by Dr. Will Cole

We eat a lot of sugar in the United States – an average of 765 grams of sugar every five days – the amount in 17 cans of soda! (In 1822, we had the equivalent of one can of soda every 5 days in sugar consumption.) That translates to about 130 pounds of added sugar every year, and about 3,550 pounds of sugar over the course of a lifetime. That’s like eating 1.7 million Skittles or an industrial-sized dumpster of cane sugar.

You might wonder about these numbers if you aren’t chomping on fistfuls of candy or drinking 2-liter bottles of soda at one sitting, but much of this sugar consumption comes from hidden sources of the sweet stuff – it’s in condiments, kombucha, crackers, soup, salad dressing, and almost everything else that comes in a package. Even so-called “health food” like granola or health bars, smoothies, and yogurt. Sugar is often disguised, hidden behind euphemistic names, so it can be hard to recognize, but let’s be honest, most of us don’t want to have to worry about going without a single grain of sugar for the rest of our lives.

So let’s get practical. Here’s my list of the sweeteners to avoid completely, which ones are not great but okay in moderation, and which ones should be your go-tos when you want something sweet.

The Worst

Artificial sweeteners

These are the worst of the worst. The most common culprits, on colorful display wherever coffee is sold, include:

  • Sucralose – Splenda
  • Aspartame – Equal, NutraSweet
  • Saccharin – Sweet N’ Low
  • Neotame – a chemical derivative of aspartame found in various food products
  • Acesulfame – often found in sodas and fruit juices as well as dairy and ice cream products

I have written in the past about the link between artificial sweeteners and health problems. According to studies, these chemical sweeteners actually change the bacterial makeup of your microbiome, which can lead to weight gain (the very thing you were probably hoping to avoid by choosing zero-calorie sweeteners), along with an increased change for autoimmune problems, diabetes, and other metabolic disorders.

High-fructose corn syrup

This sweetener is so ubiquitous that it’s mind-boggling. Even foods that you wouldn’t think would contain any sweetener contain HFCS, which is derived from stalks of corn and converted to syrup through an intensive chemical process. Due to its chemical makeup, it does not need to be digested by your body so it makes a beeline straight into your bloodstream, which can lead to insulin spikes that contribute to hormonal problems like leptin resistance, which in turn increases weight gain and weight-loss resistance.

The Not-As-Bad

Agave nectar

Often considered the “healthy” alternative for sugar, we now know that even though it is low on the glycemic index (a way of measuring how fast certain carbohydrates will raise your blood sugar), it is extremely high in fructose. Your body still converts fructose into glucose, glycogen, lactate, and fat in your liver. This puts stress on your liver and can contribute to insulin resistance and fatty liver disease.


Also known as raw cane sugar, this type of sugar is not so “raw” and unrefined as it makes itself out to be. It is still highly processes, which removes not only some of its natural impurities but also nutrients. While it’s still far less processed than refined white sugar, it’s still not much better for you.

Brown-rice syrup

This sweetener is made from the combination of brown rice and enzymes. The enzymes break down the starch, and then it is boiled down to create a syrup. The fermentation actually makes the sugars easier to digest. The big issue though is that barley enzymes are often used, which contain gluten. Unless you are specifically looking for gluten-free brown-rice syrup, you could be unknowingly perpetuating health problems if you are sensitive to gluten. It is also important to not that arsenic can build up when large amounts of rice. Studies have shown that arsenic levels have been found to be high in organic brown-rice syrup used in a lot of different products. I advise against too much of this product, to decrease toxin exposure.

The Decent


A zero-calorie low-glycemic sweetener that’s also natural and doesn’t mess with your microbiome or your blood sugar? Sounds almost too good to be true – and in some ways, it is. As long as you use raw organic stevia that is still in its green form you will get the best health benefits of this sweetener. However, other forms are more processed and often bleached and filled with preservatives, so you are still exposing yourself to other chemicals and toxins. Also, some types include added ingredients and are not pure stevia. Plus, a few studies show stevia’s ability to impact hormones.

Maple syrup

Forget that bottle of Mrs. Butterworth’s – that’s not real maple syrup. Instead, look for 100% pure organic maple syrup. What makes this a much better alternative to traditional sugar is the fact that it actually contains good-for-you minerals like zinc and inflammation-fighting polyphenol antioxidants. And since it’s sourced straight from tree sap, it goes through minimal processing. The darker the maple syrup the better, because it contains higher amounts of antioxidants – up to 24 different kinds!


Nature’s perfect sweetener, honey has enormous benefits, as long as it is in its raw unpasteurized, unfiltered form. It contains many powerful antioxidants like polyphenols, which have been shown to help combat cancer and promote heart health. It is also great for fighting off sickness since it also still contains bee pollen, which boosts immunity. The creme de la creme of honey is manuka honey, from New Zealand. It has a far superior nutritional content compared to any other honey, and also boasts vigorous antimicrobial properties.


This sweetener is made by boiling raw sugar down multiple times. As the sucrose crystallizes out, the remaining dark viscous substance has concentrated nutrients from the cane sugar plant. Blackstrap molasses is the most nutrient-dense form of molasses with the least sugar, and is achieved by processing the syrup three times to remove as much sucrose as possible. Blackstrap molasses contains more iron than any other natural sweetener. Iron is important to help fight fatigue since it helps with red blood cell health.


When they come without added sugar (check the label!), these sweet fruits are completely unprocessed and can be eaten fresh or dried or pureed into a paste to add to many different recipes. Since they are very high in fructose, it is still important to keep their intake to a minimum. Dates in particular, are very nutrient dense and can help those struggling with constipation and help improve overall digestive health by increasing growth of beneficial bacteria thanks to their high fiber content.

Fruit juice

Although fruit juice contains fructose, it is a better option than many other types of sweetener because – especially if you juice it yourself – it is only lightly processed. Fruit juice contains all the same antioxidants present in it’s whole fruit form, but drink it in moderation and only choose ones without any added sugar.

Sugar alcohols

Often found in “sugar-free” foods, these include sorbitol, mannitol, and xylitol and are derived through chemically processing the carbohydrates found in fruits and berries. These don’t even have to be included on a product label unless it is specifically labeled “sugar-free.” Unlike other sugar-free sweeteners that have zero calories, sugar alcohols do contain up to three calories per gram but they do not have an effect on blood sugar. However, they can have a laxative effect so they don’t work for everyone. For some, they can seriously flare up digestive problems like IBS and SIBO. Your body does not completely absorb these, and they end up fermenting in the large intestine, which can cause gas and bloating. If they don’t bother you, however, they can be an acceptable option.

Monk fruit

Like stevia and sugar alcohols, monk or luo han guo fruit is another low-carb sweetener option. It’s fermented from the pulp of the fruit, and this fermentation process removes the sugars but leaves a residual sweet flavor. Used for hundreds of years in Asian countries where it is harvested, monk fruit contains beneficial antioxidants called mogrosides, which has made this fruit a natural anti-inflammatory tool in Chinese medicine. If you decide to try it, make sure you get pure monk fruit without additives. Also, be aware that like sugar alcohols, too much can trigger stomach issues in some people.

Coconut sugar/nectar

Coconut-based sweeteners are derived from the coconut blossoms of the coconut tree, not the coconut itself. They contain small amounts of nutrients like zinc, potassium, and short-chain fatty acids, but you’d have to eat a lot ot make a difference. These sweeteners are processed but coconut sugar does contain inulin fiber, which has been shown to help improve diabetic health, because it helps to slow the absorption of glucose and keep blood-sugar levels balanced.

The Bottom Line

The ideal situation when it comes to sweet foods is to only eat those that are naturally sweet, like fruit and to still not go overboard. However, I am a realist and I know that sometimes, you want a little added sweetness when it comes to desserts or added to your coffee. In those cases, I always recommend raw organic stevia, monk fruit, maple syrup, molasses, and dates. With any of these, moderation is still important – no more than a couple tablespoons per day is ideal. The other sweeteners in the first two categories should, I believe, be avoided as much as possible to promote optimal health. However, for those with chronic health conditions, you may have to avoid all sweeteners, at least while you are healing. Of course I also recommend working with a functional medicine practitioner to determine your individual needs.

If you want to learn more about your own health case please check out our free health evaluation. We offer in person as well as phone and webcam consultations for people across the country and around the world.

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