Does It Matter If a Sweetener Is “Natural”? | Chris Kresser
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Does It Matter If a Sweetener Is “Natural”?

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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.

Honey

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

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.

103 Comments

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  1. Woah 3-5 tablespoons of honey per day seems like a lot. It’s high FODMAPs. I think I would do really poorly with more than a teaspoon or two of honey per day because of the excess fructose. But given the antibacterial activity weighed against the poorly absorbed fructose, I wonder how that would really work out for someone with SIBO?

  2. Just want to thank you Chris for sharing the research. Since I purchased your book I have been impressed with the amount of additional, research-based information you continually provide.

  3. If you are allergic to ragweed, you might want to stay away from stevia as they are related. I wish I had known this before I tried stevia! Now I know I am allergic to both.

  4. I don’t tend to use many sweeteners because I don’t really have a sweet tooth. The odd time I do need something, I use either fruit (dried dates or other dried fruit), or I use raw (local) honey or a small amount of pure maple syrup.
    I do use a small amount of unrefined organic cane sugar to feed my water kefir and kombucha as that gives me the best results.

  5. Rapadura sugar from sugar cane (not to be confused with refined white sugar) : “a 100 g serving of rapadura sugar provides between 600 and 1,000 mg of potassium, between 40 and 100 mg of magnesium, between 80 and 110 mg of calcium and between 50 and 100 mg of phosphorus. ”
    Furthermore, the same amount of rapadura sugar contains between 120 and 1,200 international units (IU) of vitamin A as well as trace amounts of B vitamins.”
    http://www.livestrong.com/article/524501-rapadura-sugar-and-its-health-benefits/
    For a natural sweetener, sounds pretty good….

    • @ Marcus
      true…… I don’t think 100 grams a day would be beneficial to eat, tho a tsp or 2 would be fine IMO. I use that in my coffee/tea and just eat other sugar in it’s natural form via fruit…I also think it’s good to balance your sugar intake with some good fat and protein at the same time

  6. Great Article! Have a look at Manuka Honey. It’s from New Zealand and can be more expensive – but has amazing medicinal qualities to it. It is my go to whenever my family are coming down with a ‘cold’. You can different levels of UMF (unique manuka factor) with it becoming very expensive above 10+!

  7. Nice concise article Chris. I only use honey, maple syrup, and coconut sugar. I am still a bit wary of Stevia. It still just reminds me of an artificial sweetener. If something seems too good to be true it probably is…this is my gut feeling on Stevia. No science, just my own feeling.

    • that’s an odd thing to say fitmum, you know that stevia is just a sweetener processed from a plant? Which is the same thing that sugar is; the only distinction is that stevia just happens to be non-caloric. As far as the studies go there’s a lot more reason to believe stevia is safer and healthier than ‘natural’ sugars.
      Artificial sweeteners are synthetically manufactured in a laboratory, so the association is a bit of a stretch.

  8. If you are eating raw honey for its associated health benefits then its best not to heat it at all. That goes for putting it in your tea/coffee. So over 40ºC or body temperature. Best to drizzle it on some cooler dish or eat it straight from the jar!

    In Ireland its about 5€ (7$?) a jar. I started taking it this winter. The difference between raw honey from my local beekeeper and the shop bought one is amazing. The raw one is delicately flavoured. The shop ones are usually heat treated which basically turns it into sugar syrop. I just don’t bother with the shop bought ones now. At that price I prefer to keep it as a beautiful treat.

  9. For many years I have preferred luo han guo, also known as monk fruit. It is zero glycemic, has a superior taste to stevia, which if not blended with xylitol or erythritol can have a noticeable aftertaste.

    Many products now combine luo han with inulin (also a prebiotic fibre), or Erythritol.

    Of course Lustig believes sugar is sugar is sugar, regardless if it is honey, white sugar, brown sugar, etc.

    I believe the best plan for health is to avoid all sweeteners, and learn to like foods that are not sweetened.

    Nathan Zassman
    Aviva Natural Health Solutions

  10. I’m an insulin dependent diabetic, and I truly wish that raw honey didn’t spike my blood sugar, but it certainly does. I grow stevia and make extract, and have toyed with powdering via dehydration, the dried, ground, green leaf just doesn’t appeal due to the scum factor…If I purchase it, I use the powdered organic sweet leaf variety, it’s less bitter and easy to travel with. The rest of my family uses raw honey, and the teenagers compromise with coconut sugar when they rebel.

  11. What about the notion that simple sugars don’t contain the vitamins and minerals for the body to process them, leading to nutrient depletion? Any validity to that?

    I see that molasses definitely don’t fall into that category. But what about the others?

  12. I’ve been hanging out for this article! I was hoping it would be a little longer though 🙁 Thanks for taking my suggestion and giving coconut sugar a mention, it’s a pity we don’t have much data on coconut sugar.

    Will you be writing anymore articles in this series? It would be nice to know what you think a healthy amount of natural sweetener consumption per day is, and perhaps tie that in to the paleolithic background and explain how some cultures managed to remain healthy while eating rather large quantities of honey, thanks chris.

    • Dextrose powder is pure glucose, less sweet than sugar. It’s the form of sugar we refer to as “blood sugar” and requires no digestion. It has a GI of 100.

  13. When comparing per-kg doses used in studies with small animals it is important to keep in mind that the clearance (and hence overall exposure) of most xenobiotics scales across species as body weight raised to the 0.75 power, not raised to the power 1.0 as is assumed when scaling doses by body weight directly. The example for scaling a 2.5g/kg dose in a 0.1 kg hamster (0.25g) is equivalent to a dose of 0.25*(70/0.1)^0.75=34g in a 70kg human (roughly 0.5g/kg). Thirty-four 1-gram packets is still a heck of a lot of stevia.

    • actually he said helped control blood sugar and insulin resistance, not honey. Any benefit of these sweeteners in attributable to their phytonutrients, there are a lot more things that effect insulin signalling than just the sugar content of food.

  14. Thank you so much for spelling this out. I have nearly finished reading your book and after having no sugar for four months except an occasional square of 85% chocolate, have found the thing I miss most is a bit of honey or maple syrup from time to time. I believe I have fructose malabsorption as I can never eat foods that contain high fructose corn syrup without reaction. Also no onion or anything with onion powder or leeks etc. Also don’t tolerate raw apple. It’s a minefield out there!!

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