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ASK THE NUTRITIONIST: What are some potential sugar substitutes?

In her weekly column, licensed nutritionist Nonie De Long talks about some potential substitutes for sugar
Stock image.

Dear readers,

This week’s column covers the ninth of the top 10 nutrition questions I get asked. Tune in next week for the top nutrition question I get asked. If you missed it, the first week I covered soy products and the controversy around whether they are good or bad for your health. Then I covered whether or not we need nutritional supplements and organic foods. We also explored  the health benefits of dairy products and why some people choose to turn to dairy alternatives. Then we explored eggs and why they are a great addition to a healthy diet - even if you have high cholesterol.

After that we looked at plant-based diets and whether it’s healthy to eat meat. Last week we explored how to beat a sugar addiction. Today we’re going to look at the best sugar substitutes and why they’re superior.

Recap: why limit sugar?

There are a number of reasons to limit sugar. The obvious is weight loss. Other reasons include addressing candida overgrowth, reducing stimulatory foods to address mood or cognitive disturbances, reducing inflammation, reducing edema and blood pressure naturally, increasing overall longevity, reducing risk of heart disease and metabolic syndrome, managing diabetes or diabetes risk, managing epilepsy and stopping the progression of Alzheimer’s naturally, losing belly fat, and of course, reducing dental issues. On top of all of these, sugar is addictive, as we discussed last week. More addictive than cocaine, in fact.

I know many holistic nutritionists that believe raw honey is the best sugar substitute, followed by maple syrup and agave (because they are natural), but I would have to disagree with them. Why? Well, the glycemic index of these is still going to trigger a release of insulin. If you read my column with any regularity, you know that is the single most common thing underpinning 90 per cent of common health woes today.

This includes diabetes, Alzheimer's, heart disease, obesity, cancers, inflammatory diseases, and mental health issues. Over stimulation of insulin often plays a role in all of these conditions. So, finding a sugar substitute that doesn’t trigger insulin is the most important consideration, in my opinion. Second to that, we need to consider taste, as there are different flavour profiles to sugar substitutes that lend themselves better to differing dishes and uses.

For example, stevia is nasty in coffee, in my opinion, but the fresh leaves are lovely in tea. Honey, likewise, goes nicely in herbal teas, but in coffee is less than enjoyable and monk fruit (or a monk fruit blend) is more favorable. I will get into this also, as application is everything. It’s kind of useless to know what’s healthiest without knowing what it actually works well in and how to best make use of it.

Let’s look at the best choices more closely.

Monk fruit (GI 0)

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 150-200x sweeter than sugar and contains zero calories. To boot, it does not impact blood sugar at all, and is safe for diabetics, with a glycemic index (GI) of 0. 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 forms.

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

Maybe because it’s rather expensive (hard to grow, difficult to import, and in demand), it’s often blended with other substitute sweeteners like erythritol (see below) or dextrose (highly processed corn derivative). It can sometimes be blended with stevia, and this combo is my absolute favourite sugar substitute in terms of flavour! The brand I like is called Whole Earth and it comes in green packets. The blend works better than stevia alone (less bitter) and I know there is no corn (erythritol), which is preferable to me.

Stevia: (GI 0)

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. It’s what I use in my teas. From one single 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 up into a fine white powder or suspended in liquid or made into little dissolving tablets. It’s 200-300x sweeter than sugar and some find it has a slightly bitter, licorice (natural herb, not the candy) type flavour. It’s easy to overdo it because it’s so sweet, as anyone who’s mistakenly added a teaspoon to a cup of coffee can attest!

Stevia has a GI 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, but those studies are on the commercial, processed forms. I can’t wait to see more studies emerge on the natural, whole product!

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

Of the processed stevia that’s available, the least processed is Green Leaf Stevia. It’s 30-40x sweeter than sugar, but it’s more bitter. Stevia extracts are 200-300x sweeter than sugar and less bitter. Altered stevia is GMO, 200-400x 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. It blends very well with other sugar substitutes for baking and general use.

Palm Sugar (GI 35)

Palm sugar is another lowerer GI, 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 GI of 35 and can be gotten in granulated, block, or liquid form.

Its primary form of sugar is sucrose, which is part fructose. I’ve read that it is unhealthy or comparable to table sugar because it’s high in fructose. However, its fructose content comes out around 3 per cent. It would be inaccurate to say it’s unwholesome. It also does not take into account all its nutrients and significantly lower glycemic index.

Palm sugar is very high in minerals, dietary fibre, vitamins, and 16 amino acids - and all these remain completely intact because it’s not heated. (Remember, though, when you bake with such a sweetener, the vitamins and enzymes are going to be damaged) 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 and cooking 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 GI sweeteners. It’s great when making apple pie and granola recipes, for example.

Xylitol (GI 12)

Xylitol is a sugar alcohol made from the bark of the birch tree. It 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 GI 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 bone, 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. If you’re going to chew gum, xylitol sweetened gum is the best choice, especially after meals.

I’ve noticed that Xylitol doesn’t dissolve perfectly. However, it’s great as a sweetener in drinks and sauces and works well in baked goods. I like it for baking, especially cookies. However, sugar alcohols can cause digestive distress to some people if over consumed. For example, malitol sweetened chocolates: they taste decent so you might think it’s safe (and fun) to eat a whole bag. Don’t. The results can be explosive!

Xylitol is toxic to dogs so it’s best not to use it in homes where dogs might get into it. If children might leave treats where dogs could get them, for example. A small amount of xylitol can harm dogs.

You can try this if you have a child who doesn’t like toothpaste: dip their brush into xylitol to brush their teeth. They love it and it prevents cavities. It’s all natural and there are no health concerns. It’s a win-win.

Erythritol (GI 1)

Erythritol is a sugar alcohol, much like xylitol, but it’s a hyper processed derivative of corn. It’s made into a white powder that’s 70 per cent as sweet as sugar with 6 per cent of the calories. And it has a very neutral taste. It has a GI of 1 and is not going to impact blood sugar at all. Unlike xylitol, though, it blends very well and isn’t known to harm dogs and is less likely to cause digestive upset. For this reason, it’s often blended into other, more expensive sweeteners like monk fruit to extend them.

It’s very new to the sweetener category and testing has not been done independently, but the FDA has decided to promote it and approve it as safe.

However, Erythritol is not even a remotely 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 and unprecedented in farming practice. These crops are then heavily sprayed with industrial pesticides known to be extremely carcinogenic and killing our bee populations. For more info on this read here and here. Despite its seemingly good caloric and blood sugar profile, I can’t recommend this product as wholesome. I prefer xylitol as a sugar alcohol, and stevia as an extender in sugar substitute blends.

Honey (GI 50)

Honey, in its raw form, is a whole, natural food. Unless it’s heated (pasteurized) it contains enzymes, probiotics and prebiotics, as well as a robust array of vitamins, minerals, antioxidants, and nutrients we are only starting to understand. While the glycemic index is higher than that of some of the sweeteners below (50 compared to table sugar’s 60), the glycemic load of honey can be as low as three. For an in depth description of the difference between glycemic index and glycemic load, go here. For the purposes of this article, we have been comparing glycemic index (GI) values.

Honey 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 10-100 times that of sucrose from table sugar.

Table sugar is broken down by our enzymes, while honey is broken down by its own enzymes. A teaspoon (21g) of honey has about 64 calories, while the same amount of table sugar has 80 calories. There is conflicting evidence of honey’s impact on blood sugar levels for those with diabetes. Some study seems to show it lowers blood sugar, but overall elevates hemoglobin A1c, which is correlated to diabetes risk. It’s unclear as of yet if it’s of benefit or not. I have noted clinically that it can trigger mood swings, just as sugar does, and inhibit ketosis, indicating an insulin response.

Babies less 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 by food monitoring agencies.

The flavour goes well in spreads, sauces, and herbal teas or raw desserts. However, if you’re using a sweetener to cook with - the honey is no longer raw! Probiotics do not withstand heating, nor do enzymes or vitamins, so it’s difficult for me to recommend honey as a good sugar substitute for baking, especially since, devoid of said nutrients, it's likely to spike blood sugar more than other substitutes available.

For a more in-depth article on the benefits of honey, there is a wonderful article on greenmedinfo.

Maple syrup (GI 54)

This sticky, amber-coloured, liquid is a boiled down extract of the sap of the maple tree. It has a GI of 54 and is high in minerals, especially manganese. It contains 24 different antioxidants. Dark, grade B syrup is considered the most nutritious. However, most vitamins are destroyed during the heating process, as vitamins are heat sensitive. As such, and given its glycemic index and calories, it’s not an optimal choice. It can be used sparingly for treats as a better choice than table sugar, artificial sweeteners, and high fructose corn syrup, but is less beneficial than raw honey or those below for regular use.

Agave (GI 15)

Agave 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 GI of 15, which makes it more diabetic friendly, and it’s a natural product that is only processed by heating, but the heating destroys any enzymes and vitamins. However, and here’s where it gets tricky, most of the sweetness of the syrup comes from fructose (85 per cent), which is known to be extremely damaging to health - far worse than glucose. Coupled with the fact that purity can be a problem (cutting with corn syrup) this is not an optimal sugar substitute.

For a glycemic index of many sweeteners in a graph you can go here. For a baking conversion chart of many natural sugar alternatives, go here.

There you have my favourite sugar substitutes and when and why I recommend them. I hope this is helpful. As always, if you have your own nutrition related question, send me an email. If you’d like to read more articles like this, you can find me here.

Nonie Nutritionista