But in recent years, the health dangers of the refined sugars — pure sucrose and fructose — have become clear. Eating sugar-sweetened foods, and beverages such as soda, dramatically increases risks for diabetes, cardiovascular disease, and dementia.
Non-nutritive sweeteners such as saccharine, aspartame, sucralose, and stevia are safer than sucrose and fructose for people with diabetes, but concerns have been raised about possible longer-term effects on metabolism (Kan 2024) and gut microbes (Payne 2012; Wang 2022). Artificial sweeteners are not very good for baking, either.
If we want to be healthy, are we just doomed to not eat sweet things?
Although refined sugar has been around for several centuries, it was expensive and only really available to the wealthy. It wasn't until technological advancements in the late 1800s that refined sugar became widely available. What were people sweetening their food with before then? Might these more traditional, non- (or only slightly) refined sweeteners be better choices to sweeten food than refined sugar and non-nutritive sweeteners?
Historically, foods were sweetened with fruit, such as dates, as well as honey and "molasses," which is just a name for a thick syrup. Popular kinds of molasses/syrups include "molasses," the brown kind made from the remains of beet and cane processing for refined sugar; agave (made from a kind of cactus); and carob. Carob is also used as a powder.
Honey
Honey is a truly ancient sweetener. For instance, cave paintings estimated to be eight thousand years old show people foraging for honey, and many written texts from Egypt to Sumeria, Assyria, and Babylonia refer to culinary uses of honey. In Exodus of the Judeo-Christian Bible, Palestine is referred to as "the land of milk and honey" (and which seemed to be a good thing).
Honey is made by honey bees from nectar they collect from flowers or "honeydew" from trees. Differences in the flavor and nutritional content of the honey depend on the kinds of flowers the bees visit (Alzahrani 2012). In addition to sugar, honey contains bioavailable (meaning gets absorbed) antioxidant substances and minerals (Ranneh 2021; Palma-Morales 2023; Brudzynski 2023). This by itself suggests that honey could be better than refined sugar for sweetening.
So, is honey better than sugar for sweetening food?
For cardiometabolic disease, the answer is a bit murky. The research has not been well standardized, meaning that results vary according to the quality of the honey and whether it was raw or sterilized. Honey does seem to be better than sucrose vis-à-vis cardiovascular measures (Palma-Morales 2023). For obesity and diabetes the results are mixed, but hard to interpret because of the inconsistencies in methodology. There is some evidence that honey can improve oral cancer chemotherapy mucositis, as well as cough and other symptoms associated with upper respiratory infections in infants. Taken together, the evidence (cautiously) supports replacing sucrose with honey as a sweetener (Palma-Morales 2023). More, better research needs to be done.
One possible complication for assessing health benefits of honey in foods is that it can have both pro-oxidant/antimicrobial or antioxidant/tissue protective actions (Brudzynski 2023). These are opposite functions and occur at different levels of acidity and content of minerals in the honey. Honey with more minerals is more likely to be pro-oxidant/antimicrobial than honey with fewer minerals (Brudzynski 2023). Antioxidant action of honey happens when the honey is more acidic. While this opposition can complicate interpreting research when these factors haven't been standardized, on the upside, it could also help predict which honeys might be beneficial to ingest (higher acid, more antioxidant) compared to those best for wound-healing salves (lower acid, pro-oxidant and antimicrobial, but maybe with unpredictable activity on gut microbes).
Evidence for honey as a topical salve is clear. Honey does have anti-microbial actions due to hydrogen peroxide production by the honey bee enzymes. Hydrogen peroxide is also formed by "autooxidation" of polyphenols (Brudzynski 2023). This is the rationale for honey use in wound healing. The darkness of honey color is an indicator for anti-microbial capability (Brudzynski 2023). All honeys have this capability, but darker honeys have more.
How do you substitute honey for refined sugar in recipes? Use two-thirds to ¾ cup honey for each cup of sugar because honey is sweeter (more fructose). How much in between those values will depend on personal preference for sweetness, as well as taste characteristics of individual honeys.
Also, because honey is a thick liquid and refined sugar is a crystal solid, in order to maintain proper consistency of a baked good, you need to reduce the amount of liquid in the recipe. When substituting ¾ cup honey for 1 cup sugar, reduce the liquid by 3 tablespoons.
Finally, because honey has more fructose than sugar, it browns faster. It is recommended to reduce baking temperature by 25 degrees F (https://norcalnectar.com/blog/honey-sugar-conversion-chart).
It's worth a reminder: raw honey should not be given to babies ("no honey for your honey," as they say) because low levels of botulism spores can occur in raw honey. In general, sourcing of honey is important (Al Walli 2021) because honey from improper bee-keeping can be contaminated with antibiotics and pesticides. And some commercial cheap brands of honey are not actually honey (!!).
Stronger flavored sweeteners: Maple syrup and sugar cane molasses
Maple syrup and molasses are made by boiling syrup collected from maple trees or juice collected from crushed sugar cane or beets.
I got to see maple syrup being made some years ago when I attended the Maple Festival in Highland County, Virginia, held in late February and early March. It was interesting — they tapped the trees and the sap that came out was carried by tubes top central vat where it was boiled until thick. And that was pretty much it! Nutritional analyses have found that maple syrup, like honey, contains (in addition to sucrose) vitamins, minerals, amino acids, and polyphenols (Mohammed 2023).
Molasses is made now principally as a by-product of refined sugar production. In the United States, cane juice is boiled until sugar starts to crystallize, the crystals are collected, and what's left is "cane syrup." To make molasses, it is boiled again, with sugar crystals collected, and what is left is thicker, darker, and contains amino acids, minerals, and polyphenols from the canes. When boiled again, it becomes "blackstrap" molasses, the least sweet but most nutritious of the molasses. Blackstrap molasses is mostly used for animal feed to boost nutrition and "improve palatability." Molasses supports microbes that make butyrate (Detman 2021), and studies have found that supplementing feed with molasses can protect the guts of cattle from stress (Silva 2023). All the studies I found of molasses were done with animals, so I don't know whether this is true for people.
Fun facts: according to Wikipedia (https://en.wikipedia.org/wiki/Molasses), prior to the 20th century (when crystalline sucrose became widely available), molasses was a very popular sweetener in the United States, and George Washington used it to make beer. It is still used now to make rum, and added to sugar to make "brown sugar." I use it to make figgy pudding, and in brines to roast turkey and smoke fish.
If you want to substitute molasses or maple syrup for sugar, they are each about as sweet as table sugar, so you can use the same amount of these as you would do with sugar (https://www.kingarthurbaking.com/blog/2017/08/18/baking-with-liquid-sweeteners). But because they are liquids, you have to reduce the volume by 3–4 tablespoons per 1 cup substitution. If the recipe doesn't call for liquids, you can add 1 tablespoon of additional flour per ¼ cup of maple syrup.
Carob
Carob is a member of the legume family that is naturally sweet, with a flavor described as "nutty." It grows in Mediterranean regions and has been used as a sweetener there since ancient times (Ikram 2023). Its pulpy inside is naturally sweet. It is usually as a powder, like cocoa, but can also be made into a molasses. The seeds/beans are not as sweet as the pulp but have a fair amount of protein (Gioxari 2022). The proteins do include gliadin and glutenins, so probably carob seeds should be avoided by people with celiac disease. There's more about carob in Journal Club.
Agave syrup
Agave syrup has become popular recently because it is very sweet but has a lower glycemic index (it is absorbed more slowly) than sucrose. This suggests it might be a little safer for people with metabolic disease. It is a syrup refined from the agave tequiliana or agave salmiana plant that is very high in fructose (Velasquez-Rios 2019), hence the super-sweet taste and low glycemic index (fructose is absorbed into the body slower than glucose). But unlike pure fructose syrup, agave contains antioxidants and polyphenols that may have anti-inflammatory capability (Velasquez-Rios 2019; Saraiva 2022). Like honey, one way of guessing which syrups have the most antioxidants (etc.) compared to just sugars is to look at the color. Like honey, darker syrups have higher antioxidants etc. (Saraiva 2022).
Agave is similar to honey in that it is sweeter than sugar and browns faster, but it is usually more liquid. You can use ⅔ cup of agave for every 1 cup sugar, and reduce the liquid by ¼ to ⅓ cup. Like honey, the oven temperature should be reduced by 25 degrees F to prevent overbrowning.
These traditional sweeteners all contain nutritious substances including vitamins and minerals, unlike refined sugar, which only confers "empty calories." To my taste, they also have much more interesting flavors, which make them more attractive as sweeteners than the pure sweet sucrose and non-nutritive sweeteners.
As always, though — moderation in all things! Although traditional sweeteners do have nutritional value, they still have sugars. And too much sugar still is risky.