Find 7 Crohn's-friendly alternatives to refined sugar.
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A midafternoon soda or a conveniently packaged breakfast pastry may sound delicious, but when you have Crohn’s disease, foods with significant amounts of added sugar may not be a great idea. “Crohn’s disease is defined as an inflammatory bowel disease, and refined sugar itself is a pro-inflammatory ingredient,” says Giana DiMaria, RD, a registered dietitian and an instructor of medicine at New York Medical College in Valhalla.
Certain sugars in your diet can worsen gastrointestinal (GI) symptoms because they belong to a category of carbohydrates called fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs), says Edward Oldfield IV, MD, a gastroenterologist with Sentara Health in Newport News, Virginia. “[FODMAPs] are poorly absorbed, draw extra water into the intestines, and are rapidly fermented (broken down) by bacteria.” This superfast breakdown can produce GI-irritating by-products and symptoms such as gas, pain, bloating, and diarrhea.
Eating added sugars in excess can also lead to an unbalanced gut microbiome (dysbiosis) and increased intestinal permeability, which means toxins and unwanted bacteria can move through the layers of your intestine, says DiMaria. “Some symptoms that result from compromised gut function associated with high sugar intake in Crohn’s disease are abdominal pain and cramping, bloating, diarrhea associated with nutrient malabsorption, and chronic fatigue.”
Besides these effects, eating or drinking too much added sugar can make you less hungry for things like fruits and vegetables, which are foods that can improve your symptoms, says David Gardinier, RD, a registered dietitian specializing in gastroenterology at Cleveland Clinic. But you don’t have to give up all sweet things when you have Crohn’s — read on for other sweetener options that are easier on the gut.
1. Fruit
Use fruit to make things naturally sweet. Frozen bananas can make “nice cream,” a delicious alternative to ice cream, says DiMaria, who encourages her patients to get creative by adding other ingredients like strawberries, peanut butter, or blueberries. It’s easy to make: Just throw a sliced frozen banana in a food processor or blender, add 1 to 2 tablespoons of your favorite plant-based or dairy milk (more if you include other ingredients), and puree it for a minute or two.
“This works because it provides the consistency and texture of ice cream with a healthier and natural sweetness from fruit,” says DiMaria. As well as delivering some serious sweetness, fruits also come with vital nutrients like fiber, vitamin C, and potassium.
Fruit is a great option because it contains natural sugars paired with anti-inflammatory antioxidants and phytonutrients, says Gardinier. “Smoothies can [also] be a good way to get this sweetness in a form that is easy on the gut.”
2. Aspartame and Other Artificial Sweeteners
Aspartame, an artificial sweetener added to many diet sodas and candy, is about 200 times sweeter than table sugar, so you don’t need much of it to pack a punch. Most commonly sold as Equal or Nutrasweet, aspartame has been connected to a higher cancer risk in some studies, but the U.S. Food and Drug Administration has ruled that it’s safe when consumed under the generous daily maximum.
Other artificial sweeteners include:
Acesulfame potassium, also known as Ace-K (Sunett, Sweet One)
Neotame (Newtame)
Saccharin (Sweet‘N Low, Necta Sweet)
Sucralose (Splenda)
Advantame
Consuming artificial sweeteners in moderation is key, Dr. Oldfield says, suggesting that people with Crohn’s stick to 1 tablespoon or less per day. Artificial sweeteners can trigger symptoms in people with Crohn’s, and preliminary research suggests that they may also contribute to the imbalance of gut bacteria in inflammatory bowel disease, and to an increase in inflammation.
3. Maple Syrup
Maple syrup is made from the sap of sugar maple trees, and Oldfield often recommends it as a natural sugar substitute. Natural sweeteners like pure maple syrup offer more nutrition than refined sugar, containing vitamins and minerals like niacin (vitamin B3), thiamine (vitamin B1), potassium, and calcium. Researchers are also studying maple syrup’s antioxidant properties, which could potentially help decrease inflammation.
While maple syrup won’t replace the antioxidants you should be getting from fruits and vegetables, its nutritional profile makes using limited amounts a better choice than table sugar.
4. Molasses
Molasses, a thick and sticky substance made from the residue created by sugar cane processing, can offer a bit of sweetness to sauces, desserts, and marinades. It contains iron, calcium, magnesium, and potassium.
As with maple syrup, molasses still contains sugars and should be limited, so using it as a sweetener should be done as part a balanced diet.
5. Cinnamon
Cinnamon may not taste incredibly sweet on its own, but some find that it adds sweetness to foods when you’re trying to avoid added sugars. You can sprinkle it on just about anything, from yogurt and fruit to oatmeal and savory stews.
Experts recommend cinnamon alongside nutmeg or allspice for an added hint of sweetness when cravings hit. Cinnamon may also combat inflammation, but more research is needed to understand whether this alternative to sugar may benefit people with Crohn’s disease.
6. Monk Fruit
Monk fruit, a plant-based extract, is 100 to 250 times sweeter than sugar and can be used in both baking and cooking. This sugar alternative can be found in liquid or powder form; make sure you read each product’s instructions, because it may not be equivalent to sugar, measurement-wise.
7. Nutritional Supplement Shakes
Sometimes you may crave a sweet drink, and if you do, Gardinier recommends choosing one that also delivers some healthy nutrients. “If you are going to have something sweet, consider doing a nutritional supplement shake, as they may be less likely to worsen symptoms, compared to traditional sweets like pastries, candy, or soft drinks,” says Gardinier. You can find nutrient shakes at any grocery store or pharmacy, typically near the vitamin and mineral supplements section.
Many nutritional supplement shakes contain an excessive amount of added sugars or artificial sweeteners, so check nutrition labels or ask your healthcare team for suggestions of the best brands to try.
A registered dietitian can help you come up with creative ways to enjoy sweets and still meet your nutritional needs, should you ever find yourself out of ideas. If you don’t already have one who specializes in inflammatory bowel disease on your healthcare team, ask your doctor for a referral, or seek one out on your own. Many insurance plans cover dietitian services.
The Takeaway
Too much added sugar can worsen Crohn’s, but there are a number of alternatives to choose from.
The best sweets and sweeteners for people with Crohn’s disease include fruit, artificial sweeteners, maple syrup, molasses, cinnamon, and monk fruit.
If you need help finding sugar alternatives, you can ask a registered dietitian for recommendations.
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Resources
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Ma X et al. Excessive Intake of Sugar: An Accomplice of Inflammation. Frontiers in Immunology. August 30, 2022.
Yan J et al. Dietary Patterns and Gut Microbiota Changes in Inflammatory Bowel Disease: Current Insights and Future Challenges. Nutrients. September 27, 2022.
Ranasinghe IR et al. Crohn Disease. StatPearls. February 24, 2024.
Basson AR et al. Sweets and Inflammatory Bowel Disease: Patients Favor Artificial Sweeteners and Diet Foods/Drinks Over Table Sugar and Consume Less Fruits/Vegetables. Inflammatory Bowel Diseases. January 21, 2023.
Mohammed F et al. Nutritional, Pharmacological, and Sensory Properties of Maple Syrup: A Comprehensive Review. Heliyon. September 2023.
Deledda A et al. Diet-Derived Antioxidants and Their Role in Inflammation, Obesity and Gut Microbiota Modulation. Antioxidants. April 29, 2021.
Lynn Grieger is a registered dietitian-nutritionist, certified diabetes care and education specialist, certified personal trainer, and certified health and wellness coach. She completed requirements to become a registered dietitian at Valparaiso University in 1987 and completed a dietetic internship at Ingalls Memorial Hospital in Harvey, Illinois, in 1988.
Lynn brings her expertise in nutrition, exercise, and behavior change to her work in helping people reach their individual health and fitness goals. In addition to writing for Everyday Health, she has also written for websites and publications like Food and Health Communications, Today's Dietitian, iVillage.com, and Rodale Press.She has a passion for healthy, nutrient-dense, great-tasting food and for being outdoors as much as possible — she can often be found running or hiking, and has completed a marathon in every state.
Abby McCoy is an experienced registered nurse who has worked with adults and pediatric patients encompassing trauma, orthopedics, home care, transplant, and case management. She is a married mother of four and loves the circus — that is her home! She has family all over the world, and loves to travel as much as possible.
McCoy has written for publications like Remedy Health Media, Sleepopolis, and Expectful. She is passionate about health education and loves using her experience and knowledge in her writing.
