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Can Sweeteners Fit into a Healthy Diet?


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are sweeteners healthy
Sweeteners can be part of a healthy diet. Jupiterimages/BananaStock/Thinkstock

Previously, 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. One of my favorite raw honey options is Beekeeper’s Naturals.

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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.


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.

Previous articles in this series:

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  1. Chris–

    What do you know about glycerin? The information I have researched is conflicting, with some sources saying it has “NOT DETECTED” amounts of carbs/ sugars and others listing up to 15 mg/ tsp– yikes! It is a sugar alcohol, so it must be metabolized like other sugar alcohols, ie– erythritol, xylitol, etc., but I cannot find any scientific studies about the impact on blood sugar and where it would fall on the spectrum of sugar alcohols, with xylitol being higher and erythritol being the lowest. The ADA says that it negatively affects blood sugar, but no evidence is cited. Personally, I suspect that it would be metabolized like any other sugar alcohol, and would affect some people more than others based on digestion vs. fermentation in the gut. Insights?