The Sweet Dilemma: Pros and Cons of Popular Sugar Alternatives
October 28th, 2025
Photo: Abbey Degraw
Writer: Silvia Foss
Editor: Megan Lennenmann
Sugar—it’s comforting, delicious, and, let’s be honest, so hard to give up. With its overuse causing health concerns, sugar alternatives have taken over from diet sodas to protein bars. In a promise to be “natural,” many advertise zero calories—but is it truly better for you? Let’s break down the sweet (and not-so-sweet) truth of these alternatives.
What’s the Difference?
Sweeteners fall into two main categories: natural and artificial.
Natural sweeteners include pure forms of sugar, honey, maple syrup, and coconut sugar as well as options like stevia and monk fruit. At first glance, many natural options may seem healthier but, “the trace amounts of antioxidants, vitamins and minerals they contain are not enough to make a significant difference when it comes to your health,” explains Erma Levy, a senior research dietitian at the University of Texas. These natural sweeteners can often raise blood sugar and are high in calories.
Stevia is a little different: it’s derived from plants but contains compounds that taste sweet without spiking blood sugar while having zero calories. But stevia, and many other zero-calorie natural sweeteners, can be 200-600 times sweeter than sugar (Johns Hopkins Medicine, n.l.), altering your tolerance for sweetness, leading you to consume even more sugar than before (Levy, 2025).
Artificial sweeteners, like sucralose (Splenda), aspartame (Equal), and saccharin (Sweet’N Low) are lab-made but deliver the same intense sweetness with zero calories. However, your body doesn’t process them the same way as sugar, which is why they don’t affect energy or blood glucose. While there's not sufficient evidence of artificial sweeteners causing this association, “some studies done with laboratory animals have found links between artificial sweeteners and cancer. As a result, Levy recommends still avoiding them when possible.
Health Impacts: Beyond the Calories
One of the biggest draws of sugar substitutes is that they let you enjoy sweetness without the sugar crash. They can be a great alternative for people managing diabetes, insulin resistance, or anyone simply trying to reduce calorie intake.
However, there’s some debate about their long-term effects. In addition to sugar alternatives’ cancer links, research done at Cedar Sinai by Ava Hosseini suggests that artificial sweeteners could alter gut bacteria, influencing metabolism, cravings, as well as liver and nervous system health.
While natural sweeteners like agave and maple syrup are, well, “natural”, they’re still sugar. They may contain trace minerals and antioxidants, but too much can still raise blood sugar and contribute to caloric intake. Their antioxidant or mineral qualities are not substantial enough to greatly impact health (Levy 2025).
Honey has been associated with a number of health benefits. It has high antioxidant levels, reducing the risk of cardiovascular and neurological diseases. It can also be a reliable cough suppressant and form of relief for gastrointestinal conditions (Mayo Clinic, n.l.). But not all honey will provide these benefits. Most grocery store honey often has many of the beneficial ingredients filtered out, with more added sugars. When looking for the purest form of honey, look for raw honey in the grocery store (Raman, 2023).
The takeaway? Sweeteners can be a useful swap, but there’s no magic fix—whether natural or artificial, it’s all about balance and knowing what works best for your body and goals.
Pros and Cons of Sweeteners: The Sweet and Sour
The Pros:
Minimal or no calories: Ideal for lowering calorie intake without losing flavor (discounting most natural sweeteners like honey).
Blood sugar friendly: A solid alternative for people with diabetes or glucose sensitivity (discounting most natural sweeteners like honey).
Dental benefits: They don’t cause cavities like regular sugar. Studies done at Ibn Sina National College for Medical Studies have even shown xylitol (a sugar alcohol often found in gum) to benefit dental health (Nayak, 2014).
The Cons:
Aftertaste: Stevia can taste bitter or metallic to some .
Gut health concerns: Artificial sweeteners may disrupt gut bacteria and overall health.
Links to Cancer: While not conclusive, many studies have suggested a link between artificial sweeteners and cancer.
Still sugar: Natural options like honey or agave still affect blood sugar.
Finding the Right Sweetener for You
There’s no one-size-fits-all answer. Your best sweetener depends on your goals.
Managing blood sugar? Choose stevia, monk fruit, or sucralose for minimal impact.
Prefer natural options? Use honey or maple syrup sparingly. They’re real foods, just not calorie-free.
Calorie-conscious but flavor-focused? Try a blend, like sugar mixed with stevia/monk fruit, for a more natural taste.
The Bottom Line
Sweeteners can absolutely fit into a healthy lifestyle—if you use them mindfully. The real goal isn’t just finding the “best” sweetener—it’s finding a balance that feels sustainable and still lets you enjoy life’s little treats.
References
Demarco, C., & Blackburn, K. (2025, March 25). Artificial sweeteners vs. natural sweeteners: Which one is better? University of Texas MD Anderson Cancer Center. https://www.mdanderson.org/cancerwise/artificial-sweeteners-vs--natural-sweeteners--which-one-is-better.h00-159774867.html
Johns Hopkins. (n.d.). Facts About Sugar and Sugar Substitutes. Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/facts-about-sugar-and-sugar-substitutes
Mathur, R., & Hosseini, A. (2023, December 13). RESEARCH ALERT: Artificial Sweeteners Significantly Alter the Small Bowel Microbiome. Cedars Sinai. https://www.cedars-sinai.org/newsroom/research-alert-artificial-sweeteners-significantly-alter-the-small-bowel-microbiome/
Nayak, P. A., Nayak, U. A., & Khandelwal, V. (2014). The effect of xylitol on dental caries and oral flora. Clinical, cosmetic and investigational dentistry, 6, 89–94. https://doi.org/10.2147/CCIDE.S55761
Mayo Clinic. (2023, August 10). Honey. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements-honey/art-20363819
Raman, R. (2023, April 29). All About Raw Honey: How Is It Different Than Regular Honey? Healthline. https://www.healthline.com/nutrition/raw-honey-vs-regular
