Fatty Liver Sugar Alternatives: Best Sweetener for NAFLD / MASLD

If you have a fatty liver, you hopefully know already that you shouldn’t eat any refined sugar aka white sugar.

Today, we’re focusing on the best sweetener to consume instead of sugar.

I know just how difficult it is to give up on sugar (for me, it was more difficult than giving up alcohol). But it has to be done and with these alternatives, we can still satisfy that sweet tooth.

We have talked about the amount of added sugars one should consume per day, and now it’s time to look at the most popular alternatives: Stevia, Honey, Maple Syrup or Brown Sugar.

I will also have other sweetener recommendations at the end, so make sure to read the entire article.

Please note: This is not an article talking about diabetes-induced fatty liver disease. If you also have diabetes, make sure that you consult a doctor before making any choice!

Fatty liver sugar alternative: Honey

fresh honey

This is probably the most recommended sweetener for fatty liver disease and everybody loves it. It is sweet, tastes good and is natural.

But even though it is indeed a lot healthier than white sugar, it still packs a huge punch in terms of carbohydrates (which basically become sugar in your body), so consume in moderation.

For example, 100 grams of sugar have 100 grams of carbs, while 100 grams of honey “only” have 82 grams of carbs. That’s still a lot!

However, raw numbers are not everything that matters here. The sugar in honey is absorbed slower than white sugar is, so it doesn’t have the same impact on the Glicemic Index, while also helping us feel full for a bit longer.

In other words, it’s not a bomb that explodes instantly. Instead, it drips slower into your blood stream, causing less damage.

Also, honey is considered sweeter than sugar. This means that half a teaspoon of honey tastes just as sweet as a full teaspoon of sugar would.

These are just estimates, but good to know that you can still achieve the same amount of sweetness by using a lower quantity (which already has fewer carbs!)

All in all, experts agree that honey is indeed a healthier alternative to sugar if you’re suffering from a fatty liver as it instantly allows you to cut the amount of carbs you consume.

Plus, honey also has other nutrients, while white sugar is 100% carbs.

However, there is one EXTREMELY IMPORTANT thing to know about honey: it becomes toxic if you heat it up too much. There are even studies on the matter, so don’t use it for cooking.

If you opt to switch from refined sugar to honey (this is what I personally did), try to have some other things in mind in order to make sure that you get all the possible benefits from it:

– use less honey than sugar and always work on reducing the amount.

For example, when I switched, I started adding half a teaspoon of honey to my coffee (as opposed to one full teaspoon of sugar), then reduced it until today when I only add just a bit, maybe a quarter of a teaspoon, if not less.

– use raw honey or organic honey or at least try to get it from trustworthy sources. It appears that much of the honey in stores is actually fake and made with sugar, and that’s exactly what you don’t need.

If you are looking for some recommendations in terms of what honey to buy, I have those for you as well, available on Amazon:

  • My all time favorite, Nature Nate’s honey (affiliate link), which is raw and unfiltered honey that comes in a great package that makes it easy to use and has a great taste
  • Or YS Organic Bee Farms (affiliate link) – which is also raw, unfiltered and unpasteurized.

If you don’t want to buy the recommended products, always try to look out for raw honey (since that’s not processed at all) and get it from a trustworthy brand or seller.

Fatty liver sugar alternative: Maple Syrup

bottle of maple syrup

In my opinion, Maple Syrup is a bit better than Honey because of two main reasons: it has even fewer sugars/carbs than honey and it is considered heat stable by everybody.

In terms of sugar, 100 grams of Maple Syrup have 67 grams of carbs while the same amount of white sugar has 100.

This means that Maple Syrup has a lot less carbs than sugar, but also less than honey.

This makes it a better choice, since we should always look at ways to keep the numbers as low as possible.

It also has all the other good minerals and antioxidants that you might want – but you can check out the complete nutritional values if you want to.

So Maple Syrup is indeed a healthier alternative than White Sugar (and in my opinion, considering carbs alone, better than honey).

Make sure you use Grade B, darker Maple Syrup as it has more antioxidants and a sweeter, stronger taste.

The only problem here is that it’s usually more expensive than honey and not everybody loves the taste – or the fact that it does leave an aftertaste in coffee for example, as opposed to honey which doesn’t.

Also, the same rules that go with honey apply here as well: make sure that you buy it from a trustworthy source in order to buy the real deal and not something processed and made with sugar.

Finally, make sure that you use as little of it as possible and reduce its usage to a minimum if you get it as your preferred alternative to sugar.

I personally would switch to it instead of honey, but I live in a country in Europe where it’s difficult to find and very, very expensive so I just use it sparingly and go for honey or Stevia or other sweeteners recommended in this article.

If you need some recommendations or opinions on which are the best ones to get, I would always go for organic Canadian-made Maple Syrup, just to keep it as healthy as possible for our liver (Amazon links below):

Fatty liver sugar alternative: Stevia

Stevia Rebaudiana plant leaves
Stevia Rebaudiana plant leaves

This is considered a miracle sweetener and it does sound impressive when you read about it!

Said to be 200 times sweeter than white sugar and containing ZERO calories and ZERO carbs, now that’s something that sounds too good to be true!

But it is true and it seems that Stevia indeed can be considered the best sweetener for fatty liver.

It’s true, some people complain that it leaves a slightly metallic aftertaste, but that’s something you can deal with (and not everybody feels that – for example, I don’t really get that metallic aftertaste).

The only potential problem with Stevia is that there are not a lot of studies around it. A more recent one caused a bit of controversy, but I still use this sweetener. You can read more in-depth about Stevia here.

There are many questions regarding potential health problems it can cause if used in large quantities or for a long time, but right now there is no actual, factual proof (that I know of) suggesting that Stevia might be unhealthy.

Have in mind that since Stevia is so incredibly sweet, you need to adapt all quantities when cooking or using it.

It might also be problematic with some recipes that use sugar since sugar also gives volume (basically, for 200 grams of sugar, you will only use 1 gram of Stevia).

Still, you can win that volume back by adding extra low-fat yogurt or whipped egg whites. There’s a solution to anything!

When purchasing Stevia, make sure that’s what you are getting. Many brands mix it with other artificial sweeteners (to make it less sweet), but that would be less healthy and not an option since artificial sweeteners are considered even more dangerous than white sugar.

The only artificial sweeteners that are considered safer are the so called alcohol sugars (which don’t have any actual alcohol in them, despite the name) such as Erythritol or Maltitol.

So always read the list of ingredients on your Stevia products and make sure that you get the real deal or something you’re happy with, all things considered.

Below is my go-to Stevia brand you can get from Amazon, followed by an alternative:

Fatty liver sugar alternative: Brown Sugar

This is the easiest to find and it was my first choice after being diagnosed with a fatty liver disease – back when I didn’t know as much as I do today about sugars and carbohydrates.

Many still recommend brown sugar as a healthier white sugar alternative, but the truth is that the differences between the two are minimal. 100 grams Brown Sugar have 98 grams of carbs, while White Sugar has 100.

Here are the complete nutritional values, if you want to check them out and compare, according to Wikipedia.

So no, the difference is too small to actually consider Brown Sugar as a healthier alternative to white sugar or a safer sweetener for fatty liver.

It is a bit less processed, but there are way better options out there, so I would personally not recommend it.

Use honey, use maple syrup or Stevia instead if you really want to make a difference and stay away from both white sugar, as well as brown sugar (or raw sugar or whatever it is called).

Other sweeteners I use and recommend

Apart from the sweeteners that I have recommended above, other are considered good alternatives by the experts.

I am talking about erythritol, maltitol, sorbitol or xylitol. These, despite the name, don’t have any actual alcohol in them and usually come as low-calorie or no calorie sweeteners.

I am using them – especially when it comes to store-bought items, but when at home I always use either Stevia or honey instead. But it’s good to know that you have options.

If you want to learn more about sugar alcohols, I have published this blog talking about erythritol and fatty liver disease.


Sugar is bad when you suffer from a fatty liver and you should eat as little as possible, no matter if we’re talking about white sugar, honey, maple syrup or other alternatives.

Carbs are bad because our body turns them into fat – but unfortunately we can’t completely eliminate them from our diet (and we should not!).

A varied diet is the secret here and I personally believe that the best possible choice would be to mix all the alternatives and use them based on the situation: so have some Maple Syrup, Honey and Stevia around and use the latter for baking, and alternate honey and maple syrup based on what you’re trying to sweeten.

If you have no problems with Stevia and its aftertaste (try it out first as not all people feel that aftertaste), then it could be considered the best option of them all, as it has 0 carbs and sugars.

But if you want to play as safe as possible with something natural, Maple Syrup comes first and Honey second in my personal chart.

Since these two have different antioxidants and other goodies, it’s probably best to mix them, as I said: use Maple Syrup once, use Honey the next time and so on. A varied diet is what you need and you have some healthier options to achieve that!

And if you’re still looking for that diet, make sure to check out my recommended one, the one that helped me reverse my fatty liver!

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25 thoughts on “Fatty Liver Sugar Alternatives: Best Sweetener for NAFLD / MASLD”

  1. I’m sorry, but your section on brown sugar is not only misleading, it is factually incorrect. Brown sugar (products sold in stores under the label “brown sugar”) is NOT the same thing as raw sugar or the brand name “Sugar in the Raw”. While those products do have a brownish color, products sold under the name “brown sugar” are nothing more than white refined sugar with molasses added for color and flavor. It is every bit as unhealthy as regular white table sugar, because that’s what it is with added molasses.

    • Unfortunately, there are many countries in the world and it is impossible for me to know how each company chooses to call sugars (and do so trying to mislead people into thinking that they are eating something else). The only way to be 100% sure that you are indeed buying what you are hoping you are is by reading the list of ingredients.

      Regarding what I have said, Brown sugar is in my country and the countries that I have visited different than white sugar with added molasses… but in the end they are so similar that it’s best to choose one of the other alternatives 🙂

  2. This was a great post.

    About the previous comment, if a product is labeled brown sugar while it is white sugar with added molasses, it can be misleading. Buyers expect raw sugar when they see brown sugar. But this aside I think that the main ingredients of raw and brown sugar are molasses and sugar anyways. The amount of other ingredients it raw sugar doesn’t seem to be material. Though I read somewhere that it has chromium which is a necessary element.

  3. Speaking of molasses, what is it’s impact to a fatty liver. Being a derivative of sugar but having more nutrition, I was wondering if it can be considered. I use it in coffee, cocoa, beans and certain teas because a little goes a long way in flavor.

    • Pure molases could be considered an alternative. As always, keep the quantities as low as possible when using it or any other sugar substitute.

  4. Seeing a lot of cane sugar listed as an ingredient in drinks. Where does that fall in the danger zone? I was just diagnosed with fatty liver after a lifetime of living on Dr. Pepper. I am using iced tea with Stevia as a replacement, along with more water, but am curious about some of the “healthy” brands like Odwalla where I see cane sugar listed. Is this the enemy as well?

    • Unfortunately, there is almost no difference between cane sugar and regular sugar, so yes, it is unfortunately in the red zone.

    • Although an “alcohol,” it doesn’t have anything in common with the alcohol that we’re not allowed to have. And yes, out of the sugar substitutes, the sugar alcohols (including erythritol) are considered safe.

      I would still go with a pure stevia extract (if you check the ingredients on your product, you will probably see that it has less than 1% stevia and the rest erythritol)… but if that’s not available, this one should be good as well.

  5. When Stevia became popular, I tried it and immediately experienced terrible intestinal discomfort. So it was crossed off my list. The sugar alcohols seem to be a good choice for many, but it should be noted that consumption of even a small amount can be lethal to dogs and cats. This is something that needs to be taken into consideration. Some people do not keep any sugar alcohols around the house for this very reason.
    Maple syrup sounds about the best of the group. Organic syrup is very expensive but then again, if used sparingly it should be something to “invest” in.
    What about coconut sugar? Many people are not even aware of its existence. It is made from the nectar of the coconut flower. The taste is similar to brown sugar and takes some getting used to in coffee. But I’ve been drinking coffee for quite a while with this sugar and have grown used to the taste.
    A good summary of the “sugars”. It is always important to read labels and know exactly what we are eating. Thanks for the information.

    • Thanks for the additional details, Sharon! Very useful information. I don’t have pets that could be affected by the sugar alcohols, so I had no idea how much of a danger they pose to cats and dogs. Good to know!

      I didn’t look into coconut sugar too much, to be honest, but I checked it now and it 94% of it is sugar… which is nowhere near maple syrup, but definitely better than sugar. And if it has some of that coconut flavor, I can see it improving the taste of many products you’d use it in.

    • Yes, although erythritol or stevia might be better choices as they don’t come with the potential side effects xylitol does (which are minor anyway).

      • Thanks so much these were the answers i was looking for i wanted to ask,
        is it better to get pure erythritol then stevia? because i heard stevia has that strange after taste so thats why im wanting to have pure erythritol, since i heard it doesnt have the bad after taste

  6. I would love to hear your thoughts on two other natural sweeteners. 100% Pure Yacon Syrup and Monkfruit sweetener. I have used the Yacon Syrup and it’s great to sweeten tea or oatmeal. It’s similar in flavor to a maple syrup. It is very high in fiber so very little of it affects the blood sugars. You can read more about it here: https://www.healthline.com/nutrition/does-yacon-syrup-work#TOC_TITLE_HDR_2
    I have used Lakanto Monkfruit sweetener as well as a few products (like chocolate ships) made by Lakanto. I find the sweetener not as sweet as I would like… but I just use more of it… and the chocolate chips (while very expensive) were amazing! “Monk fruit and stevia are both no calorie sweeteners. They have zero impact on your blood sugar levels, and they possess similar health benefits. When choosing between monk fruit and stevia, you should also think about whether you’re allergic to any members of the gourd family of fruits.” I am not sure how to find out if either of these are safe for people with fatty liver so I would love your input.

    • I have limited knowledge about Monk fruit – I just heard about it, but never found it so simply skipped it. It’s the first time I hear about the Yakon syrup so unfortunately I can’t be of much help now.

    • I stopped using Stevia ( I used to use the pure form) it gave me really bad gut issues and triggered my IBS. I now use Simply Monk Fruit it has 25% Mongroside V and I have not had any problems. I researched the different monkfruit sweeteners and feel that one is the best and does not have additives.

  7. Hi,
    I was diagnosed with NSFLD last fall. I also was pre-diabetic, have high cholesterol, and my WBC was a 4 (this is genetic, always low). This was after I had lost weight and have a normal BMI.

    I tracked everything I ate before that blood test (for about 6 months), so when I looked back I saw that I was eating way too much sugar (hidden in yogurt and “healthy” breakfast bars). So, I cut way back on the sugar and replaced it with stevia (which I always used but I increased it).

    My last blood test (after 3 months) showed good blood levels (no longer prediabetic), but my liver fat was higher and my WBC was even lower (a 2). Then I found this study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584803/

    It turns out, in mice, stevia makes liver more fatty and (in female mice) it drastically lowered white blood cell counts. Exactly what I saw in my blood work. Strangely, there’s many articles saying that stevia reduced fatty liver, but I’m thinking there’s a mistake in that assertion.

    • I personally use Stevia regularly, without similar problems to those mentioned. It only proves that more studies need to be made – and on humans too – in order to draw a conclusion.

      Either way, in your case, I would definitely stay away from Stevia at least for a few months to see if that’s indeed what’s causing the problems. Anything that harms you should be taken off the allowed list, even if it has the opposite effects on anybody else.


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