One of the most frequently suggested dietary changes for pain patients is to eliminate or cut back on sugar. There are many excellent reasons for this, including sugar’s role in inflammation and its ability to accelerate the rate of aging in cells. Many people, however, find eliminating sugar difficult, and with good reason: sugar is highly addictive. One recent study even found that sugar acts on the brain in the same way as cocaine and opioids. Some pain patients may choose to keep a bit of sweetness in their lives by seeking out the best sugar substitute. Sugar substitutes have come a long way since the days of the little pink packet, with many more natural options. There are many different sugar substitutes on the market, but not all are appropriate substitutions for pain patients. Here are ten of our favorite, all-natural, best sugar substitute.

Best sugar substitute? Our top 10 all-natural choices

1. Applesauce

Applesauce is a naturally sweet sugar substitute that works wonders in baked goods, adding sweetness, flavor, and moisture. Try this carrot cake with zero added sugar in the cake.

2. Honey

Honey is one of nature’s greatest sweeteners and one of the best sugar substitutes. Not only does it work well in anything from baked goods to morning coffee, honey is also a natural anti-microbial and anti-bacterial substance that can help promote healthy gut flora. Honey never spoils. If your honey develops crystals when it gets cold, place the container in warm water for a smoother texture.

Gluten-free and cutting out processed sugar? Try this flourless chocolate cake.

3. Frozen juice concentrate

Frozen juice concentrate cooks out the excess water so what’s left is pure, concentrated, sweet fruit flavor. Stir this into yogurt or use it to sweeten baked goods like a deep dish apple pie.

4. Agave syrup

Agave syrup comes from the same plant as tequila but without the alcohol. Use agave as you would use honey – in baked goods and hot or iced beverages – but use it sparingly. The high fructose content of this sugar substitute can have potentially negative consequences, including weight gain and a spike in blood sugar.

5. Maple syrup

Maple syrup is a wondrous thing. Sap from maple trees is drained into buckets every spring and then boiled down for hours to make this delicious natural sweetener. It contains over 50 different antioxidants and is richly flavored. Use it sparingly to add flavor and sweetness to this carrot cake.

6. Dates

Dates are a nutrient-dense food that just so happens to be wonderfully sweet and delicious. They impart a rich flavor to baked goods and can also be dried and made into date sugar (which is highly processed, so stick with whole dates). Try this recipe for date-sweetened double peanut butter chocolate chip cookies (you can sneak some dark chocolate chips in your batter for extra antioxidants, or leave them out to spare the sugar).

7. Cinnamon

Something about the spicy, earthy flavor of cinnamon makes it the best sugar substitute in your coffee. Add it to plain yogurt in the morning or warm milk at night before bed for a restful sleep.

8. Unsweetened cocoa powder (or bar chocolate) + vanilla extract

You may not be able to imagine hot chocolate without the sugar, but adding a dash of vanilla into warm milk and then melting or stirring in unsweetened cocoa gives you all of the flavor with no added sugar.

9. Pureed banana

Use pureed banana as a sugar substitute in baked goods and smoothies to impart a deliciously sweet flavor. Frozen bananas dipped in melted, unsweetened chocolate are also a delicious treat on a hot day!

10. Brown rice syrup

Brown rice syrup is made from brown rice and works well as a sugar substitute in breads and other baked goods. This sugar substitute has more nutrients than white sugar and is widely available in the natural foods section of the grocery store.

There are many additional recipes that combine different sugar substitutes, like sticky chocolate date cake sweetened with dates and stevia and a flourless lemon, blueberry, and poppyseed cake that combines the sweetness of the fruit with honey.

Looking for the best sugar substitute? Don’t go for artificial

We have not included any types of artificial sweeteners on this list of sugar substitutes. This omission is intentional. Although recent research has debunked the popular belief that artificial sweeteners can cause cancer, the truth is that artificial sweeteners may have some dangerous health effects, including:

  • Weight gain
  • Cardiovascular issues
  • Metabolic syndrome
  • Type 2 diabetes

In addition, artificial sweeteners can be up to 20,000 times sweeter than sugar. This may produce the sense that regular sugar is not sweet enough, resulting in overconsumption.

Truthfully, sugar is sugar. Any sugar substitutes, even the natural kind, should be used sparingly with an eye to reducing consumption of sweeteners of any kind. Relying on naturally sweet and healthy treats like fruits and vegetables picked and eaten in season is a much healthier choice overall.

If you are trying to reduce your consumption of sugar or sugar substitutes, it may be helpful to identify where most of your sugar consumption occurs (e.g., in soda or in “hidden sugars” such as those in condiments and pre-packaged meals) and start by reducing or eliminating those sources. Read labels to check for amounts of sugar, and try to keep your overall daily sugar intake to nine teaspoons a day for men or six teaspoons a day for women.

What are your favorite low- or no-sugar-added recipes?


Weekly updates on conditions, treatments, and news about everything happening inside pain medicine.

You have Successfully Subscribed!