Hierarchy of Sweeteners: Best and Worst - Lakeside Natural Medicine

Natural Health and Wellness for the Whole Family

Hierarchy of Sweeteners: Best and Worst

BySarah Axtell, ND May 12, 2023

Best sweeteners if you are metabolically healthy (ie. do not have insulin resistance, high blood sugar, obesity). Small amounts of the following natural sweeteners are ok since they are minimally processed:

  • Maple syrup
  • Honey
  • Coconut sugar

*These sweeteners will still spike your blood sugar so best to keep to a minimum. When I bake, I try to use one of the above sweeteners in a quantity of 1/3 cup or less in the whole batch.

Best sweetener if you have elevated blood sugar, diabetes, insulin resistance, are overweight or struggle with weight loss resistance:

  • Stevia. Opt for a pure stevia product with no added ingredients. I like Trader Joe’s liquid stevia and Sweet Leaf stevia drops. Many commercial stevia products have erythritol (see below) and natural flavors.
  • Monk Fruit. Monk fruit itself is ok but often it is combined with erythritol. I find it difficult to find a pure monk fruit product.

*These sweeteners will not spike your blood sugar. They are VERY sweet- a little goes a long way.

Worst sweeteners:

  • High fructose corn syrup- leads to fatty liver, diabetes, weight gain
  • Agave- while natural, it is similar to high fructose corn syrup in terms of how it is metabolized. It is high in fructose and metabolized by the liver.
  • Aspartame- carcinogenic, neurotoxic
  • Cane sugar

What about erythritol, malitol, sorbitol, xylitol? These are sugar alcohols that can cause a lot of gas and bloating. So absolutely avoid if you have IBS! While we used to think these sugar alcohols were generally safe (besides causing some gas and bloating), new research shows that erythritol is closely associated with an increased risk for “major adverse cardiovascular events,” including heart disease and stroke. I say avoid!

Editor’s Note: The information in this article is intended for your educational use only. Always seek the advice of your physician or other qualified health practitioners with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.


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