The world of sweeteners can be confusing, as there are many choices.

Making the wrong choice can lead to type 2 diabetes and weight gain, or diarrhea and high blood sugars. But making the right choice can mean enjoying cheesecake or cookies without health problems or weight gain.

Here, I review the 5 natural sweeteners that we use on the Wheat Belly (and now Undoctored) lifestyles.


This is the Wheat Belly guide to the use of natural sweeteners. Why even get into the world of natural sweeteners? Some people will ask why we do this at all.

Well, a number of years ago I learned this lesson the hard way. I asked patients to eat very cleanly. They’d eat only meats, fish, poultry, and healthy oils like coconut and olive oil, and vegetables, and nuts. But then holidays would roll around, like Thanksgiving or Christmas, or a birthday party, or a family get-together. They’d come back 12, 14, 15 pounds heavier — and be metabolic disasters, because they indulged, say, in pumpkin pie at Thanksgiving, or a slice of birthday cake at someone’s birthday, their son or grandson or granddaughter’s birthday.

They’d also have all the phenomena of re-exposure to grains as well. But they’d be metabolic disasters. Small LDL particles that cause heart disease would skyrocket. Their triglycerides go way up. Their blood sugars would go back up. Blood pressures would go back up. They’d regain weight, of course, all in visceral fat. So every holiday for many people was accompanied by this explosion in backtracking on progress that they’ve made on this lifestyle.

So I learned that I had to provide healthy or benign alternatives. I started developing recipes, and sharing them with my patients (this is in my practice years ago). And they’d come back after holidays, having made, say, a safe pumpkin pie, or having a safe birthday cake, or having a wonderful big piece of cheesecake, with nothing bad, nothing given up — no increase in weight, no explosion in blood sugar, or small LDL particles, no rise in triglycerides. In other words, they enjoyed their holidays, their family get-togethers, their entertaining events, with no health downside. So that’s why I added these natural sweeteners.

NO sucrose, high-fructose corn syrup, agave, coconut sugar, brown sugar, cane syrup, etc.

Now, let’s be clear there are some sweeteners we do not use: of course no sugar, no fructose-containing sweeteners like agave nectar (which is horrible), high fructose corn syrup of course.

NO sorbitol, mannitol and maltitol, lactitol

We also don’t use many of the sugar alcohols like sorbitol, mannitol and maltitol, because in addition to causing extravagant gastrointestinal distress, like gas, bloating and diarrhea, they also raise blood sugar — they act just like sugar. So they’re really no better. It’s just another form of sugar, in effect. So there’s just a handful of sweeteners we choose.

NO aspartame, sucralose and saccharine

We also avoid the synthetic sweeteners like aspartame, sucralose and saccharine, because those have recently been shown to cause extravagant changes in bowel flora composition. It pushes your bowel flora composition towards that of diabetics. In other words, it cultivates Type 2 diabetes, and weight gain. So all those soft drinks and sugar-free foods made with those three synthetic sweeteners are no better than sugar, in many cases worse, because of their effects on bowel flora.

So we’re left with five natural sweeteners that so far have proven very benign. You don’t see weight gain. You don’t see a rise in insulin. You don’t see a rise in blood sugar, if used in the appropriate quantities. There are a couple that will raise blood sugar a little bit, if you use a lot of them. We’ll talk about that.

1. Monk fruit (lo han guo)

My first choice is monk fruit, a natural derivative of the monk fruit plant, grown in Southeast Asia. It’s very benign, has a very clean taste, tends not to have that bitter aftertaste. The downside is that it’s so highly concentrated that most companies don’t sell it as pure monk fruit. You can buy it that way, but you have to use almost minuscule amounts. It’s a little tricky to use because so little is required to match the sweetness of sugar.

Most products therefore are combinations of monk fruit with some other sweeteners. Now be careful what they mix them with. If it’s mixed with maltodextrin you don’t want to buy that, because that’s sugar. If it’s mixed with erythritol (one of our other five benign sweeteners), that’s okay. So watch out what it’s mixed with: so, pure monk fruit, or monk fruit mixed with another benign sweetener.

2. Stevia

Stevia, another excellent sweetener: the downside is that about half the people who use it get this bitter aftertaste. So it’s usually better using it as one of the components in a mixture of sweeteners. I’ll combine, for instance, monk fruit and stevia, or stevia and inulin, or stevia and erythritol; very useful combinations that reduce the bitter aftertaste.

Stevia is natural. It has not been associated with a rise in insulin, certainly not blood sugar, nor weight gain. Some people prefer some of the variations on stevia like stevia glycerite, or rebiana (which is an isolate, a fraction of stevia). Some people believe that has less aftertaste for them.

3. Inulin (fructooligosaccharides, FOS)

You may remember inulin as a prebiotic fiber, that comes from root vegetables. It’s not the best sweetener, because it’s kind of weak. It only has about 60 – 70% of the sweetness of sugar, but it has a wonderful prebiotic fiber effect. Downside: only use modest quantities. It is best to not use more than a teaspoon for any one serving, or you might get excessive bloating or gas or diarrhea, certainly in the beginning, when you haven’t gotten full control your bowel flora. Use it as a secondary or tertiary sweetener after other sweeteners, when you make your sweetener combinations.

4. Erythritol

Erythritol is a sugar alcohol, but it’s the most benign sugar alcohol. When used in the modest quantities we use in our recipes, for instance, it almost never causes diarrhea, bloating, gas. It does in some people, in which case you may be exceptionally sensitive. But most people do not have that. It’s very clean tasting; sweetness only about 70% of sugar, though. So if a recipe calls for, say, 1 tablespoon of sugar, you’ll have to use about 1⅓ tablespoons of erythritol to match that quantity of sweetness. Erythritol is a natural sugar found in small quantities in fruits like apples and pears, so it’s a very benign sweetener.

5. Xylitol

Xylitol is another natural sweetener. It’s my least favorite. It is a sugar alcohol also, and you can have the effects of sugar alcohol: gastrointestinal distress, etc. if you use a lot of it; generally not, if you use a small amount of it. But I put on the list because it’s the best at recreating some of the unique properties of sugar, such as glazing, or sauces, or jams — better in recreating some of the viscosity and glaze effects of sugar. So I use it last. If making a recipe that calls for a glaze, for instance, use your other benign sweeteners to sweeten the filling, the pie filling say, but use the xylitol just for the glaze.

Xylitol is toxic to dogs. Don’t let your dog get ahold of any dish you make with xylitol. Use it as your last choice in sweeteners, because it can act somewhat like sugar; maybe a third to a half as much of a rise in blood sugar compared to an equal quantity of sugar.

Well there you have it. Use these five sweeteners alone or in combination. Play with them. Get familiar with how they work. People sometimes ask, I should mention, then what is the conversion? Well, a lot of these sweeteners don’t have a fixed conversion, especially stevia, because each preparation is different. So start by looking at the package of the product you buy. If it says something like ⅛ teaspoon of our stevia equals a tablespoon of sugar that’ll give you starting point. But recognize that all the products are different, with the exception of xylitol which is a 1:1 conversion to sugar, and erythritol, which is about 70% (so about 1.3 times as much erythritol required as sugar).

Beyond that, refers a package and get familiar with either your own mixture you come up with, or the mixture you purchased — the fixed combination of various sweeteners. Get used to that combination. Be comfortable with it, and you’ll find that you can create some wonderful recipes. And, always taste your mix or batter and adjust the sweetness.

Recall that in the Wheat Belly lifestyle, your perception sweetness will undergo a change over time. You’ll become more and more sensitive to sweetness, so that means needing less, and less, and less. Maybe first time you make a recipe, you need ½ cup of your sweeteners and then three months later you only need ¼ cup. So be aware that your taste will change. But be assured that these sweeteners we’ve been using the last several years and have not encountered any significant problems at all.