Tips to Stop Sugar Cravings + A Guide to Healthy Natural Sweeteners
Published On: February 26, 2024
The massive intake of sugar in this country is one of the main drivers of chronic disease. Just like drug addiction, sugar causes real “food addiction” in some people, making it hard to stop.1, 2
But how much sugar is too much sugar? And what about natural, unrefined sweeteners or low-calorie sweeteners like stevia, xylitol, and erythritol?
In this article, I’ll explain the evidence and help you set a reasonable goal for daily sugar intake that will help ease those sugar cravings.
We’ll also discuss:
- What types of sugar we need (and don’t need)
- The common and lesser-known health effects of sugar consumption
- Why we crave sugar
- Is sugar truly addictive?
- How much-added sugar the average person needs (and the scoop on “Recommended Daily Sugar Intakes”)
- The pros and cons of natural sweeteners, including natural or low-calorie sweeteners, and what we recommend using
- And how much sugar is too much
You Don’t Need Sugar to Survive, But You Do Need Glucose
Nearly every cellular process, including brain function, relies on glucose — but as most of you already know, glucose should not and need not come from refined sugar products or foods high in sugar.
Most adults have roughly 5 liters of blood flowing throughout their body, and the body works hard to maintain a very tight balance of optimal blood sugar, which is only a total of 4 grams (about 1 teaspoon!).
If the blood sugar falls below this, referred to as HYPOglycemia, we feel it.
This is often described as “feeling hangry,” which can look like anxiety, irritability, excessive sweating, weakness, shakiness, headaches, etc.
If our blood sugar is too high, called HYPERglycemia, we don’t often “feel” it.
Yet our pancreas is working hard to try to bring blood sugar down by manufacturing and secreting insulin, a hormone that helps move sugar from the bloodstream into cells.
Blood sugar swings can also cause a stress response and surge in the stress hormones, cortisol and adrenaline, but that’s an article for another time.3
If you’ve ever tried a sugar-elimination diet and read labels closely, I’m sure you’ve figured out how hard it is to completely avoid sugar in its many forms (high fructose corn syrup, honey, fructose, dextrose, sucrose, fruit juice concentrate, syrup etc).
It’s everywhere, from ketchup to bread.
Data from the National Cancer Institute indicates that the average American consumes about 17 teaspoons a day, and peaking in teenage males at 25 teaspoons a day.4
That breaks down to about 1/3 to 1/2 a cup per person per day. That is WAY too much!
The truth is most of us get more than enough natural sugars, in the form of carbohydrates, from our diets.
We’ll discuss this more in subsequent sections.
What are the Health Effects of Excess Consumption of Sugar?
Excessive sugar consumption (especially when paired with low activity) is not only linked with cavities but with most chronic diseases, including but not limited to:5, 6 ,7 ,8, 9
- Aging
- Behavioral issue
- Dental issues
- Diabetes
- Fatty liver disease
- High blood pressure
- High cholesterol
- Immune function issues
- Mental health issues, like depression and anxiety
- Metabolic syndrome
- Neurodegenerative disease
- Obesity/ Weight gain
- Polycystic ovarian syndrome (PCOS) and infertility
Chronically elevated blood sugar levels ultimately lead to insulin resistance, a state that is known to be the root cause of many chronic diseases.10
New research even suggests a mother’s intake of refined sugar can have negative effects on her unborn baby’s behavior, immunity, and inflammatory levels through adulthood.11
This is likely why we are now seeing increasing rates of these chronic diseases in young people.
I saw this firsthand during my residency training in inner-city San Antonio, Texas. Obesity in childhood is commonplace there, and I routinely diagnosed teenagers with pre-diabetes and even diabetes.
Such a tragedy when, in the past, this was an adult-onset condition.
Why Do I Crave Sugar?
If you suffer from sugar cravings, you are not alone, and the sugar industry isn’t helping you overcome it.
Why? Because sugar is indeed addictive.
Here’s how this works.
Addictive drugs cause neurochemical changes in the brain, such as changes in dopamine and opioid receptor binding, which reinforce addictive behaviors.12, 13
Likewise, sugar has been shown to stimulate the brain’s reward centers through the neurotransmitter dopamine.14
And just like other addictive drugs, people can develop a tolerance to sugar, meaning they need more and more to satisfy their dopamine-driven cravings/sweet tooth.15
Some people are genetically more prone to sugar addiction, which translates to disordered eating and obesity.
Thus sugar causes “food addiction” in some people, and avoiding sugar is not as easy as using “self-control.”16
Sugar cravings or sugar addiction might also be related to:
- Blood sugar imbalance
- Certain medications—over-the-counter or prescription
- Low magnesium levels
- Candida/fungal overgrowth
- Fatigue/Lack of sleep
- Hormone imbalances or changes in hormone levels, such as during menstruation or pregnancy
- Lack of fat and/or protein in the diet
- Nutrient deficiencies or insufficiencies
- Emotional wounds or traumas
- Stress
Another theory is that human beings are evolutionarily hard-wired to crave sweets and starches for survival.
This makes sense given the thousands upon thousands of years people hunted and gathered, unsure where their next meal was coming from.
The discovery of sweet and/or starchy food, like yams, fruits, or honey, was a treat that would give plenty of energy to help a person make it through to their next meal.
Consuming sweets and starches also helps us store fat, which is a help rather than a hindrance in a survival situation. Plus, hunters and gatherers were extremely active, which helped keep blood sugar in check.
Additionally, research has shown that famines primed certain ethnic groups to become more insulin-resistant in order to survive. This is known as the "thrifty gene" and "thrifty phenotype" hypotheses.17
Research has also shown those who experience famine early in life may have a greater risk of type II diabetes and metabolic syndrome.18
This is why those from certain ethnic groups are more prone to diabetes and blood sugar issues than others. What was once an evolutionary advantage is now hurting us.
So, does this mean we can’t have any sugar at all…even natural varieties?
Fortunately, most people do not have to give up sugar entirely, and even those with metabolic conditions have options to satisfy their sweet tooth.
How Many Grams of Sugar Per Day is Optimal? What’s the RDA?
First, it must be stated: even without eating ANY dietary sugar, the body can make ALL of the sugar it needs through gluconeogenesis, a process the body uses to convert fat, lactate, or certain glucogenic amino acids (building blocks of protein) into sugar, which the body can do to meet all of its needs.
This is why, for example, those who follow a strict ketogenic diet (sometimes used for the treatment of mental health disorders or epilepsy) can survive.
Eating healthy carbohydrates from vegetables, fruits, and whole grains also supply the body with plenty of glucose—no need for “added sugars”.
Once again, this makes sense given the easy availability of refined and even natural sugars, like honey or maple syrup, is a relatively new dietary phenomenon.
So, then, what amount of added sugar is too much?
In the United States, the U.S. Food and Drug Administration (FDA) developed Daily Values (%DV) to help consumers determine the level of various nutrients in a standard serving of food. 
Do you know what the percent DV is for sugar? Read this label. Do you see it?
Are you surprised that sugar doesn’t even have a recommended DV?
The good news is there has been progress.
In July 2015, the FDA issued a supplemental proposed rule that would require the %DV for added sugars.19
Luckily, we have other definitive guidelines to rely on.
Thanks to the irrefutable evidence linking sugar consumption to heart disease, in August 2009, The American Heart Association (AHA) released guidelines published in Circulation: Journal of the American Heart Association with the following recommendations:20
- Most women should consume no more than 25 grams, or less than 6 teaspoons of added sugar a day.
- Most men should consume no more than 37.5 grams, or less than 9 teaspoons a day.
- Children ages 4-8 with a daily caloric intake of 1,600 calories should consume no more than 12 grams, or 3 teaspoons a day.
WAIT… did you say 12 grams a day??
If you are giving your child almost any packaged or processed foods, you will likely exceed this.
In March 2015, the World Health Organization published similar guidelines for sugar intake for adults and children. WHO advocates limiting “free sugar” consumption to roughly 25 grams (6 teaspoons) per day.21
Note that both of these recommendations refer to free or added sugars, which include honey, syrups, fruit juices, and fruit juice concentrates.
This does not include the sugar naturally present in whole fruits and vegetables or milk (though I do think it’s worth noting that an 8 oz serving of milk has 12 grams of sugar in the form of lactose).
Remember, the body only needs 4 grams of glucose (blood sugar) at any given moment.
And although everyone processes sugar a bit differently, you can bet exceeding 25 grams a day (or less for some people) is going to bump that number up higher than is optimal.
How to Avoid Added Sugars In Your Diet
Unfortunately, the food industry makes avoiding added sugars extremely difficult.
For example, don’t be fooled by foods packaged and marketed as “health foods” or even “organic”---these can still be loaded with added sugar.
A great example is a green juice called Odwalla’s Superfood Smoothie.
One 15.2 oz bottle has 50 grams of added sugar! Yes, it’s all fruit juice. But that’s still a burden on our bodies.
Based on AHA’s recommendation for women, that’s 200% DV for sugar. For children who are recommended to consume less than 12g of sugar a day, this is 400% DV!
How would consumer behavior change if THIS was printed on the label?
Eat Less Sugar…You’re Already Sweet Enough!
This doesn’t mean you can’t have some sweetener in your latte or some desserts in your life.
A little bit of added sugar, especially if you lead an active life and do not have diabetes, is okay now and again.
In my practice, I advise my patients to follow the 80/20 rule: 80% of meals should be ideal; 20% can be less than ideal. We’re all human here, let’s not get stuck on the perfection train.
But, for some, such as those with chronic conditions or blood sugar issues, I challenge them to remove ALL added sugars to allow for their health to improve.
Regardless, I challenge you to count your sugar intake at home.
As a reference, 1 teaspoon of sugar = 4.2 grams = 16 calories.
Be aware that many processed foods contain multiple forms of sweeteners, which makes it hard to really know just how much sugar the food contains.
We can simplify things by choosing to eat whole, unprocessed foods as much as possible and focusing on clean proteins, fats, and fiber (non-starchy vegetables, some healthy carbs like basmati rice or sweet potatoes, and 1-3 servings of fruit daily) as the foundation of our diets.
I also recommend looking for prepared foods and condiments that do not contain added sugar. Just be sure you’re not accidentally buying products that have swapped sugar for artificial sweeteners, which have been linked to all kinds of health issues, including blood sugar problems, cardiovascular events, weight-gain, obesity, and metabolic ailments.22
What About Natural Sweeteners and Low- or No-Calorie Sweeteners?
Following that 80/20 principle, if you’re going to use sweeteners we recommend going as natural as possible.
For non-diabetics, this means opting for:
- Coconut sugar
- Maple syrup
- Maple sugar
- Raw honey
- Date sugar, date syrup, or date puree
Most of these sugars can be substituted 1:1 for white sugar, although date sugar is much more datey so I recommend searching specific recipes.
The syrups can also be substituted for white sugar but typically require removing about 1/3 cup liquid. If a recipe doesn’t call for that much liquid, opt for a granulated sweetener instead.
Honey can also be used for baking but has a distinct flavor, so you have to play around with it. I prefer maple syrup in this case.
For diabetics or those looking for low- or no-calorie sweeteners, we generally recommend:
- 100% pure stevia
- Monkfruit, also known as Lakanto
- Xylitol
- Erythritol
Full disclosure, stevia can be difficult to bake with, so look for recipes specific to its use.
Monkfruit can also be tricky because it’s about 300 times sweeter than sugar.
Sugar alcohols may be substituted 1:1 but not always, so again, look for specific recipes.
Are these natural sweeteners and sugar alcohols perfectly healthy?
Apart from pure stevia, which not everyone likes, no, not really.
The natural sugars like coconut sugar, raw honey, maple syrup, etc. are still sugars and must be counted as such. The benefits of using these versus plain old table sugar are they are less refined and, in most cases, non-GMO.
Most people don’t realize the majority of the sugar we get today does not come from natural sugar cane. Rather, it is harvested from genetically modified sugar beets.
Which, in our opinion, makes it much more questionable than pure, organic, non-GMO cane sugar.
Insofar as the zero or low-calorie sweeteners go, 100% pure stevia is going to be the healthiest option of these.
However, since not everyone likes the flavor of pure stevia and it can be challenging to bake with, we are not opposed to using some monk fruit (which is usually mixed with erythritol), xylitol (just keep it away from pets as it’s toxic to dogs), and non-GMO erythritol.
How are stevia, xylitol, and erythritol different than artificial sweeteners like saccharine, sucralose, and aspartame?
This is such an important point to understand.
Pure stevia comes from the stevia leaf, which has been used as a natural sweetener for centuries.
It has quite a fascinating and controversial history and used to be available only in health food stores as a supplement. These days you can find it almost everywhere, either pure or combined with other low- or no-calorie sweeteners in liquid, granulated, or powdered form.
Xylitol and erythritol are sugar alcohols and are not the same as artificial sweeteners (which we do not recommend, ever).
The key difference is that sugar alcohols contain zero or very few calories and are not as sweet as sugar, whereas artificial sweeteners are chemicals engineered to be ultra-sweet with no calories.
Sugar alcohols may be made from plants, like birch sugar (xylitol) or corn, but many are made from artificial substances.
Xylitol has also been shown beneficial for dental health and preventing ear infections.23
The main downsides to using sugar alcohols are they can cause digestive upset, like gas or bloating, and excess use has been linked to weight gain.
A recent study also suggested a link between high erythritol consumption and cardiovascular events.24
However, more research is needed to draw conclusions—like what other lifestyle factors might have been involved that led to such high consumption?
Research has also shown that consuming a large amount (6 packets a day) of artificial sweeteners or stevia, but especially saccharin and sucralose, can cause significant changes in the gut and oral microbiome.
The study also showed the artificial sweetener group had higher blood sugar levels than those who ate real sugar, suggesting these types of sweeteners may lead to glucose intolerance.25
I personally don’t think it’s fair they lumped natural stevia (which is not an artificial sweetener) in with other artificial sweeteners, but regardless, it suggests there is no free ride when it comes to sweeteners.
Bottom line, use sweeteners sparingly but don’t try to completely deprive yourself either!
Unless you’re going sugar-free for health reasons, this type of strategy typically winds up backfiring, and you’ll end up binging on sweets.
Rather, aim to keep your sugar and sweet consumption low, and when you do indulge, look for sweets that contain these natural sweeteners versus GMO sugar or artificial sweeteners.
If you’re looking for recipes, I typically search “paleo desserts” or “nutrient-dense desserts,” which always yield hundreds of naturally sweetened options.
You can also check out these recipes for:
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Need Help Navigating Sugar Cravings?
It can be tough to break up with sugar or reduce sugar intake on your own. We get it.
In our practice, we work with almost every patient on blood sugar balance and often recommend tools like a continuous glucose meter (CGM) to help our patients monitor their blood glucose levels and get real-time feedback.
We’ve found approaches like this to be extremely helpful in empowering people to create a healthy relationship with food and sweets without feeling deprived or put upon.
Need some help on your healing journey?
If you’re in my tri-state area (Colorado, Michigan, or Texas) my team and I would love to hear from you.
For everyone else, I’d love to stay connected via Instagram or through our monthly newsletter.
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- https://pubmed.ncbi.nlm.nih.gov/17668074/
- https://pubmed.ncbi.nlm.nih.gov/30945139/
- http://epi.grants.cancer.gov/diet/usualintakes/pop/2007-10/table_a40.html
- https://link.springer.com/referenceworkentry/10.1007/978-0-387-33754-8_112
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9471313/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8643565/
- https://www.cdc.gov/pcd/issues/2021/20_0574.htm
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198281/
- https://pubmed.ncbi.nlm.nih.gov/26376619/
- https://pubmed.ncbi.nlm.nih.gov/29428599/
- https://pubmed.ncbi.nlm.nih.gov/30945139/
- https://pubmed.ncbi.nlm.nih.gov/17668074/
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- https://www.nature.com/articles/s41387-020-0121-x
- https://pubmed.ncbi.nlm.nih.gov/17668074/
- http://circ.ahajournals.org/content/120/11/1011.full
- http://www.who.int/nutrition/publications/guidelines/sugars_intake/en/
- https://www.cmaj.ca/content/189/28/E929
- https://www.cochrane.org/news/featured-review-xylitol-sugar-supplement-preventing-middle-ear-infection-children
- https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events
- https://www.utmb.edu/mdnews/podcast/episode/our-microbiome-on-artificial-sweeteners#:~:text=People%20who%20ate%20the%20artificial,may%20lead%20to%20glucose%20intolerance