How to Remain Sweet on an Anti-Inflammatory Diet

Enjoying foods without added sugar can be challenging, but it may help with PsA flares.

If you’ve been living with psoriatic arthritis (PsA), chances are you’ve considered following an anti-inflammatory diet.

There’s some evidence to suggest that anti-inflammatory diets may help with PsA symptoms. Reducing sugar intake could be an important part of that.

Sugary items always show up on the list of inflammatory foods: So what do you do when you have PsA, and you get a craving for something sweet?

As a baker with PsA who has been trying to use less (or no) processed sugar since I was first diagnosed, I tend to ingest more naturally derived sweeteners, like agave, honey, and maple syrup, often using them as sugar substitutes in my recipes.

But I often wondered if these alternatives are really “better” for you than processed sugar and if they still cause inflammation.

To make matters more confusing, there are a plethora of zero-calorie sugar substitutes on the market now, including options like monk fruit and stevia and a whole gaggle of sugar alcohols, with tongue-tying names like erythritol and maltitol.

With such a dizzying array of options, what’s a well-meaning, nutritionally conscious person with a sweet tooth supposed to do? Here are some of my favorite alternatives to table sugar:

Join the free PsA community!

Connect with thousands of members and find support through daily live chats, curated resources, and one-to-one messaging.

Sign up

What is “table sugar” anyway?

Sucrose, also called “table sugar,” is derived from sugar cane or sugar beet plants. The juice is extracted from these plants and leaves, then filtered and crystalized into golden “raw” sugar, sometimes referred to as turbinado sugar.

This process significantly reduces most nutrients, except fructose and glucose, and it’s purified even more to create white sugar.

Consumption of sugar has been associated with an increased risk of obesity, cardiovascular disease, elevated blood pressure, diabetes, liver disease, and even cognitive decline and cancer. These serious health issues and their relationship to increased inflammation in the body may be a factor that affects PsA flares.

Alternatives to sugar

While excess amounts of any sugars have health risks, these products are some of my favorite alternatives to sucrose.

Honey

Honey, maple and agave syrup, and coconut sugar all have some nutritional value. While honey is high in sugar, it’s also high in antioxidants and could be good for supporting cardiovascular health.

Maple syrup

Both maple syrup and honey contain trace amounts of minerals. I prefer to choose real maple syrup, which is the sap from maple trees, as opposed to artificial maple syrup, which is often high fructose corn syrup with added colors and flavors.

While honey contains trace amounts of vitamins C and B, real maple syrup is a good source of manganese.

Maple syrup also contains antioxidants, making it a good potential anti-inflammatory ingredient.

Agave syrup

Agave syrup is derived from the agave plant and is composed primarily of fructose, a type of simple sugar that generally has a low glycemic index (GI) value (13) and causes a smaller rise in blood sugar levels.

Agave also dissolves nicely in liquids, like iced tea, in a way maple syrup or honey may not.

While agave syrup is a popular sugar alternative, it’s high in fructose and there are some concerns that consuming too much might harm liver health. For this reason, moderation is key.

Coconut sugar

Finally, because it’s minimally processed, coconut sugar maintains many of its minerals. It contains small amounts of potassium and calcium.

Like honey and maple syrup, coconut sugar is a good substitute for processed sugar when baking, and can be evenly exchanged for white sugar (though bakers beware: it does add a caramelly flavor and color).

The bottom line is moderation

We still need more human studies with larger sample sizes to learn more about the long-term effects of natural and alternative sweeteners on overall health.

For now, I prefer opting for small amounts of sweeteners from natural sources that are minimally processed and avoiding white sugar whenever possible. While it isn’t easy, even small reductions in your sucrose intake may make the difference between a PsA flare or a day without aching joints.

Either way, it all seems bittersweet.