The ancestral health community and other heath-conscious bloggers have increasingly embraced natural sweeteners such as honey, stevia, and maple syrup as healthier alternatives to refined sugar. But just how much healthier, really, are these natural sweeteners?
In this article, I’ll review the three major “natural” sweeteners typically used by Paleo dieters, and determine whether or not these foods belong in a healthy eating plan.
Find out if “natural” sweeteners like honey, stevia, and maple syrup belong in a #Paleo diet.
As I mentioned in the first article of this series, honey has long been an important food in the human diet. Its fructose to glucose ratio is similar to that of high fructose corn syrup, with about 38% fructose and 31% glucose (the rest being primarily water). (1) Honey also contains enzymes and other proteins, trace minerals, flavonoids and other polyphenols.
Although honey is “Paleo” even in the strictest sense, it can be easy to think of it as just another source of sugar; better than table sugar, perhaps, but still an indulgence that should be kept to an absolute minimum. Sugar is sugar, right? On the contrary, increasing evidence indicates that honey is a functional food with uniquely beneficial physiological effects.
For example, two human studies found that supplementing with 3-5 tbsp of honey per day (depending on body weight) increases serum antioxidant levels, including vitamin C and glutathione reductase. (2, 3) In another study, the same dose of honey lowered plasma prostaglandin levels by 48-63% after 15 days, signaling a reduction in inflammation. (4)
In overweight and obese patients, consumption of about 3.5 tbsp honey per day for a month resulted in lower LDL cholesterol, triglycerides, and C-reactive protein (particularly in people with elevated values), and higher HDL cholesterol. (5) In another study, honey also reduced levels of homocysteine and blood glucose. (6)
Honey also has antibacterial activity, and can shorten the duration of acute bacterial diarrhea in children. (7) Honey might even be an effective treatment in some cases of h. pylori infection. (8) Other potential benefits of honey include antiviral, antitumor, and antimutagenic effects, and reduction of IBD-associated inflammation, but these have yet to be tested on humans. (9) So it would appear that honey has many benefits that outweigh the potential downsides of consuming a concentrated sweetener. I recommend using raw honey, which will have the most enzymes and nutrients when destructive heat has not been used.
Stevia continues to be a contentious topic in the ancestral health world, with some respected bloggers endorsing it heartily and others cautioning against it. Although I’ve seen good points raised by both sides, the majority of the evidence indicates that stevia, used in reasonable quantities, is a harmless (and possibly beneficial) natural sweetener.
Because stevia contains almost no calories, one potential issue with stevia is that the sweet taste without the influx of sugar might confuse our insulin response (I’ll talk about this at length when I cover artificial sweeteners). While this is an understandable concern, stevia has actually been used traditionally as a treatment for diabetics and may actually improve blood sugar control. (10)
In one study, participants were given a dose of either sucrose or stevia before lunch. Compared with the sucrose preload, the stevia preload resulted in lower blood sugar after the meal and a lower insulin load, even compared with aspartame. (11) Also, even though the stevia provided fewer calories than the sucrose, participants didn’t compensate by consuming more calories at lunch.
Another small study with 16 volunteers found that 5-gram doses of stevia extract every 6 hours for three days improved glucose tolerance. (12) In insulin-resistant and diabetic rats, stevia improved insulin sensitivity, glucose tolerance, and liver and kidney function. (13, 14, 15)
Stevia has also been called into question due to its potential negative impact on fertility. Stevia was used traditionally in South America as a contraceptive, although we don’t know how effective it was, and results from animal studies have been mixed.
One study found that doses of stevioside up to 2.5g/kg bodyweight per day didn’t affect the fertility of hamsters, even after three generations. (16) For a human, this would translate to about 0.34g/kg, so a person weighing 70 kg (about 150 lbs) would need to consume almost 24 stevia packets every single day to reach that dose. That’s far more than anyone would reasonably consume, even if they were consciously trying to maximize their stevia intake.
Although two other studies did find that stevia reduced fertility in male and female rats, those conclusions have since been refuted by studies using more reliable methods. (17, 18, 19) Overall, the risk of negatively impacting fertility by consuming moderate amounts of stevia is very slim, but I would still advise people to be wary of stevia if they’re struggling with infertility.
As for other potential benefits of stevia, a 2-year RCT in Chinese adults with mild hypertension found that taking 500mg of stevioside powder 3 times per day significantly reduced blood pressure compared with baseline and placebo, from an average of 150/95 to 140/89. (20) However, smaller doses didn’t provide the same benefit, and there isn’t enough evidence to recommend large doses of stevia as a supplement to lower blood pressure. (21)
Finally, stevia appears to have anti-cancer, anti-inflammatory, antioxidant, and antibacterial properties, but thus far we don’t know whether these properties have practical significance in humans. (22, 23) Ultimately, I think stevia is a good sweetener to use for those who have blood sugar control issues and would prefer to use a non-caloric sweetener.
Maple Syrup, Coconut Sugar, and Molasses
Maple syrup, coconut sugar, and molasses are other popular natural sweeteners, but they don’t have the modern research or the traditional background that honey and stevia do. Composition-wise, they’re all relatively similar: they’re mostly sucrose, with some free glucose and fructose. (24) They all contain some minerals such as calcium, zinc, and iron, but they’re not going to contribute all that much to your daily mineral needs. (The exception to this might be molasses, which contains 20% of the daily value for potassium, 10% DV for calcium and vitamin B6, 15% DV for iron, and 8% DV for magnesium in just a tablespoon. (25))
All three are lower on the glycemic index than white sugar, which falls at around 65, with the award-winner being coconut sugar at 35. (26) Maple syrup has gotten a little research attention, and preliminary analytical and in vitro studies show that it has antioxidant and anticancer properties, as well as potential for the management of type 2 diabetes. (27, 28, 29, 30) However, this isn’t anywhere near being of clinical significance for humans.
If you’re just looking for an alternative to refined sugar to use occasionally, all of these are fine sweetener choices; they’re natural, minimally processed (depending on the quality you purchase), and still contain the minerals and phytonutrients that occur naturally. They also have favorable fructose:glucose ratios, which can be an important consideration for those with gut issues or fructose intolerance. (This is one reason I don’t recommend agave nectar.)
But if you’re looking for health benefits beyond simply replacing refined sugar with something a little healthier, current research (and tradition) sides with honey and stevia.
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