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.


Join the conversation

  1. As a dietitian who uses a Paleo template and consults with some pediatric cancer kiddos, I am most interested on your take on the balance of use of Stevia in place of sugar as families try to keep blood sugar regulation in tight control and sugar intake to a minimum during cancer treatment (and as prevention). How do you handle sugar and sugar substitute consumption with cancer?

  2. I have eliminated sugar (all refined sugar except in trace quantities in non-sweet packaged foods, all added caloric sweeteners such as honey and syrups, and drastically cut back on fruit sugars by sticking to whole fresh fruits, not dried or juiced). In fact, I’ve done so several times. The result is always a period of intense withdrawal (no mental symptoms, but physical misery for days, followed by fatigue, low mood, aches and pains and obsessive cravings for weeks), then at two to three weeks, I feel great. My skin clears, my hair looks better, I have more energy than before the elimination, my joints feel 20 years younger, my sinuses are clear — it’s wonderful. Then I always start eating sugar again. Then I can’t stop again. It’s definitely addictive.
    To me, artificial sweeteners are worse than simply eliminating sweets, because I feel worse after eating them. Sweet tastes are fun, but the real feel-good effect of sugar for me is the sugar hitting my brain. I’m looking for a nutrient that gives me that quick energy without crashing three hours later.

  3. if you have dysbiosis or bacteria problems then yeah fructose especially will cause you serious problems because it is metabolized more slowly and lower in the gut… dextrose on the other hand is almost immediately metabolized higher up in the digestive system so doesn’t have the same negative effect- but will still give you a spike because, well, it’s pure glucose… so we need to start parsing out the effects of sweetner consumption on gut flora and blood sugar/insulin response…

  4. I think the Hadza consume honey comb, not honey. In other words, honey all mixed in with bee larvae, pollen, beeswax, etc.

  5. Honey feels the most sound of all sweeteners, in moderation and some varieties even have such therapeutic qualities they are used in hospitals for overcoming pathogenic overload. New Zealand Manuka honey is one variety as well as Australian Jellybush. Not that I would use heat these or waste by cooking, but my point is that all honey has some anti-bacterial/healing properties. Natasha Campbell-McBride recommends honey as the only sweetener GAPS approved. So my sweetener of choice in moderation is honey and I’d like to read more about what Chris has to say about this!

    • As would I. I’m about to embark on a fairly strict AIP/low FODMAP program and one exception I was curious about was the consumption of manuka honey (1-2 tablespoons) to supplement my betaine HCL in helping fix my low stomach acid problem.

  6. I would like to hear your research on sugar and cancer cells. I have been told that sugar feeds cancer cells? If so, which sweeteners are safe and what about fructose from fruits?

  7. I’m interested if there have been any new insights into the genetics and gut microbiota involvement in the handling of sugars. It seems like some people can eat all the sugary fruits and honey they want, without any negative effects like dental carries, or diabetes, while others can only tolerate low amounts of fruit each day, and barely eat any other sweet foods. What protects the former people? Do they have some sort of genetics for better Vitamin K2 or zinc recycling? Do they just have better gut flora? I think some groups are more susceptible to problems with sugar, and I wonder if there are any studies exploring this idea. I was wondering whether you could address these nuances to some extent, to reconcile somewhat how some people can thrive on a high sugar diet, while others put themselves at risk for various diseases.

    • Great questions, Cat. Years of research may be required to answer all these, but at least the work is already ongoing!

      I don’t have a strong answer for you, but I’ll mention that from my reading about what a continual, high-carb, highly refined diet does to the gut microflora, I think one way certain peoples may get by on eating lots of sugar AT TIMES, is that they also have meals consisting of healthy plant fiber, such as green leafy vegetables (not just grain-derived commercial products that claim to be “fiber”), and these fibrous meals, if eaten almost every day, get good nutrients, in the form of resistant starches, to the large intestine, thus keeping the very essence of the immune system alive and well (lower GI germs), and also nourishing the endothelium with the short chain fats derived from the fiber.

      We know there are many people these days though who NEVER have such a healthy meal, and exclusively eat, not just sugar, but highly processed carbs and fats which provide no bulk to propel nutrition into the large intestine. It’s possible that these people are the ones giving the heavy ingestion of sugar such a bad name, because they have such a horrible diet all the time.

      I’ve seen people from mid-east gene pools do well on mixing sweet foods with healthy foods, but people from other regions of the world just go down the tube by becoming addicted to sweets and carbs to the extent that they can no longer chose foods rationally, even though they know they are on a poor diet.

      I’ve read that when the lower intestinal microbes don’t get fed in that location, they may move up hill to the small intestine, but this affects the pH of the environment negatively, thus breeding more yeast while letting the microbes that support the immune system perish. There’s a lot of information out there on this.

      Check out some of the articles on the Human Food Project site:

      Scroll down on the page. Besides the “Most Recent Articles” listed, there are also many more articles on the page under the heading “Recent Posts”. Many of these go heavily into some of your questions.

      Also, check out the related site American Gut Project, where you can have your gut microbiome assayed and compare your microbial mix with thousands of others world-wide. I have submitted a sample, but have not been notified of results yet. It takes months, but I’m hoping the information coming out of it all will be worth the wait.

  8. Different strokes for different folks. One man’s nectar is another man’s poison. Buy a glucose meter for 15 bucks and see how you respond to different combinations. Of course, this has to jibe with many other factors. A one-hour spike of 130 once a day is different than multiple spikes daily. Test yourself with honey and RS, and without RS. Personally I want to see hard evidence that sucralose is bad. Hope that is where this discussion is going as well as defending honey.

  9. If we eat it very occasionally, I don’t think honey is a problem. The question is though – can we? Sugary things are addictive and it’s so easy to fall into the trap of eating them all the time or too much of them. I

  10. I’ve read in Paleo magazine that stevia is considered to be an artificial sweetner, which doesn’t make sense to me as it is made from a plant. White sugar is highly refined, yet isn’t considered artificial as it too is from a plant. I am working with a Paleo RD and I’ve asked her about this. Her understanding is that the problem is how stevia is manufactured, and she’s not sure if the problem is only with some companies or all companies, and doesn’t know what the exact problem is. To know the current level of “truth” about stevia would be wonderful!

    Also, what about luo han guo as a sweetner? Is it OK? I can only find it mixed with xylitol. If luo han guo is fine to use, what brands are pure and not mixed with xylitol?

  11. After reading this I almost assaulted the honey jar! But I’m starting the 1-month reset period, so I’m hanging on. Very curious to read the sequel!

  12. I think one important thing to note is that for both the Hadza and the Mbuti, honey consumption is a seasonal affair and presumably an unrefined product. This means that there is probably a balance in their diet when looking at a year as a whole. For modern lifestyles, sugar consumption is 365 days a year and is a completely refined product. Can they truly be compared then? In one case, people are eating something natural at a natural time of year for them and their environment. In the other case, people are eating something unnatural all the time. Perhaps climate and time of year play a role in our abilities to deal with sweetener intake. Plus, their lifestyles are more physical versus our sedentary office lives so perhaps we have evolved to not need sweeteners in the same quantities. So many questions. And finally, if we limit our sweetener intake to honey then perhaps we could glean the health benefits without the side effects. Most of the sweet stuff that we eat today is cane or corn derived which arguably is not the same thing. Are all sweeteners made equal? Are some healthful and are others down right evil?

  13. Hi Chris,
    I would be interested to know your opinion and more info on using dextrose instead of natural sugars i.e. honey or coconut sugar?

  14. I think it is also important that you explain the difference between fructose and glucose when consumed in excess. Recently you have defended fructose when consumed in a normally calorie diet, however I think when consumed in excess fructose is more dangerous than glucose per calorie.

  15. Hi Chris, I would appreciate it if you could cover unrefined sugars like coconut sugar and rapadura. Coconut sugar is particularly important for thai curries is there really is no sweetener substitute if you want to make a good coconut thai curry!

  16. What a great post! If you eat in nature, you will get your sweet fix by having berries, almond butter, coconut butter, yams,ect…It seems that the paleo community is still trying to find ways to keep the old eating habits instead of changing your lifestyles. Do you really need to sweeten anything? Try foregoing any ‘sugar’ and get sweetness from nature.

  17. Xylitol and all other alcohol sugars are fermentable in the gut and have been known to irritate the guts of those who suffer from IBS etc. The only alcohol sugar not shown to be as fermentable is erythritol, however those who suffer from fungal infections and candida should not consume it because it is processed with a yeast similar to candida. The only truly non problematic sugar free sweetener is stevia. I’d like to see the rigorous studies showing that it has a definitive negative effect on insulin.

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