Natural Sweeteners: Honey, Maple Syrup, Agave, Stevia and Monk Fruit Checked
Honey, maple syrup, agave, molasses, stevia and monk fruit checked against health agency definitions and human research, with the infant honey warning and evidence gaps.
Content last updated . This page has not been medically reviewed.
Safety first. Natural products can cause side effects and interact with medicines. Read natural ingredient safety before you use anything on this page.
Never give honey to a baby younger than 12 months. NHS says honey can contain the bacteria that causes botulism, and MedlinePlus says infant botulism happens when a baby consumes spores from soil or honey. [1][2]
Quick answer
Sweeteners sold as "natural" fall into two groups. Honey, maple syrup, agave syrup and molasses are sugars. Stevia and monk fruit extracts are high-intensity sweeteners with little or no sugar content. Health agencies treat these groups differently, and for most of these products the sources we read show limited human research, not proof of health benefit.
Sugar-type sweeteners count as sugar
The World Health Organization (WHO) defines "free sugars" to include sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, and recommends adults and children reduce free sugar to less than 10% of total energy. [3] In the US, FDA counts sugars from syrups and honey as added sugars on the Nutrition Facts label. [4] The Dietary Guidelines for Americans recommend limiting calories from added sugars to less than 10 percent of total calories per day. [4] NHS advises avoiding food and drink with sweeteners or sugar for children aged 4 years or younger, and says that includes the natural sugar in honey, syrup, fruit juice and smoothies. [5]What research shows, sweetener by sweetener
Studies of one product do not transfer to another, and the plant or food in each row is what was studied.| Sweetener | What the source found | Strength of evidence |
|---|---|---|
| Honey (see Honey) | An umbrella review pooled 69 randomized trials with 3544 participants. It found that 10 g of honey daily may lower hemoglobin A1C but adversely affect systolic blood pressure, aspartate transferase, triglycerides and fasting blood glucose. The authors say long-term or high-dose honey in people with health concerns warrants caution. [6] | Mixed |
| Maple syrup | One randomized crossover trial in 42 overweight adults with mild cardiometabolic alterations replaced 5% of calories from added sugars with maple syrup or a flavored sucrose syrup for 8 weeks. Glucose area under the curve fell with maple syrup compared with sucrose syrup. Blood lipids did not change. [7] | Promising but limited (one small, short trial) |
| Agave syrup (a food made from agave plant sap) | A 2022 review says further research on effects on human metabolism is needed to back its health claims as a natural sugar substitute. [8] Proper evidence not found: human trials of agave syrup. We searched PubMed for agave syrup and agave nectar in humans and found food-science, animal and review papers, not a human outcome trial. | Insufficient evidence |
| Molasses | In a laboratory assay of retail products, dark and blackstrap molasses had the highest antioxidant capacity of 12 sweeteners, while agave nectar had minimal activity and maple syrup and honey were intermediate. [9] Proper evidence not found: human health outcomes for molasses. We searched PubMed for blackstrap molasses and molasses in humans and found no usable trial. | Laboratory measurement only |
| Stevia (Stevia rebaudiana (Bertoni) Bertoni, leaf extracts) | A 2024 meta-analysis of 26 studies with 1439 participants found stevia was associated with lower blood glucose, but did not significantly affect insulin or HbA1c. [10] The authors rate this low-certainty evidence. [10] | Promising but limited, low certainty |
| Monk fruit (Siraitia grosvenorii, fruit extract) | Little human evidence. A 2025 systematic review found 5 randomized trials, which reported lower blood sugar (10 to 18%) and insulin (12 to 22%) responses after meals and no severe side effects; we read only its abstract, and its authors call for long-term trials. [14] We found no long-term trials of health outcomes. | Insufficient evidence |
The molasses and agave laboratory assay measured antioxidant capacity in a test tube. It does not show a benefit to people. [9]
Not covered here
Sugar alcohols, artificial sweeteners, coconut sugar and date sugar are not covered. For labels, see Reading Food Labels. For juice and whole fruit, see Fruit Juice vs Whole Fruit.Frequently asked questions
Is maple syrup healthier than sugar?
One small 8-week trial found better glucose results when maple syrup replaced sucrose syrup in adults with mild cardiometabolic alterations. That is promising but limited, and health agencies still count syrups as added sugars. [7][4]
Is honey better for blood sugar than sugar?
An umbrella review of 69 trials found mixed results, with lower HbA1c but adverse effects on several other markers at 10 g daily. [6] People managing diabetes should ask their clinician.
Is agave a good choice for people with diabetes?
Proper evidence not found. A 2022 review says more research on human metabolism is needed. [8] Ask a clinician or dietitian.
Are stevia and monk fruit safe?
FDA has not questioned GRAS determinations for certain highly purified stevia glycosides and monk fruit extracts, but whole-leaf and crude stevia extracts are not permitted as sweeteners. [11]
Can babies have honey?
No, not before 12 months, because of infant botulism. [1]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Regulatory status of stevia and monk fruit
FDA's page on high-intensity sweeteners says they generally will not raise blood sugar levels. [11] For certain highly purified steviol glycosides from stevia leaves and for extracts of monk fruit (Siraitia grosvenorii Swingle), FDA has not questioned the notifiers' GRAS (generally recognized as safe) determinations under the intended conditions of use. [11] Whole-leaf and crude stevia extracts are subject to an Import Alert and are not permitted for use as sweeteners. [11] FDA says an acceptable daily intake has not been specified for monk fruit. [11] That page is dated 2017, so check current FDA information.
In 2023, WHO issued a conditional recommendation against using non-sugar sweeteners, which include stevia and its derivatives, to control body weight or reduce the risk of noncommunicable diseases. [12] It does not apply to people with pre-existing diabetes. [12]
Safety and who should ask a clinician
- Babies and young children: no honey under 12 months, as above. [1] See Honey and Infant Botulism.
- Diabetes or blood sugar medicines: the sources we read do not give advice on using these sweeteners with diabetes medicines. Ask a clinician or dietitian. See Natural Ingredients for Blood Sugar and Weight Claims.
- Allergy: honey is a bee product; see Bee Product Allergy. GBIF places Stevia rebaudiana in the daisy family (Asteraceae). [13] Allergic reactions to stevia sweeteners are not described in the sources we read.
- Pregnancy, breastfeeding and medicine interactions: not described for these sweeteners in the sources we read. Ask a pharmacist or clinician.
References
- NHS (UK). Botulism. Read 2026-10-23.
- MedlinePlus, U.S. National Library of Medicine. Botulism. Read 2026-10-23.
- World Health Organization (WHO). WHO calls on countries to reduce sugars intake among adults and children, 2015. Read 2026-10-23.
- U.S. Food and Drug Administration (FDA). Added Sugars on the Nutrition Facts Label. Read 2026-10-23.
- NHS (UK). Foods to avoid giving babies and young children. Read 2026-10-23.
- Dosage exploration of the effects of honey and its derivatives on cardiometabolic outcomes: an overview of systematic reviews and GRADE-assessed updated meta-analysis. Nutrition & Diabetes, 2025, PubMed 41261111. Read 2026-10-23.
- Substituting refined sugars with maple syrup decreases key cardiometabolic risk factors in individuals with mild metabolic alterations: a randomized, double-blind, controlled crossover trial. Journal of Nutrition, 2024, PubMed 39163971. Read 2026-10-23.
- Agave syrup: chemical analysis and nutritional profile, applications in the food industry and health impacts. International Journal of Environmental Research and Public Health, 2022, PubMed 35742286. Review. Read 2026-10-23.
- Total antioxidant content of alternatives to refined sugar. Journal of the American Dietetic Association, 2009, PubMed 19103324. Laboratory assay of retail products. Read 2026-10-23.
- Effect of stevia on blood glucose and HbA1C: a meta-analysis. Diabetes & Metabolic Syndrome, 2024, PubMed 39098209. Read 2026-10-23.
- U.S. Food and Drug Administration (FDA). High-Intensity Sweeteners. Page content dated 2017. Read 2026-10-23.
- World Health Organization (WHO). WHO advises not to use non-sugar sweeteners for weight control in newly released guideline, 2023. Read 2026-10-23.
- Global Biodiversity Information Facility (GBIF). Stevia rebaudiana (Bertoni) Bertoni, backbone taxonomy record. Read 2026-10-23.
- Kaim U, Labus K. Monk Fruit Extract and Sustainable Health: A PRISMA-Guided Systematic Review of Randomized Controlled Trials. Nutrients, 2025. PMID 40362742 (abstract via Europe PMC). Read 2026-10-24.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.