What's the best healthy sugar alternative?

The average person in Britain consumes a whooping 19 teaspoons of sugar every day – double the recommended amount.

Many of us are trying to cut back, and sweeteners are an obvious solution. But it can be hard to know what’s best.

A 2024 Leeds University study could help dieters – participants eating sweeteners experienced slightly better weight maintenance than sugar-eaters, plus reduced cravings for sweet foods and improved mood, while it didn’t increase their risk of diabetes or heart disease.

However, other studies suggest possible health risks. In 2023, the World Health Organisation (WHO) linked sweeteners to an increased risk of Type 2 diabetes, heart disease and some cancers. But it acknowledged that more research was needed.

Sweeteners have also been linked to poor blood sugar control and increased cravings for sweet foods.

“Generally, people are better choosing more natural foods like honey, dates or bananas, and having them in smaller amounts,” says Dr Emily Porter, specialist dietitian at the Gut Health Clinic.

“However, some people find sweeteners helpful. If your diet is broadly healthy, I wouldn’t be too concerned about using them.”

The pros and cons of sugar alternatives

Here, we investigate the pros and cons of the most popular sugar alternatives.

1. Natural sugars

Honey, agave, maple syrup

Natural sugars are still sugars: if consumed to excess, they have the same negative health effects, though most experts think that for those not on a diet they are a slightly better choice in small amounts.

“Honey, for example, has been used in traditional medicine as some types have natural antibiotic properties and contain antioxidants,” says dietitian Dr Emily Leeming, author of Genius Gut. “Maple syrup also contains antioxidants.”

Agave is derived from the agave plant and in Mexico was traditionally thought to have healing properties.

• Taste: The taste varies according to the type, but maple syrup and agave tend to be sweeter than honey.
• Calories: Honey, agave and maple syrup have slightly more calories than sugar.
• Pros and cons: Agave has a low GI rating and so has less of an impact on blood sugar than sugar, honey or maple syrup. However, it’s very high in fructose, which has been linked to increased fat storage and insulin resistance

2. Natural sugar alternatives

Stevia, Xylitol

Stevia is extracted from the leaves of the stevia plant, which is native to South America. Xylitol is a natural sugar alcohol found in many plants. Both are found in sweets, soft drinks and baked goods.

• Taste: Stevia is 250-300 times sweeter than sugar and has a bitter/liquorice-style aftertaste that many people don’t like. Xylitol tastes similar to sugar.
• Calories: Stevia has virtually no calories; xylitol has 2.4 calories per gram – 40% fewer than sugar.
• Pros and cons: Neither raises blood sugar or insulin, so are a good choice for diabetics. Research shows that xylitol, often used in toothpaste, can reduce tooth decay although a new study links it to increased blood clotting and hence heart attack risk. Xylitol can be used in baking to replace sugar as can stevia (in smaller amounts than sugar), although it does leave an aftertaste.

Rob Hobson, nutritionist for Healthspan and author of Unprocess Your Life, says: “My go-to would be stevia as it’s the most natural. Xylitol and other polyols, such as sorbitol and erythritol, can have a laxative effect if consumed in large amounts.”

3. Chemical and artificial sweeteners 

Sucralose

Sucralose is a chemical sweetener widely used in food products and as a sugar substitute in cooking and baking.

• Taste: It is 600 times sweeter than table sugar and is said to have the least aftertaste.
• Calories: Sucralose has no calories, though commercial brands do contain a small amount. Familiar brands include Splenda and Canderel Sweetely.
• Pros and cons: Since sucralose is heat resistant, it is good for cooking and baking. But some studies have suggested that at high temperatures it may interact with other ingredients and produce harmful chemicals. Another study found it was safe.
• A study by the Weizmann Institute found that sucralose could impact gut bacteria and blood-sugar control.

Aspartame

This artificial sweetener is made from two amino acids. It’s found in everything from diet drinks, juice and chewing gum to desserts, medicine and toothpaste.

• Taste: Aspartame is 200 times sweeter than table sugar and has a distinctive aftertaste.
• Calories: The same amount as sugar (4 per gram), but it is much sweeter, so you only need a tiny amount. Brands include Canderel and Silver Spoon.
• Pros and cons: The WHO suggested it may be linked to cancer. But Cancer Research UK says there is “no convincing evidence that aspartame causes cancer”. Some studies suggest it could disrupt the balance of bacteria in your gut, although not people’s blood sugar response, so it’s a good choice for diabetics.

Saccharin

Saccharin is an artificial chemical sweetener that has been used for more than 100 years. It has a long shelf life and is found in diet drinks, low-calorie sweets, biscuits and medicines.

• Taste: It is 300-400 times sweeter than sugar, but can have an unpleasant bitter aftertaste, so is often mixed with other sweeteners. Familiar brands are Sweetex and Hermesetas.
• Calories: It has no calories.
• Pros and cons: Although considered safe, in a recent peer-reviewed study, scientists from the Weizmann Institute found that like sucralose, saccharin impacted gut bacteria and disrupted people’s blood sugar response as a result. Scientists urged caution for diabetics.