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Does It Matter If a Sweetener Is “Natural”?


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natural sweetener, healthy natural sweeteners
Healthy natural sweeteners, like honey, have a lot of additional health benefits. istock.com/bit245

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.

One of my favorite brands of raw honey is Beekeeper’s Natural.


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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Join the conversation

  1. I have swallowing issues, so all my supplements must be taken in a powdered form, so that I can mix it in some liquid. And, the pure, pharmaceutical grade works best for me. Why am I talking supplements here? Because, if you want pure, pharmaceutical grade Stevia, go to http://www.BulkSupplements.com and save yourself some money! Check out their other offerings as well. You can also get their supplements on Amazon.com. I have placed many orders with them. They are located in Nevada, have excellent customer service and ship quickly, plus their products are the best in their field.

    I stay away from anything with alcohol, and additional ingredients, like natural flavors. What is natural flavor anyway!

  2. I use stevia in my Ice Tea and Honey or Maple sugar on my “faux” sweet potatoes pancakes. I grow stevia in my backyard so I will mix fresh stevia leaves with fruit when it’s not at it’s prime to punch up the sweetness.

  3. Thank you for the facts about honey. I have noticed I feel better on the days I remember to have some (I have a Hashi’s diagnosis).

    I have been using a Manuka honey, which claims medicinal properties so of course I bought some, lol! It is delicious; it tastes slightly different from regular raw honey. Might be worthy of inclusion in a future blog post?

  4. Thanks for this article. One of our little pleasures on a very strict Autoimmune Paleo diet is a small teaspoon of honey in the comb. (OF COURSE, eaten with an adequate amount of protein to keep our blood sugar levels stable!) 😉 bwahahaha

  5. What about agave nectar from the juice of the Blue Agave plant as a substitute sweetner?

    • It’s practically pure fructose, with all the attendant evils thereof – a liver nasty.

    • The word “nectar” is a minomer, in this context, clever marketing.

      Quoting Dr. Art Ayers:
      “Agave Syrup is Fructose
      Agave syrup contains fructose produced by industrial processing of the fructose polysaccharides, inulin, in agave extracts. I cannot understand why anyone would use this commercially processed fructose as a sweetener. It doesn’t raise blood sugar as much as sucrose, because there is much more fructose than sugar (like very high fructose corn syrup) it raises blood fructose levels instead, which is much, much worse.”

  6. Has anyone heard that honey becomes toxic above 250 degrees? If so, this could be an issue when using it for baking.

    • wow- that is very interesting info about coconut palm sugar that i had no idea about. that is too bad as i love coconut sugar, in moderation, and it is economical. now i am having serious second thoughts, until i know more about it and its sustainability.

      thank you very much, christine, for sharing that information.

  7. As always, great info, well written,, a true service for all, thank you so much, and please keep it on,

  8. If honey lowers blood glucose, can/should it be used by diabetics or people with insulin resistance? If so, how?

    • I dońt think so. What lowers blood glucose most is avoiding all sweets. My mom is type 1. Uses a little stevia and has a bit of potatos and rice here and there to avoid ketosis, but she is VLC and absolutely fine.

      • I am a type 2 diabetic with Hashimoto’s that cannot tolerate any kind of sugar without a major glucose spike though I have noticed that after 2 years of whole foods (minus all grains and most dairy) that I am slowly more and more responsive as time and healing progress. That said, honey (local raw) still will jack me up to 180 or higher 1 hour postprandial but my glucose levels will fall much faster than they used to though not normal yet. In the past I would remain elevated for 4-6 hours which then became chronic elevation. I find the commentary about how honey can actually assist glucose control confusing but interesting judging by my own body experiences. I consider myself very food sensitive and it runs in the family strongly though we are all of 100% (dna tested) European descent which should not be the case from my understanding. Just shows you everyone’s situation is unique. Atm I only use stevia for coffee or tea as a treat but don’t bother with any other sweeteners after deleting grains-no cravings for grains or sweets. I used erythritol early on but naturally stopped baking altogether unless it’s a family birthday or Thanksgiving/Christmas and even then it is a healthy alternative.

  9. To me stevia is a tough one as of course our ancestors would never have had access to anything like it. It is still a refined and concentrated, manufactured product.
    Honey is tough too as primal societies would not have had squeeze bottle super liquid type honey and were more likely to consume honeycomb.

    • ‘To me stevia is a tough one as of course our ancestors would never have had access to anything like it.’
      Why not? It’s a plant.

      ‘It is still a refined and concentrated, manufactured product.’
      Not if you use the fresh leaf or dried powdered leaf or if you make or buy a natural extract.

  10. Can anyone tell me what VitaFiber is and if there is an US equivelent? I found a recipe for homemade Quest Bars, but it calls for VitaFiber which is only sold online. What would you use instaed if you were me? I’m a T1D so I don’t tolerate most sugars well, but need to introduce about 20g of carbs pre-workout and have been looking to make my own (cost effective) bars. Based on the article it looks like Stevia would be my natural alternative. http://www.bioneutra.ca/product_vitafiber.htm

    • To use raw organic honey you want a Jun scoby not kombucha. The anti-bacterial properties of honey can damage kombucha scobys over time. I’ve never tried it with kefir but I imagine you will have similar issues.

      Jun is available from Brooklyn Kombucha.

      • I wonder if gradually adding a small amount of honey to kefir might create an adapted colony that can eventually handle more or all honey? I guess I’ll have to try it.

        • I implore you to save your time and money and not bother. I agree its possible but the probability of doing so safely outside a sterile lab environment is minimal at best. If you need more proof just do a web search and you’ll find plenty of folks who have tried and failed. If you are trying to eliminate cane sugar, I suggest jun, if you just want to incorporate the benefits/flavor of honey, use ‘spare’ cultures or consider a secondary fermentation using honey.

    • I have read that you shouldn’t because of the natural antimicrobial quality of the honey and that it isn’t an appropriate food sour e for the feeding microbes. It might have been on the Cultures For Health website that I read this.

  11. Please consider the bees before you buy honey. Bees are starving and need honey for their very survival, whereas we do not. They are dying in unprecedented numbers worldwide with huge consequences for our food supply.

    Most beekeepers take the bees’ honey and feed them sugar, which weakens them and takes their vital food source. They also do many other things to bees that are very cruel and harmful.

    My husband’s web site has articles on honey bees and their current desperate plight for survival. See also Michael Thiele’s web site http://www.gaiabees.com He is an amazing west coast bee lover/’keeper’ with a lovely presence.

    • I prefer to think that the bees will “bee” fine, but I have cut way back on honey intake. I have my xylitol. 🙂

  12. Thanks for this great article. I use about a teaspoon of raw honey in my one cup of coffee each morning and have an occasional Paleo treat made with honey. I’m eating mostly Paleo, but after an initial 16-pound weight loss, the weight loss suddenly stopped and the bloating/inflammation is back, so I am trying to figure out what is causing it. I had wondered about the small amount of honey that I consume. I do not consume any processed sugar.

  13. Excellent article. I’m never disappointed by your writing and I really appreciate your attention to the scientific component and inclusion of references. I will be sharing the info with others. Thanks!

  14. It was my understanding Maple Syrup does have a traditional background… Native American populations have been boiling it down for a long time before they taught European Settlers to do it.

    I am glad to read your opinion on Stevia. I have been avoiding it particularly because I am trying to maximize my fertility, even though the connection seems weak, at best.

    Still, is there any benefit of using the dark liquid extracts or whole leaf versus clear ones? The clear ones certainly are easier to work with.

  15. For the hamster dosage with stevia, you must convert it to the human-equivalent dosage (for the hamster, divide by 7.4). 2.5g/kg becomes .33g/kg, making your example value become 23, not 175. That is a significant difference.

    • Jennifer, in the spirit of full disclosure, you should indicate in your article that Xylitol is not tolerated by everyone, and that there is a “learning curve” for your gut bacteria when using Xylitol. Xylitol is not processed by our normal nutrition mechanisms, but rather passes into the intestine where various gut bacteria actually utilize the xylitol in a fermentation process, breaking it up into short-chain fatty acids that we do actually end up processing (which, in fact does not make xyltol actually calorie free although the caloric contribution is minimal). The unfortunate side effects of the fermentation process is gas and bloating for many, and until you have enough of the right gut bacteria to process the xylitol there is an unfortunate side effect of very loose stools. I can attest to the above from personal experience with xylitol. I’m not refuting the positive points you bring up in your blog post, but in the interest of full disclosure, a person needs to be aware of the big negatives to xylitol.

      • Thanks for weighing in about xylitol, Eric. I personally never had much of an issue with digestive upset and I see it as a transitory thing, not a “big negative.” But you’re probably right that I ought to include those points in my blog post.

        • Great to hear both sides of xylitol. One thing people should be aware of if they have dogs is that it is extremely toxic to them, even in small doses. I almost lost my dog to xylitol toxicity. So keep that xylitol out of reach of the pooches!

      • Amen on the tummy upset from xylitol! My experience exactly–even with small amounts.

    • Last night I made a rhubarb dessert with xylitol. We have used it in the past by the spoonful sprinkled on berries. Within 20 minutes of finishing I had a belly ache. There was more in this serving than I had ever had before. I won’t breaking with it again or eating more than a sprinkle like before.

      • IMO, Mr. Nagel is not seeing the big picture here. Xylitol has been used in Finland since the ’30’s and has a a long record of safety apart from being toxic to dogs.
        Initially it may cause GI upset, but this is temporary and is often due to a herxheimer effect, since it is known to kill Candida.

  16. The only sweetener I can eat is raw honey. Raw organic cane sugar isn’t a major problem for me either, although my body seems to prefer honey. However, actual phaux-sweeteners like stevia mess me up really bad (stomach pain within 20 minutes).

    • I wonder if it’s pure stevia or a mixed product that messed you up…most stevia sold these days has other ingredients like erythitol which has a pretty drastic effect on our family’s digestive systems. I urge people to check labels and look for a pure product. Omica brand or Sweet Leaf seem to be the best we’ve found. Or better yet, grow it yourself!

      • I recently posted about this on my own blog under the dangers of stevia. Most brands are not pure stevia and are extracted from chemical processes making them toxic. I use sweetleaf with no issues as it is organic and extracted from natural processes. I also use raw honey and I have a diabetic friend that uses it and it does not even raise her blood sugar. Primalpsychologist.com