Skip to content

ASK THE NUTRITIONIST: Are there good natural sugar substitutes?

Columnist explains pros and cons of natural sugar substitutes
Stock photo

Dear readers,

This is the second part in a two-part series on sugar substitutes.

Last week, we explored artifical sugar substitutes and data on their safety that is not widely publicized. This week, we’ll look more closely at the more natural sugar substitutes.

To recap, last week, we looked at saccharin, aspartame, acesulfame potassium and sucralose. There is abundant data to demonstrate health concerns, especially regarding a deleterious effect on the gut microbiome, which, in turn, affects the way the body processes sugar. These changes can increase glucose intolerance, insulin resistance, and obesity — the very things these sweeteners are marketed to help with. There is also data demonstrating they cause impaired neurological function — or brain damage — and may not be safe to consume when pregnant. You can read the full column and source material here.

As discussed last week, there are a number of reasons to limit real sugar. Dr. Robert Lustig, an American pediatric endocrinologist and professor emeritus of pediatrics in the division of endocrinology at the University of California, San Francisco, talks about sugar in the same context as controlled drugs: “Cocaine and heroin are deadly because they are addictive and toxic — and so is sugar … We need to wean ourselves off. We need to de-sweeten our lives. We need to make sugar a treat, not a diet staple.” (source)

So, reducing our reliance on sweet foods is important for good health. If you find yourself addicted to sugar, you can absolutely retrain your taste buds to enjoy other tastes instead. But it does take time and nutrition education. Contact me if you want help with this.

But when we want an occasional sweet treat, a healthy alternative to sugar is helpful, and ensuring it’s low glycemic helps us avoid the blood-sugar reaction that perpetuates sugar cravings and addiction. So, this week, let’s look at the various natural sweeteners more closely to discern if any are superior as a replacement.


Unless honey is heated (pasteurized), it’s not processed and contains enzymes, probiotics and prebiotics, as well as a robust array of vitamins, minerals, antioxidants, and nutrients we are only starting to understand. It does not feed candida albicans and it promotes good bacteria in the gut. In one study published in 2000, it increased the number of Lactobacillus acidophilus and Lactobacillus plantarum bacteria by 10 to 100 times that of sucrose from table sugar. Table sugar is broken down by our enzymes, while honey is broken down by its own enzymes, so it’s easier on the digestive system all around. For this reason, a lot of people think it’s healthier than sugar in recipes. However, neither probiotics nor enzymes withstand heat. Vitamins are damaged by it, also.

A teaspoon (21 grams) of honey has about 64 calories and 17 grams of carbohydrates, while the same amount of table sugar has 80 calories and 12.6 grams of carbohydrates. Its glycemic index is higher than that of some of the sweeteners below (50 compared to table sugar’s 60), so it’s not considered low glycemic. It has a significant effect on blood sugar and, as such, I don’t recommend it except on rare occasions as a raw treat.

Babies younger than a year old should never eat raw honey, as it can cause botulism — food poisoning that can be fatal. After that age, it is generally regarded as safe (GRAS) by food-monitoring agencies.

Maple syrup 

This sticky, amber-coloured liquid is a boiled-down extract of the sap of the maple tree. It’s high in minerals, especially manganese, and contains 24 antioxidants. Dark, Grade B syrup is considered the most nutritious. But remember vitamins are damaged during the heating process. As such, and given its glycemic index of 54, it’s not an optimal choice. It’s not low carb or safe for diabetics. I don’t recommend it.


Agave nectar is a sweet syrup extracted from the desert agave plant of South America, which is most commonly known for making tequila. The plant is cut to harvest the heart, which is then boiled and strained to create a sweet syrup. It has a glycemic index of 15, so it has less effect on blood sugar and insulin. However, the processing destroys any enzymes and vitamins. While it’s marketed as healthy, most of the sweetness of the syrup comes from fructose (85 per cent), which is known to be extremely damaging to health — perhaps far more than glucose (sugar). This is because the only way the body can process fructose is via the liver, and it puts an incredible burden on the liver when overconsumed. Excess fructose contributes to a host of health problems. Coupled with the fact purity can be a problem for products labelled as agave nectar (cutting with corn syrup), it really isn’t a healthy sugar substitute.

Monk fruit

Monk fruit (luo han guo) sweetener comes from a gourd grown in Southeast Asia. It was first harvested by monks, and thus the name. The sweetener is taken from an extract of the fruit that is then dried. It’s 150 to 200 times sweeter than sugar and contains zero calories. To boot, it does not affect blood sugar, and is safe for diabetics, with a glycemic index of zero. It’s a completely natural product that’s been used in China for hundreds of years. You can get it in liquid, powder or granule form.

Because it’s so new to the market, it’s not well studied here yet. Despite that, consumer response to it has been more favourable than many sugar substitutes. Why, you ask? I think because Starbucks picked it up and also because it has a better flavour profile than many substitutes, with no bitterness or weird aftertaste. It bakes well and is easy to blend.

Maybe because it’s rather expensive (hard to grow, difficult to import, in demand), it’s often blended with other substitute sweeteners like erythritol (see below) or dextrose (a highly processed corn derivative). It can sometimes be blended with stevia, also.


Stevia is a naturally sweet herb from Brazil and Paraguay, where it’s been used for 1,500 years. It’s super-easy to grow in pots or your garden, where it yields leaves that can be used dry for sweetener, or ground up. Note: This natural, easy-to-grow-and-harvest form of the plant has not been studied for safety yet. Isn’t it interesting there are a number of studies demonstrating safety concerns with all the artificial sweeteners we looked at last week, but they are considered safe by food-regulating agencies, and this natural, sustainable product, which has been used safely for 1,500 years by some cultures, is not yet endorsed? Hmm.

Despite this, it’s what I use in my tea. From one plant, I have sweetened all my herbal teas for three years. How’s that for sustainable?

In its commercial form (Rebaudioside A), it’s highly processed and ends up ground into a fine white powder or suspended in liquid or made into little dissolving tablets. It’s 200 to 300 times sweeter than sugar, and some find it has a slightly bitter, licorice-type flavour. (The herb; not the candy.) It’s easy to overdo it because it’s so sweet. It’s often blended with other sweeteners.

Stevia has a glycemic index of zero and does not spike blood sugar at all. Studies have started to show it has a favourable outcome on blood-sugar levels and diabetes, as well as on dental health, cholesterol, blood pressure, and more. It is known to have antimicrobial, anti-diarrheal, diuretic, anti-inflammatory, and immunomodulatory actions. The whole-leaf form is showing promise for treating the bacteria that causes Lyme disease.

It’s a little-known fact stevia was used in the sugar shortage in Britain in the Second World War. In the 1970s, Japan started using it to replace saccharin, and it took hold. Today, it’s one of that country’s most popular sweeteners. There are many countries that now use it.

Of the processed stevia that’s available, the least processed is green leaf stevia. It’s 30 to 40 times sweeter than sugar, but it’s more bitter. Stevia extracts are 200 to 300 times sweeter than sugar and less bitter. Altered stevia is a genetically modified organism (GMO), 200 to 400 times sweeter than sugar, and best to avoid. Again, my favourite stevia to use is the natural plant leaves, which can be easily grown and dried by anyone for a few dollars’ worth of seeds — if you can get your hands on them.


By licorice, I don’t mean the candy, but the herb, licorice root or Glycyrrhiza glabra, or the Chinese strain, Glycyrrhiza uralensis. It’s native to Europe and Asia and has been used for thousands of years by herbalists worldwide for various conditions, including stress and digestive healing. In Chinese medicine, it’s often used to help other herbs work better. As such, it’s their most-used herb. In Western medicine, we often use it as an adaptogen. This means it helps the body’s nervous system adapt better when under stress. It’s also highly anti-inflammatory and can be used to heal stomach ulcers.

Licorice is 30 to 50 times sweeter than sugar, which is why it was historically used as a sweetener in candy and medicine. However, it’s not considered safe for everyone. A compound in it — glycyrrhizin — can increase blood pressure while reducing potassium levels and increasing edema in some people. As such, it’s not used as a sweetener today.

Palm sugar

Palm sugar is another lower-carbohydrate, natural sugar alternative. It’s made from the dried sap of the coconut/palm tree and has been used in tropical Asia for thousands of years. It has a slightly nutty, brown sugar or caramel flavour, with a glycemic index of 35 and can be in granulated, block or liquid form. At 35, it is going to spike blood sugar and be unsuitable for diabetics and anyone with belly fat. Its fructose content comes in around three per cent.

However, palm sugar is very high in nutrients — minerals, dietary fibre, vitamins, and 16 amino acids — and all these remain completely intact because it’s not heated in the granular and block forms. (Remember, though, when you bake with such a sweetener, the vitamins and enzymes are going to be killed. Minerals remain intact during heating.) It’s the latest in the craze for the benefits of the coconut, which certainly impresses with the list of superfoods it delivers.

I use this product half and half with stevia, xylitol, or monk fruit when baking (rare occasion) simply because it gives that rich, brown sugar flavour for half the glycemic index, so it’s not as likely to cause blood-sugar problems, especially when halved with lower glycemic index sweeteners.


Xylitol is a sugar alcohol made from the bark of the birch tree that looks and tastes relatively close to sugar, with 40 per cent fewer calories. It tastes like cool or slightly menthol, crystallized sugar and is half as sweet as sugar, but it does not contain any nutritional benefits. It has a glycemic index of 12 and is much safer for diabetics than normal sugar or artificial sweeteners because it won’t cause an excessive insulin response. As such, it’s great for weight loss, as well. It’s also been shown to strengthen bones and help prevent ear and upper respiratory infections.

But where it really shines is in oral health. It doesn’t just not damage teeth; it’s been shown to be protective of dental enamel. So, if you’re going to chew gum, xylitol-sweetened gum is the best choice. You can try this if you have children who don’t like to brush their teeth: Dip their brushes into xylitol to brush. They love it and it prevents cavities. Win-win.

You will notice xylitol doesn’t dissolve perfectly and sugar alcohols can cause digestive distress to some people. This can happen with sugar alcohols. For example, maltitol-sweetened chocolates: They taste OK, so you might think it’s safe (and fun) to eat a whole bag. Don’t. This particular sugar alcohol, while yummy, often causes extreme digestive upset, including unbelievable amounts of gas, cramping, and explosive diarrhea. In fact, it works much like a laxative. In reviews online, it has been likened to “an intestinal power wash.” Xylitol does not seem to cause the same digestive distress for most people, but I’ve read of some people reacting to it with an upset tummy.

Xylitol is toxic to dogs, so it’s best not to use it in homes where dogs might get into it.

When baking with xylitol, I notice it’s best if blended with other sweeteners and it seems to make baked goods turn out softer. I blend it with other sweeteners in some recipes.


Erythritol is a sugar alcohol, much like xylitol, and it’s marketed as natural because it’s a derivative of corn. It’s made into a white powder that’s 70 per cent as sweet as sugar with six per cent of the calories. And it has a neutral taste. It has a glycemic index of one and is not going to affect blood sugar at all. Unlike xylitol, though, it blends well and isn’t known to harm dogs and is far less likely to cause any digestive upset.

Despite the fact it’s new to the sweetener category, and testing has not been done independently, the United States Food and Drug Administration (FDA) has decided to accept the claims of the food manufacturers that promote it and approve it as safe.

However, erythritol is hyper-processed. As such, should it really be considered a natural product? It’s currently produced by enzymatic hydrolysis of the corn and then fermented. Electrochemical means of production are being developed and a GMO form of a yeast has been introduced for the fermentation process, using glycerol to increase yields.

We also know commercial corn is grown by clear-cutting huge swaths of land to produce vast acres of mono-crops known to be unsustainable. These crops are then heavily sprayed with industrial pesticides known to be extremely carcinogenic and killing our bees and soil biome. For more information on this, read here and here and here and here. So, despite its seemingly good caloric and blood-sugar profile, I can’t recommend this product as wholesome.


Allulose is a newer, low-calorie sweetener that naturally occurs in small amounts in foods like maple syrup, dried fruits, wheat, and molasses. However, as it’s sold today, it’s synthesized in a lab. It was discovered in 1994 at Kagawa University in Japan. (source) It’s 70 per cent as sweet as sugar with about a 10th of the calories and has a similar texture and taste.

Allulose has the same chemical formula as fructose, but with a different structure, which changes the way the body metabolizes it. It has a glycemic index of zero and studies demonstrate it does not raise insulin levels at all. It’s thus thought to be safe for diabetics. The FDA has approved it as GRAS, but neither Canada nor Europe has approved it as safe to date. This doesn’t mean it’s banned; it just means it hasn’t undergone all the safety testing to be sold here yet. It can be ordered online from the States. Other names for allulose are d-allulose, psicose, and d-psicose.

Unlike other sweeteners, allulose passes through the body undigested, largely via urine. (source) It seems to inhibit enzymes in the gut that break down starches and sugars, so, long term, we really don’t understand the effect of this yet. (source) In some people, this can cause digestive upset. In my opinion, there is not enough data on allulose to recommend it yet, although I will be watching it closely. A sweetener with such a nice flavour profile and zero effect on insulin would be a great option to have.


My recommendations are stevia and monk fruit for diabetics and overall healthy sweeteners, followed by palm sugar and xylitol, depending on the use. Allulose may be a safe option on occasion, but it’s too early to know the safety profile for sure. Again, I do not recommend honey or maple syrup for those who have any belly fat, sugar cravings, or diabetes. They are too high glycemic and will exacerbate the hormonal dysregulation inherent in these conditions.

For a baking conversion chart of many natural sugar alternatives, go here.

I hope you’ve found this deep dive into sweeteners helpful in your own health journey. As always, if readers have their own health questions, I welcome them. Just send me an email.


Nonie Nutritionista