Is There Any Room for Sweeteners in a Healthy Diet? | Chris Kresser
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Is There Any Room for Sweeteners in a Healthy Diet?

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sweeteners, healthy diets
There are many sweeteners available, but not all are created equal.

Humans are hard-wired to like sweet foods. Sweet tastes are strongly tied to the reward centers in our brain, and can actually relieve pain and reduce symptoms of depression, PMS, and stress. (1)

Unfortunately, these properties strongly dispose us to over-consume sweeteners, and it’s pretty clear that the huge quantities of concentrated sweeteners consumed today are harmful to our health.

People are always searching for ways to enjoy sweet foods without the health repercussions, and this is the first post in a series that I hope will help you do just that! But before we jump into the nitty-gritty of different types of sweeteners and how they can fit into a healthy diet, I want to set the stage with some history and evolutionary background.

Did #Paleo man eat as much sugar as we do? You may be surprised!

Sweeteners in Evolution

Most of us primarily think of taste – especially sweetness – in terms of enjoyment, but sweetness is not just another source of pleasure. As omnivores, hunter-gatherers had a wide array of potential foods to choose from, and the sweet taste sensation is one of the ways humans could identify safe, non-poisonous foods with a high nutrient-to-toxin ratio.

Honey was the only concentrated sweetener available for much of human history, and common belief is that honey was quite rare, and only consumed in small quantities. While this is undoubtedly true for many hunter-gatherer groups, it doesn’t appear to be true for all of them.

We can get an idea about the role of honey in Paleolithic diets by studying modern hunter-gatherer societies like the Hadza; during the wet season, honey comprises up to 20% of their diet by weight. (2) Given honey’s caloric density, this likely represents a much larger portion of their total calories.

When asked to rank their dietary staples in order of preference, honey was ranked highest, above meat, berries, tubers, and baobab (a large tree fruit). The Mbuti pygmies of the Congo can obtain up to 80% of their calories from honey, although only during the 2-month honey season. (3)

One interesting paper hypothesized that honey was actually far more abundant throughout early history than we typically acknowledge, and that the consumption of honey at certain times in history may rival our current consumption of sweeteners. (4) Some researchers have even posited that honey, along with meat and starchy tubers, helped make us human by providing concentrated glucose to support brain growth. (5) Although it’s impossible to know exactly how much honey early humans had access to, we do know that people went to great lengths to obtain honey, even when other foods were more readily available. (6, 7)

The Evolution of Sweeteners

Once hunter-gatherers began settling down, humans gradually discovered new sources of concentrated sugars. Maple syrup was introduced by Native Americans, and became popular in North America. (8) Jaggery, produced from sugar cane, became popular in India and its use is still widespread. (9) Some sweeteners common in early China include “tree honey” and “thorn honey,” both extracted from different plants. (10) And in the 17th or 18th century, table sugar surpassed all of these traditional foods and became the world’s leading sweetener. (11)

Fast forward to 1970, when the average American’s consumption of added sugar was 23.7 teaspoons per person per day according to loss-adjusted availability data. (12) By 2012, that amount had increased to 24.7 teaspoons, and the percentage of total calories obtained from sweeteners had risen from 13% in 1977 to 16%. (13) Significantly, 80% of this increase was from sugar-sweetened beverages, rather than solid food.

Changing Attitude Towards Sweeteners

Amidst all this background, I think it’s particularly interesting to note the shift in attitude towards sweeteners.

For modern hunter-gatherers like the Hadza, a sweetener (honey, in their case) is just another food, albeit a highly prized one. We can probably assume that traditional hunter-gatherers didn’t have a conception of “healthy” and “unhealthy” like we do today, and if they did, they probably would have classified concentrated sweeteners as one of their “healthiest” foods, because they provide ample nutrients without causing illness.

Now our beliefs are quite different – opposite, in fact. Most of us have become conditioned to think of “sweet” as “unhealthy,” and instead of using sweet taste as a guide to the most calorie-dense foods, people are trying to figure out how to avoid caloric density, while still enjoying sweet tastes. This can be seen in the widespread use of non-caloric sweeteners, as well as the current research into sweet-tasting proteins that could sweeten foods without triggering an insulin response. (15)

And along with the desire to limit caloric density in general, there’s now a growing fear of sugar itself, and refined sweeteners such as table sugar and HFCS are often labeled ‘toxins.’ This is a dramatic shift from our evolutionary background, where sweetness signaled safety and a lack of toxins.

This brief history of sweeteners leaves us with many questions. If the Hadza obtain a large portion of calories from sweeteners, why can’t we? What makes traditional sweeteners like honey so different from table sugar, and for that matter, which sweeteners are healthiest? Why has sugar become such a bane to our health? Is it really addictive? And ultimately, how can sweeteners fit into a healthy diet? These are all questions I’ll attempt to answer in subsequent posts.

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  1. I think it should also be worth noting that the Hadza do not store food. They hunted and gathered food to be consumed on a daily basis for the current day. They didn’t wake up to a bowl or cup of honey. It was only after a night spent sleeping probably more than the typical 8hrs and morning spent walking, running, climbing, jumping and whatever else was required to gather honey would they get to enjoy this treat. Pretty sure they would be a bit more insulin sensitive once honey was consumed vs. the typical person today rising to a SAD breakfast daily without much effort involved.

  2. Chris it is really awesome how you cut across the debate, probing to discover the subtler truth. Yes, we wanna know!

    With sweeteners and carbs, it seems that proportions and combining provide the answer – limiting their calorie proportion and/or combining with fat or protein or their unrefined state.

    I have also tagged onto the idea that carbs later in the day have less impact.

  3. From my understanding, sugar itself does not cause health problems, it is the sugar and fat combination that does. I was on a fruitarian diet for 4 years, just to be safe I monitored my blood sugar regularly. If you eat sugar alone, your insulin works pretty quickly to bring down your blood sugar level, providing that if you don’t have sugar sensitivity. However, when you eat sugar with fat, the sugar would rise much slower and it would last much longer in your blood stream. Your insulin would have hard time to delivery the sugar to your cell because of the fat.

    I wonder if the hunter-gatherers eat sweet at one time and eat animals at another time. If they eat up what they can find, could that be what happened in the past?

    • thats something to think about quinny, i thought the more violent the insulin spike, the more harmful its effect… so is it the speed of the insulin increase, the overall time, the overall load, or the overall load as a proportion of all calories?

      as i said in my post, i combine carbs and sugars with fat or protein. its also more realistic, except maybe in the case of a fruit. but fruit and dairy goes really well together. and here in brazil, they don’t mind combining some fruit with their steak. awesome!

    • and if i’m going to get all the benefits of a whole lot of fat, like in a mousse, ice-cream or “fat-bomb”, i feel that having a little bit of sweetener will be ok as its negative effect will be lessened by the fat and protein.

    • It’s true. when you combine both, insulin has a harder time doing its job. In insulin resistance, FFAs are high in the blood, impairing insulin signaling. Most sweets will increase FFAs and glucose in the blood, which will make the glucose stick around longer than having it alone.

  4. Hi Chris, looking forward to the other articles. You make some interesting points. I think whilst the demonising of sugar is going a bit mad at the moment, there are lots of people who are having significant issues with it due to the strong cultural ties etc. that we’ve all go used to (& the low fat era). I feel that people have to go through a personal journey and discover what makes them feel most comfortable with regards to this now…because times have changed so much and we live in a modern world. I know now, I don’t use sweeteners or substitutes as much, I just eat a little sugar when social occasions present and I call it ‘social sugar’. I don’t crave sugar like I used to so stevia etc. just isn’t needed in my day to day life. I’d rather just have a square of very dark chocolate and be done with that. Look forward to reading the rest. Laura

  5. For those who asked what is the difference in fructose and glucose, the following summary details the main metabolic differences between fructose and glucose to help you understand how fructose can wreak such havoc with your health, and why it’s considerably worse for you than glucose:
    1. After eating fructose, nearly all of the metabolic burden rests on your liver. But with glucose, your liver has to break down only 20 percent. This is one reason excess fructose consumption can lead to fatty liver disease, similar to overconsumption of alcohol. In fact fructose and alcohol are processed identically by the liver.
    2. Every cell in your body, including your brain, utilizes glucose. Therefore, much of it is “burned up” immediately after you consume it. By contrast, fructose is primarily converted into free fatty acids (FFAs), VLDL (the damaging form of cholesterol), and triglycerides, which get stored as fat. These fats are damaging, bad fats.
    3. The fatty acids created during fructose metabolism accumulate as fat droplets in your liver and skeletal muscle tissues, causing insulin resistance and non-alcoholic fatty liver disease (NAFLD). Insulin resistance progresses to metabolic syndrome and type 2 diabetes.
    4. Fructose is the most lipophilic carbohydrate. In other words, fructose converts to activated glycerol (g-3-p), which is directly used to turn FFAs into triglycerides. The more g-3-p you have, the more fat you store. Glucose does not do this.
    5. When you eat 120 calories of glucose, less than one calorie is stored as fat. 120 calories of fructose results in 40 calories being stored as fat. Fructose is essentially largely converted into fat!
    6. The metabolism of fructose by your liver creates a long list of waste products and toxins, including a large amount of uric acid, which triggers your “fat switch,” causing you to gain more weight.
    7. Glucose does not do this, as it suppresses the hunger hormone ghrelin and stimulates leptin, which suppresses your appetite. Fructose has no effect on ghrelin and interferes with your brain’s communication with leptin, resulting in overeating.

    There is also a great lecture explaining the exact biochemical pathway of fructose by Dr. Robert Lustig here: http://www.youtube.com/watch?v=dBnniua6-oM.

    HFCS has certainly contributed to the obesity epidemic, but so have a lot of other things – certainly including more calories being consumed. It is mostly due to extreme ignorance and stubbornness of the conventional medical community in recognizing the diets effects on health and weight. For example, to this day conventional oncologists refuse to recognize that diet has anything to do with getting or curing cancer. This is the epitome of ignorance, subbornness, and arrogance and it is killing and harming a lot of people. Thankfully for sites like this, we can begin to educate people about what really works for getting healthy.

    Regards.

    • One thing i meant to mention is that many of these differences are diminished when fructose comes in a natural form such as raw honey. These mainly relate to processed HFCS.

      • Can you explain why the body would handle fructose from honey any differently (I don’t think you can)?

        Also, Lustig fails to realize that fructose only becomes a problem when you don’t have enough phosphatidylcholine/betaine etc to properly metabolize it in the liver (which would never happen in a diet rich with pastured liver/eggs and lots of spinach). You have to take the low glycemic impact of fructose into consideration when comparing to glucose: this could make glucose worse for some people.

        • I believe you can find some articles on Chris Masterjohn’s blog, explaining how honey is handled differently than plain sugar. It has to do with the fact that while sugar is just glucose and fructose, honey also contains a wide array of other bioactive compounds, which can exert antioxidant effects that result in different physiological responses than plain sugar. You could probably also just search pubmed for the studies that compare the physiological effects of different honeys. From what I recall, darker honeys (like buckwheat honey or wildflower, I think) have better effects. Obviously, some honeys are processed in such a way that makes them more similar to plain sugar, physiologically, and the plant used to make the honey is important as well. This is actually an interesting topic, so I hope Chris explores it more in depth than I can in a comment, because it actually does make a physiological difference whether you choose plain sugar or a less processed sweetener like honey or maple syrup.

          +1 for the low GI of fructose. I think it would be interesting to see what the evidence says about this low GI effect, versus the potential bad points about fructose, as listed above by DM, in reconciling whether fructose is a net benefit or detriment for something like diabetes. I assume it will end up being about the difference between fruits/honey vs processed sweeteners, since fruits seem to be beneficial in some studies I’ve seen on diabetes.

        • @TheNomad

          There are many reasons why pure fructose, HFCS, has a different reaction in the body than a whole food source such as raw unprocessed honey. This article is a very good explanation: http://www.greenmedinfo.com/blog/why-you-should-ditch-sugar-favor-honey. I will let you read that to explain it to you.

          Saying the reaction is the same is like saying any isolated substance or nutrient is the same whether you get it from food or a processed food or a supplement. We know that is not true at all for almost all nutrients and supplements or anything edible. It is almost always better to get any edible substance from a whole food. The enzymes and the food matrix that whole foods have that isolated substances do not make the bodies reaction and utilization dramatically different. That is nutrition 101.

          As far as betaine and phosphatydalcholine and the liver, yes these substances help the liver detox HFCS and many other toxins out of the body, but I dont think Lustig failed to realize anything at all. He is just showing the biochemical pathway. In fact what he shows is that the biochemical pathway the liver goes through for HFCS is identical to alcohol. People who consume a lot of HFCS are likely not consuming a lot of Betaine rich foods, like eggs or beets or goji berries (the tree highest foods in betaine). In other words for most people who consume a lot of HFCS, it IS a problem and they need to be aware of what they are doing. You act as though we should not even be worried about it.

          And remember a LOT of children are consuming HFCS. It is tragic that our food industry (allowed by the FDA) puts substances like HFCS in products that children are consuming and their livers are processing it as if it were alcohol. Anyone would agree that a child consuming alcohol is bad, very bad. Well, to the liver of the child its almost the same thing.

          In my opinion, the low glycemic impact of HFCS does not negate its toxic effects and does not justify using it or consuming it.

  6. I have two immediate family members who were diagnosed with different cancers within the past year. Researching, I found a lot of conflicting recommendations on dietary approaches to thwarting the cancer. The ketogenic diet seems to have a lot of credibility, and severely restricts sugar, as “sugar feeds cancer.” Aren’t all of us harboring cancer cells to one degree or another? Any thoughts on that?

  7. I’d like to know if there are ways to consume sweeteners along with other foods (such as fats, or things believed to help blood sugar like cinnamon) in a way that minimizes their negative effects. Not so that I can eat sweets all the time, but to minimize harm when I do. Thanks in advance for tackling this topic!

  8. Thank you for taking a balanced and open-minded big-picture look at sweeteners!

    I would love to see you talk about coconut sugar and also address the agave controversy.

    One additional issue I’m puzzled about is this: I cannot eat stevia or any of the sugar alcohols because they all make me terribly ill. So, I stick to honey, maple syrup and coconut sugar. I know others have issues tolerating sugar alcohols (xylitol, maltitol, erythritol, etc.) but have never heard of anyone else having trouble with stevia (other than not liking the flavor). The tolerance issues I experience make me wonder if these sweeteners really are safe?

    Thank you, I look forward very much to this discussion.

  9. I would like to know more about honey. I have cut back on refined sweeteners significantly. Every once in a while I’ll have chocolate or gelato with sugar, but other than that I stick to honey, Grade B maple syrup, fruit, and coconut sugar. What I’ve noticed recently is that after consuming some sweeteners, like honey, I get REALLY thirsty. Other sweeteners (syrup, coconut sugar) do not affect me this way. Why is that? Is it possible that although natural, honey really isn’t a good option for us?

  10. Perhaps I’m oversimplifying it but sugar is pretty “addictive”. Not for everyone of course, but for some. I can only speak from experience so my evidence is pretty anecdotal but I can sit down and eat a box of chocolate candies or cookies in one sitting. I wont sit down and eat a side of beef or a bag of rice in one sitting. Even in the case of other “sweets”, I wouldnt eat a bowl of fruit or an entire jar of honey in one sitting.

  11. I suspect that honey consumed as a major staple by certain tribes is different from the honey we buy in the grocery store. The tribes likely consumed the wild honeycomb that typically contains some protein (including enzymes) as well as honey, partly from pollen and partly from the brood. Chewing on the wax may have added further nutrients. In other words, the wild honey is probably more nutritious than the filtered honey we get from bee farms. See also link: http://milkwood.net/2012/04/15/the-dark-and-the-light-eating-different-honeycombs-as-part-of-natural-beekeeping/

  12. I appreciate the historical perspective provided, Chris. Thoughts on sugar alcohols specifically xylitol and erythritol, particularly suppositions on their interactions with gut flora would be interesting! Stevia is also shunned by a few notable paleo cooks for its similarities to steroid hormones. Any thoughts there?

  13. Hi Chris

    Thanks for the discussion on sugar. It’s an important one in the nutrition community. I would love to hear more about your take on some of the ideas expressed by Ray Peat, Danny Roddy, Matt Stone, etc. about the role of glucose and CO2 in cellular respiration and how that process connects with stress hormones and our overall health.

    I understand it’s a very polarizing topic and one that would be hard to tease out in a public forum. However, I find it interesting that you haven’t addressed these ideas (at least that I have seen/heard) given your previous relationship with Danny and your otherwise objective reporting on health-related issues.

    The general silence about these ideas in the Paleo community is concerning to me. Like you say in this article, if we’re predisposed to find sweet-tasting foods, why would they be inherently bad for us?

    If I’m missing a previous discussion, please point me in the right direction. Thank you.

  14. I love coconut nectar “sugar” granuals when i want
    to sweeten food (sweet potatos, butternut squash or quinoa “hot cereal”). Any thoughts on that? I read it has a much lower glycemic index, and more nutrition than other choices.

  15. A “sugar” question I’d like to see explored is whether our modern problem is not sugar as an isolated food group (ie, being demonized as a “bad” food in and of itself), but whether the problem actually results from a combination of high sugar consumption with a decrease micronutrient consumption. At a metabolic level, what would be the impact of our bodies trying to metabolize all of that sugar without having sufficient micronutrients also required for cellular metabolism becoming significantly problematic? Maybe humans can eat more sugar when they’re also eating a lot of plants (and probably healthy proteins and fats as well)? Maybe that’s another reason fruit sugars are “packaged” with so many nutrients (ie, why fruits are so nutrient dense).

  16. Honey is completely different to table sugar. The more refined a carbohydrate is, the more unhealthy it appears to be.

    the caloric value and/or the caloric density is NOT the only thing that matters, which many short-sighted people continue to believe. The structure and texture of the food, aswell as how it is digested, affects the bodies response to the food. For example, Stearic acids at sn-1, 3 positions of TAG limits fat deposition more than palmitic or oleic acid.

    http://www.ncbi.nlm.nih.gov/pubmed/24286356

    Honey is significantly less palatable than sugar-sweetened stuff. Granted, consuming just plain table sugar on a spoon is also quite unpalatable, but once added and dissolved in a food, dramatically enhances its palatability. Consider the confectionery company Haribo, the sweets they make are incredibly addictive. I would and could eat these all day, never feeling sated, and I would get incredibly fat in the process. Meanwhile, honey starts to become quite unappealing after about 60-70g worth eaten straight from a spoon.

    • That’s only 4 tablespoons of honey. Mixing it with food you could probably eat much more. I’ve eaten I’d guess at least 8 tablespoons worth in the past when I used to eat a lot of butter honey sandwiches.

      But I get your point, i don’t think it’s always going to be accurate though.

  17. Look forward to hearing more, and would appreciate your thoughts on inulin and erythritol. Substituting these two sweeteners (in a specific ratio) for table sugar produces excellent results and no funky after taste. I am experimenting with these as my husband suffered a seizure (of unknown cause) and we are restricting carbs, staying in mild ketosis, in the hope of preventing another seizure and also to maintain neurological health and preserve cognition/memory.

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