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Here's the skinny on the best sugar substitutes

There's plenty to be wary of when choosing a healthy sweetener, particularly if you're diabetic, licensed nutritionist Nonie De Long advises
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Dear Nutritionist,
I have been trying to lower the carbs but I have a serious sweet tooth. I like sugar in my coffee and I like desserts. I want to bake with some of the flours you recommended but I’m not sure what to use as a sugar substitute. The health food store has organic cane sugar, demerara sugar, and also rice and maple syrup and honey. The clerk told me honey is the best, if it’s raw. But I think I read somewhere it’s high in carbs. I’d really appreciate an article about the best sugar substitutes and what to avoid. 
Thank you!  

Dear Seyda
Oooh! This is a tricky question (love it)!  Why? Well, the best sugar substitute depends on the question: best for what? Let me explain.

There are a number of reasons to limit sugar. The obvious is weight loss, but is that from a calorie counting model or a carb restricting, keto or non-keto model? Other reasons include addressing candida overgrowth, reducing stimulatory foods to address mood or cognitive disturbances, reducing inflammation, reducing edema and blood pressure naturally, cutting or ripping (body building technique to lower body fat quickly for competitions), increasing overall longevity, reducing risk of heart disease and metabolic syndrome, managing diabetes or diabetes risk, managing epilepsy naturally, and of course, healing dental carries. 

(Yes, I said healing dental carries. It’s totally possible and well documented. Food really IS medicine. But this is outside the scope of this article today.)

So, while most holistic nutritionists would say, hands down, raw honey are the best (because they are natural), there are other considerations. And I would have to disagree with them. 

Just to complicate things a bit more, there are different flavour profiles to sugar substitutes that lend themselves better to differing dishes and uses. For example, stevia is nasty in coffee, imho, 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 favourable. So 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 these more closely. 

Honey, in its raw form, is a whole, natural food. Unless it’s 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. While it’s glycemic index is higher than that of some of the sweeteners below (50 compared to table sugar’s 60), it’s glycemic load is only 3. For an in depth description of the difference, go here. For the purposes of this article, we will compare 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. What is very odd, is that despite it’s sweetness and glycemic load, honey may have a blood sugar stabilizing effect. There is conflicting evidence of honey’s impact on regulating blood sugar levels for those with diabetes. It seems to lower blood sugar but elevates hemoglobin A1c, which is correlated to diabetes risk. So 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. 

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 (GRAS). 

The flavour of 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 heat treating, 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 recent article on greenmedinfo.

Maple Syrup 
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, any 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 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. 

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 150-200x sweeter than sugar and contains zero calories. To boot, it does not impact blood sugar, and is safe for diabetics, with a 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 market, It’s not well studied here yet. Despite that, consumer response has been more favourable than many sugar substitutes. Why, you ask? I think because Starbucks picked it up and also because it’s a 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 + 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 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. But this form of the plant has not been studied for safety yet. Recap: it’s been used safely for 1,500 years but because of lack of ‘studies’ it’s not yet technically endorsed as safe. Despite this, it’s what I use in my teas. 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 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 type flavour. It’s easy to overdo it because it’s sooo sweet, as anyone who’s mistakenly added a tsp 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 studies emerge on the natural, whole product!

It’s a little known fact that 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 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. 

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 GI of 35 and is available in granulated, block, or liquid form. 

It’s primary form of sugar is sucrose, which is part fructose, so I have read that it is unhealthy or comparable to table sugar for health because it’s high in fructose. But its fructose content comes out around three percent. So this would be an inaccurate assessment. 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 killed.) 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. 

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 and slightly less sweet. 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. So if you’re going to chew gum, xylitol sweetened gum is the best choice. 

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 but sugar alcohols can cause digestive distress to some people if over consumed. This can happen with sugar alcohols. For example, malitol sweetened chocolates: they taste decent so you might think it’s safe (and fun) to eat a whole bag. DON’T. 

And it’s toxic to dogs, so it’s best not to use it in homes where dogs might get into it. 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. Win win.

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 six 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. 

Despite the fact that it’s very new to the sweetener category, and testing has not been done independently, the FDA has decided to accept the claims of the food manufacturers that promote it and approve it as safe. 

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. So despite its seemingly good caloric and blood sugar profile, I can’t recommend this product as wholesome.

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

Thank you, Seyda, for writing in with such a great question! As always, if readers have their own health questions, I welcome them. Just send me an email.
Nonie Nutritionista

Nonie De Long is a registered orthomolecular nutritionist with a clinic in Bradford West Gwillimbury, where she offers holistic, integrative health care for physical and mental health issues. Check out her website here.

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