    In recent years, I’ve been moving away from the refined sugar and artificial sweeteners, and moved in the direction of natural unprocessed honey to sweeten my meals or a quick sugar boost if I craved it.

    Virgin coconut oil (VCO) is also very lovely and fragrant, though it can be overbearing if you over-do it (I ate it everyday for a month).

    In the end, I think the unprocessed raw honey is the best – maybe because it’s the simplest in form, that is easily absorbed by the body (at least for me), without the digestive complications (processed sugars seems to irritate my stomach)

  18. says

    I have been consuming Stevia for upwards of 13 years at this point and I have NEVER had any adverse affects!!! I highly recommend it to anyone and everyone :)

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