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When people hear that sugar-sweetened beverages pose health hazards, some respond by switching to diet soft drinks. That certainly seems reasonable, but evidence now suggests it might not be the best strategy. Over the past few years, we have seen evidence that non-sugar sweeteners may not offer the expected advantages (The BMJ, Jan. 3, 2019).
Do Diet Beverages Dull Hunger?
Many people choose diet soda or other artificially sweetened beverages in an attempt to control their weight. New research suggests that at least one sugar substitute may not have the desired effect.
Researchers at the University of Southern California have found that sucralose (Splenda) activates the hypothalamus differently from sugar (Nature Metabolism, March 26, 2025). They recruited 75 volunteers and solicited their responses after drinking plain water, sugar-sweetened water or sucralose-sweetened water. The sugar-sweetened beverage helped people feel more satisfied, while the sucralose-containing beverage did not increase blood levels of satiety hormones. Instead, participants reported greater feelings of hunger. Brain imaging indicated that sucralose seems to affect “key mechanisms in the hypothalamus responsible for appetite regulation.” This, in turn, might have an impact on decision-making regarding eating and drinking.
Previous research suggested that regular users of non-sugar sweeteners may be at higher risk for cardiovascular disease (The BMJ, Sept. 7, 2022). In addition to epidemiological evidence from France, scientific experiments conducted at the Cleveland Clinic cast doubt on the safety of some popular sugar substitutes.
What We Can Learn from 100,000 French Men & Women:
NutriNet-Santé, a cohort study of more than 100,000 French adults, uncovered risks of non-sugar sweeteners such as aspartame, sucralose and acesulfame potassium. When the volunteers entered the study, they answered detailed questionnaires about diet and physical activity as well as demographic and health information. In addition, they responded to dietary questionnaires approximately every six months. About 37 percent of the participants reported regular consumption of artificial sweeteners. Average sweetener intake among these people was about one packet or tablet daily (42 mg/day).
Over the course of ten years, people using sugar substitutes were slightly more likely to develop cardiovascular disease. In particular, aspartame users were about 18 percent more likely to have strokes, while those using sucralose or acesulfame potassium were 30 to 40 percent more likely to develop coronary heart disease.
According to the investigators,
“Our results suggest no benefit from substituting artificial sweeteners for added sugar on CVD [cardiovascular disease] outcomes.”
What Are the Effects of Non-Sugar Sweeteners?
Sweeteners That Promote Blood Clots:
Xylitol:
Xylitol is a natural low-calorie sweetener that is frequently used as a sugar substitute. It can be found in chewing gum, toothpaste, candy, ice cream, peanut butter and baked goods. New research indicates that xylitol increases the clotting potential of platelets (European Heart Journal, June 6, 2024). This in turn might lead to an increased risk for problems such as heart attacks, strokes and pulmonary embolisms.
The Cleveland Clinic investigators identified xylitol as a potential risk factor from a large panel of blood samples. Then they examined the effect of this sugar alcohol on platelet function. Finally, they gave volunteers a xylitol-rich drink and studied how platelet performance changed. They concluded that xylitol can enhance platelet reactivity. As a result, they believe this sugar substitute could increase the risk for major adverse cardiovascular events.
Erythritol:
Xylitol is not the first sweetener to come under suspicion. A study in 2023 showed that erythritol may encourage blood clots that can lead to heart attacks and strokes. This sugar substitute has become quite popular because it looks and tastes like sugar but does not contribute calories. As a result, manufacturers often add it to the “natural” sweeteners derived from monk fruit or stevia so that they will behave more like sugar. Just how safe is it?
Scientists at the Cleveland Clinic analyzed blood samples in people at high risk for cardiovascular complications (Nature Medicine, Feb. 27, 2023). They found that those with high levels of erythritol in their blood were more likely to suffer a heart attack or stroke or even to die in the next three years after the blood was drawn.
Blood exposed to erythritol clots more readily. As a result, the risk for heart attacks and strokes climbs when people consume it. It doesn’t take very much erythritol to cause trouble, either. Just 30 grams of the sweetener was enough to make blood levels skyrocket. That’s about as much as you might find in a pint of keto ice cream.
Sugar substitutes are more likely to appear in foods marketed to people with diabetes, overweight or other risk factors for cardiovascular diseases. In light of this, the researchers conclude, “Studies assessing the long-term safety of erythritol are warranted.” Presumably, they would now add xylitol to the list of non-sugar sweeteners that should be investigated more thoroughly.
Readers Wonder About Sweetener Safety:
Is Erythritol Linked to Strokes?
Q. What can you tell me about studies showing that the non-sugar sweetener, erythritol, can contribute to strokes and heart attacks by altering blood platelets? I still see products that contain it, and you can even buy erythritol by itself!
I had a stroke last year, and I had a bag of erythritol in my cupboard thinking it would be a healthy substitute for white sugar! Heart attacks and strokes cause many deaths every year. Shouldn’t this be better known?
A. You are right that people at risk for cardiovascular disease with high levels of erythritol in their blood were more likely to suffer heart attacks or strokes, according to the research published in Nature Medicine (Feb. 27, 2023). We agree that more information about this potential risk is needed. Too few people realize that non-sugar sweeteners may pose health risks beyond the possibility of loose bowels.
Monkfruit Mixed with Erythritol:
Q. Instead of sugar, I’ve been sweetening my coffee and breakfast cereal with monkfruit for a couple of years. The sweetener also contains erythritol. Now I’ve read that can be a problem. How concerned should I be about the effect on my arteries?
A. Most people think of erythritol as a natural sugar substitute and assume that it is perfectly safe. It is natural, but new research (above) suggests that people who use this sweetener regularly may be more prone to heart attacks or strokes. Apparently the problem is that erythritol promotes blood clots. If you stop using the sweetener, your risk should drop to normal within several days or so.
Earlier Studies on the Safety of Non-Sugar Sweeteners:
NutriNet-Santé was the largest study but not the first to cast doubt on the benefits of artificial sweeteners. In a previous analysis published in The BMJ in 2019, researchers reviewed 56 studies of non-sugar sweeteners. They found “no compelling evidence to indicate important health benefits.”
In most of these studies comparing outcomes for people consuming artificial sweeteners to those for people consuming none, there were no significant differences. In a few small studies, people using sugar substitutes had lower fasting blood sugar and slightly better body mass index. However, these findings were statistically uncertain. Previous research has not shown strong evidence that such sweeteners help people lose weight.
Are Artificial Sweeteners Safe?
The researchers point out that these studies did not adequately address questions of safety. They call for longer-term, better-designed trials to establish clearer conclusions on safety and effectiveness of sugar substitutes. (NutriNet-Santé might have been designed partly with this request in mind.)
An earlier study found some unexpected effects of such sweeteners that may have a bearing on safety. In particular, these compounds may affect the balance of microbes that inhabit our intestines. This, in turn, could have an impact on inflammation.
Non-Sugar Sweeteners May Change Metabolism:
In addition, test tube research suggests that the artificial sweetener sucralose can alter the metabolism of stem cells from fat tissue. (Stem cells are capable of becoming many different types of tissue cells, for example, muscle or bone as well as fat.)
These human cells churned out more compounds associated with inflammation and fat storage when they were exposed to sucralose. The dose was equivalent to someone drinking four cans of diet soda a day. The stem cells also showed changes in their genes that indicate fat production.
Could Sugar-Free Drinks Be Counterproductive?
If these “in vitro” laboratory results hold up in animals and humans, heavy consumption of non-sugar sweeteners could lead to fat accumulation rather than fat and weight loss. The scientists also discovered other signs of metabolic disruption due to non-sugar sweeteners. They are concerned that these changes were most noticeable in people who are already overweight or obese.
The researchers note:
“we believe that low-calorie sweeteners promote additional fat formation by allowing more glucose to enter the cells, and promotes inflammation, which may be more detrimental in obese individuals.”
Sen et al, Endocrine Society annual meeting, Orlando, FL, April 3, 2017
Vicki
My husband and I are older and use Stevia as a sweetener because of his diabetes. I am disappointed that Stevia was not on the list of alternative sweeteners and would like to hear the thoughts on that product as well! Thank you!
Greg
What type of chewing gums are safe? Avid gum chewer (4-5 pieces over the course of each day). Agree with readers about more info on Stevia as well. Nothing appears to be safe any longer, and all things consumed cause some type of health issue it seems.
Dr E
What about stevia? Used routinely in compounding pharmacies for oral liquid formulations that are bitter.
Carol
After reading this article that says many of our foods contain these chemicals I can understand why children are being affected, and there is an increase of heart disease among our children.
LA
Why on earth, does the photo show Xylitol???
When used in small quantities, as in a dental product, it’s super useful and proven effective?
Why scare people away from something that works, when so many other sugar substitutes are so much worse????
Jeanne
I guess I’m lucky because all artificial sweeteners cause me side effects, so I avoid them all. The only one I’ve found that doesn’t is monk fruit that does NOT contain erythritol. An occasional stevia is fine. Otherwise, I use sugar and just limit how much. The rest is poison.
Linda
I read some time ago (I don’t remember where) that the sweetness of sugar substitutes prompts the body to produce insulin, the same way it does in response to sugar. The unneeded insulin then promotes both hunger and fat storage. The supposition was that this is a reason why diet sodas and such do not lead to weight loss. Is this true?
Joy
I eat everything in moderation, as I was taught by my mother, leave off anything “artificial,” and drink water with lemon if I need flavor. No worries then about effects of consuming “artificial” stuff!! I am not overweight.
Barb
I stay away from all sugar substitutes and use real sugar, honey or maple syrup. One reason I do not like Stevia is it tastes bitter.
Gail
According to “Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?”, “Establishing causality in the relationships observed in epidemiological studies requires clinical trials that examine the long-term effect of erythritol consumption on outcomes related to cardiometabolic health, especially in persons with obesity and diabetes. Until these data are available, it CANNOT be concluded that dietary erythritol promotes platelet activation and cardiometabolic risk.” (My emphasis.) The conclusions in the Peoples Pharmacy article are premature.
Charlie
I use Stevia with Monk Fruit added. It works well for me with no known problems.
Chuck
This information is good, but why is it that nobody does an evaluation of Stevia??????
Katie
Whenever I see these articles they rarely mention monkfruit or stevia. I’ve used stevia for years, just to sweeten coffee or tea, or home made lemonade in summer, later I used monkfruit, too but it’s pricier.
Also, why does everything have erithritol and the like? Those things cause all kinds of stomach discomfort for many, including me. Now we find it’s even worse. A night of agony is better than a stroke, in other words!
I started to use pure stevia leaf. I got some good choczero chocolate made with monkfruit, but they added starch resistant. The dextrin affects my blood sugar. Not ok.
Please more articles on STEVIA and MONKFRUIT and more products with them with no extra garbage. I guess there’s no way to patent them, since they’ve been used for a long time in South America. That’s why we never see them in products. I went to making my own chocolate so as not to get the bad stuff.
Nancy
I never eat any sugar substitutes, including the so-called natural products like Stevia. They cause my migraines to flare like crazy. Sugar is not the evil the media would like us to think. Remember when eggs where banned, and coconut oil was terrible too? Just eat real food and don’t use so much sugar. And no, I am not overweight, even though I eat sugar!
Sd
What about Saccharine? It has been used for many years, invented in 1879. I am 87 and have used it copiously for probably 60 of those years. Why is this not included in your sweetner article?
Cindy
Jessica’s (March 13, ’23) comment on Stevia is the very first negative commentary I’ve ever read re Stevia. I use that stuff copiously, and I don’t intend to stop but I will now investigate thoroughly. If Stevia is bad, then a big part of my life (the part that likes sweet things) will die and I’ll be very unhappy. Bogus!
Ellen
I try to follow a low carb diet so for a few years I was buying products that contain sugar alcohols. Eventually the sugar alcohol caught up with me and affected my stools. I became crampy and was having multiple very soft bowel movements per day. After doing my own detective work to try and figure out what was causing this I decided to stop consuming products containing sugar alcohol. Once that was completely out of my system I did not have any more issues.
More recently, I have tried products with stevia, monk fruit, etc. and ones that are plant based and the same issues have happened.
Melissa
Okay. I changed from sodas to flavored water but looking at the label it is sweetened with sucralose. If I stop drinking it, will that reverse the reprogramming of the stem cells?
John
Why were pure stevia and pure monk fruit sweeteners not mentioned in the article? These are both available without fillers like Erythritol, etc.
Karen
Any thoughts on pure pentose (Bocha Sweet) made from kabocha squash? I never see it mentioned in any of the recent articles. It’s pricey, but it looks, measures, and tastes like cane sugar. No weird cooling effect or aftertaste.
Elle
I have been using saccharin for the past 50 years. So far it has not been a problem.
Kris
Studies go back and forth on these things so no wonder so many of us are left scratching our heads.
I’ve been using Stevia for years in moderation and mostly just in my coffee but more studies have again found that coffee is bad too. Meh.
Barb
According to Dr. Berg, there were several problems with the erythritol study
“1. Correlation does not mean causation.
2. This study was based on endogenous erythritol and did not measure dietary erythritol. The body makes endogenous erythritol.
3. The body produces erythritol when you metabolize sugar, have oxidative stress or belly fat, or consume alcohol. The great majority of people in this study were in poor health, so how do we know erythritol was the problem?
4. Other research has liked erythritol to many different health benefits.
Could it be that erythritol is increasing in the body to counter the bad effects of sugar? It seems to me that erythritol is something that’s trying to help you and not hurt you.”
You can watch his summary “Erythritol Linked to Heart Attacks and Strokes, Really?” on YouTube.
Jessica
Back again with some info on Stevia. I looked up maltodextrin, an additive listed on my Stevia package, and found it is not safe. It is derived from starchy plants, (carbohydrates) such as corn, potatoes, even wheat. It’s highly processed and has side effects similar to other artificial sweeteners. It is found in many processed foods besides Stevia. What’s worse, it can actually cause rapid, high spikes in your blood sugar shortly after ingestion. Not good for diabetics! Other side effects include itching, skin rash, flatulence, interference with gut bacteria, etc. Since I only use it for one cup of coffee per day, Stevia is now officially off my diet. I think real sugar, or honey are my only alternatives. I do not sweeten my iced tea or my breakfast cereals, only my coffee. So I think using real sugar in my coffee will pose the least risk of side effects.
Charles
Too many people are counting calories instead of counting chemicals. In my opinion, there is nothing wrong with a moderate intake of real sugar.
Barbara
First butter was bad; then its substitute margarine was bad. Sugar is bad; then its substitutes, the artificial sweeteners, are bad. What do we do now? I use sugar in my coffee and drink sugar free fizzy drinks. So confused and guilty no matter what.
Robert
The erythritol study was poorly designed, and the conclusions of the authors are nonsequiturs. Humans produce erythritol through the pentose phosphate pathway which is upregulated in chronic inflammatory states, insulin resistance, fatty liver, pre-diabetes, DM 2, etc. Erythritol production also increases as a result of alcohol consumption and excess refined carbohydrate consumption. The authors did not collect data on dietary erythritol. The study provides absolutely no evidence that the association between circulating erythritol levels and Major Adverse Cardiac Events (MACE) has anything to do with dietary erythritol intake. No conclusions should be drawn from this poorly designed study. nevertheless, based on data available so far I would recommend allulose and monk fruit instead if one needs a sweetener. Bob Hansen MD
Mary M
Here’s the rub, now what? We are banning most fruits because they are too high in fructose; we are telling folks not to do even ‘natural sugars’ and certainly not ‘sugar itself’. We’re now banning chocolate from our diets because of heavy metals, and we have determined that meat eating isn’t sustainable (and is bad for you). So in the end we don’t eat cereals (any grains), any fruit beyond vegetable fruits (blueberries, and most other berries unless organically grown are extremely high in pesticides); stop eating potatoes, tomatoes, and peppers (because of nightshade), we are now getting to the point where no foods are safe.
Nancy
So what is left? Raw broccoli? What do I do with all the Stevia I have left? It’s not fair!!
Anne
I decided a decade ago that any sweetener was likely detrimental to my health. Not a total abstainer, but close enough that cravings for the taste are not a problem.
David
A large void in the article was the non-mention of Stevia. Other studies have found Stevia virtually harmless. Monk Fruit sweetener has also been found in other studies to be relatively harmless. Why were these two sweeteners omitted from the article? Their omission is suggestive of alarmist sensationalism rather than objective journalism.
Molly
I have used Stevia for years, and it is rarely included in any study or discussion of “artificial sweeteners.” (I do not use any “…itol ” sweeteners, including erithritol, because all cause diarrhea for me.) My objection to this, and to most discussions of artificial sweeteners, is that the discussions refer to “artificial sweeteners” having the problems that the three in this study happen to have, without making clear that the results do not apply to Stevia, for example, or others that were not included. If Stevia or saccharine causes blood clots or heart disease, I would certainly want to know. But to imply that they do isn’t helpful to us long-time diabetics.
Thanks for all your good information!
Elizabeth
How safe is Stevia?
Ariel
I found that anything I ate or drank that had this sweetener in it raised my blood sugar. I am a label reader. I have found a large amount of food items that contain this sweetener.
Bruce
I am seeing a lot of “Replies” to this article asking about “Stevia”, and I understand why! I too am asking – you are NOT being clear about Stevia – even mixing it into the conversation in such a way that “sort of implicates it” yet does not. Please be clear on Stevia and set it apart – either as Guilty or Not! You are not helping by being so unclear in your article. What I have read in the past about Stevia was positive…that it “is” metabolized by the body and doesn’t contribute harmfully as do the artificial sweeteners. But throwing erythritol (another natural sweetener) into the mix and not separating the harmful potential of erythritol from Stevia is confusing and concerning to your readers – don’t you see from all the inquiries you are getting? Please clear this up for your readers! Thank you.
Tyler
Like everything else, this might turn into another “all things in moderation” situation regarding erythritol. I notice that almost all the commentaries I’ve read about these studies use the word “may” or “might”, no exception here. That suggests the research is somehow inconclusive or incomplete in some way. So perhaps the jury is still out on this.
There’s no question, however, about how toxic sugar can be. Or about how bad aspartame and Sucralose are for you. I suppose it’s best to simply lose your taste for sweets. I look forward to more conclusive research that hopefully will exonerate erythritol. For instance, what about the effect of natural blood thinners on the alleged clotting problem? What other existing medical conditions were extant in some of the test subjects that could have been a factor? Many unanswered questions. Until more convincing research is available I’ll continue to use it in moderation.
Cathy
I recently started using a product with the ingredient kabocha. I then learned that was another name for xylitol. It tastes, and is granular, like sugar. I was using it half with real sugar for coffee and tea to reduce the (already low) sugar. But I can’t find any great information on the impact of using it. I became concerned when this info on erythritol was released. Would love a show about these other choices of sweeteners, like xylitol, monk fruit, stevia, etc. and impact to the gut biome and other impacts. I know xylitol is bad for dogs but I don’t currently have pet.
Marty
I, too, would like to know about Xyletol. It supposedly comes from a tree bark and is used in chewing gum and cough drops. One report gave it credit for protecting teeth and was used in school populations in Canada to prevent cavities. I have used it in baking since it has no chemical taste and can be directly substituted for sugar. Any studies on it?
Lori
I try to avoid Aspartame, as it is a neurological exitotoxin that gives me migraines or used to. I’ve read so much about it over the years that I would rather used something else. Luckily, I don’t have a huge sweet tooth.
Pam
Perhaps non-sugar sweeteners have some negative effects, but how do they rank relative to high sugar consumption? We know sugar and fructose also disrupt the micro biome, leads to obesity, diabetes, CVD, etc.
The ideal may be not to use any sweeteners, but are these options safer to use than sugar and fructose to make that transition easier?
Marjorie
Sugar also leads to heart issues and stroke, right? So which is worse? Erythritol or sugar?
Barbara
Are there ANY sugar “substitutes” that are safe. I thought erythritol was safe. Now I read it’s not. What about stevia and monk fruit?
JAS
I drank nothing but soda & Hershey’s chocolate milk day & night (and nothing else: not water, not any alcohol, not fruit juice, nothing) — then switched to diet soda. Thirty years later, I quit everything cold turkey: I have a fatty liver & pre-diabetes & diabetes (the numbers bounce back & forth). I also ate cinnamon bread for breakfast for too many years… so I suspect the People’s Pharmacy is helping me to extend my life so “THANK YOU!” (And don’t drink ANY soda!)
Jessica
I’m wondering if I read the same article as everyone else. This article clearly discusses studies of ARTIFICIAL sweeteners like sucralose (Splenda), aspartame (NutraSweet), erythritol, etc. With one caveat: that manufacturers sometimes add erythritol to NATURAL sweeteners, (such as stevia), to boost the sweetness. I quickly grabbed my package of Stevia to read the label. Only ingreients are Maltodextrin and Stevia. So now I have to look up maltodextrin to see what that is, and where it is derived.
One comment: Aspartame causes interruption of my thought processes; an “aphasia-like” forgetfulness, as if I had suffered a stroke. It happened 3 times during dieting, using aspartame. Memory came back after stopping the aspartame use. Will never use another artificial sweetener again. I’ll take my chances with moderate use of natural sweeteners like honey, sugar, and stevia. Unless the maltodextrin additive turns out to be artificial. Then stevia will get the boot too!
Sylvia
I am especially interested in studies specifically on Stevia as a sweetener. It is a plant, but it is supposedly “highly processed” in the version okayed by the FDA. I really want to know if I should be using it in my coffee and iced tea. Since it is a plant, it would at least seem the safest option. There are unprocessed versions, which are dried and a green color like the plant, but the advice I read said to avoid it, because you cannot know exactly what is in it and it hasn’t been “approved.”
Archie
Does anyone know if there’s an idiot’s guide (i.e. non-expert’s guide) to reading the language and numbers often used in the results part of the abstract of scientific papers? I just glanced at the one on erythritol and this is the kind of thing I’m talking about.
“…validation cohorts of stable patients undergoing elective cardiac evaluation confirmed this association (fourth versus first quartile adjusted hazard ratio (95% confidence interval), 1.80 (1.18–2.77) and 2.21 (1.20–4.07), respectively).”
I understand that they’re written for scientifically-trained people rather than the general public, but it would be nice if there was some kind of guide or key that enabled ordinary mortals to understand them. I mean it’s like they’re written in code deliberately designed to hide what they mean from the public.
If anyone knows if a ‘how to read these things’ exists anywhere, I’d love to know.
Mary J
I’ve long thought that sugar is not inherently harmful but simply was not intended to be consumed in the quantities that consumers use today. I stopped eating sugar some 25 years ago (I’m NOT diabetic) and found (unexpectedly) that over the years, my taste buds changed. I no longer desire sugar and understand why we call them “sweet” peas and “sweet” potatoes. They taste sweet to me.
Daniel
I’m disappointed and find it a bit misleading that the study ignored saccharine, which is beneficial for diabetics. Currently, the FDA, World Health Organization (WHO), and the European Food Safety Authority (EFSA) agree that saccharine poses no risk and is safe for human consumption.
Also, I waited to see a comment about causation: are people becoming obese because of artificial sweeteners, or are high-risk obese individuals, who have higher intrinsic morbidity and mortality, using sweeteners to control sugar, thereby skewing the data? This appears to be more relational on the surface. It would be beneficial if you’d tease that out for the readers.
Paula
The article didn’t mention Stevia. Does it have the same effect?
Patricia
Please, dear Graedons, share the research on Stevia in your columns. Thank you.
Cindy
Sheesh! I use ONE and ONLY ONE non-sugar sweetener, and that is Stevia. I get so very sick and tired of reading article after article about the dangers of non-sugar sweeteners… but they rarely mention one single thing about Stevia! Or if they do, it’s kinda vague and nonhelpful. We need more studies on Stevia!!! Until then, I’ll assume it’s NOT harmful and I’ll keep using it. Thank you.
Gwen
WHY do these articles on the dangers of non-sugar sweeteners rarely even mention STEVIA?? It’s the only sugar replacement I use and have used for years. The only place I’ve ever seen Stevia discussed is in articles about Lyme Disease, and in that case there seem to be some positive benefits of its use, in chronic cases. But I never see studies of either benefits or side effects of using it as a sugar substitute!
Michael
I don’t believe that I have the ever seen report of a study that discriminated among different sweeteners. I suspect that there would be differences in their effects. One sweetener was blamed to be a carcinogen and banned. It was later determined that the evidence against it was flawed, after which Canada permitted it but the US wouldn’t until it could be found safe. Meanwhile, Saccharin was as allowed to remain, although it had been found to be a carcinogen Supposedly because there were no other options. Both of these and the others should be reevaluated SEPARATELY before making any determination.
Peggi
What about fruit-based sugars that are low on the glycemic scale, such as monkfruit and the sugar substitute erythritol?
A well-known GI researcher recommends these, as they don’t spike blood sugar.
Fred
I am eager to learn if stevia and/or monk fruit extract have been studied on their own? The sweeteners I have been using all seem to be mostly erythritol plus some unspecified level of stevia and/or monk fruit.
Judy
What about the sugar alcohols now available? I use a sweetener made from monk fruit extract and erythtitol, “a sugar alcohol derived from the fermentation of glucose from non-GMO corn. It is also found in fruits such as pears, melons, and grapes.” It is used just like sugar, measure for measure, but has zero calories. I haven’t experienced any side effects from it.
M.J.
Some 25 years ago I stopped eating sugar (specifically, refined white and brown). I found that, over time, my taste buds changed, and that I have no desire for sugar. I also understand why they’re called “sweet” peas and “sweet” potatoes, because they now taste sweet to me.
Autumn
VA
All I know is I started drinking a non-diet soft drink and eventually had all types of GI tract problems. I couldn’t figure out what was causing them. Finally I realized it had to be the soft drink and read the label–sucralose! Stopped drinking it cold turkey and all problems were gone in a week or two, never to return.
Martin
Ireland
Hi . Have been using stevia for many years and cannot praise it enough . I think research is a lost cause because we are all different individuals. I think when its plant-based it’s perfect.
Robert
Chicago IL
For many years I drank 1-2 diet sodas almost every day. About a year ago I stopped, and over the next 8 months I lost about 12 pounds. Other than drinking more water I did not change anything else.
John
Baltimore
I think that overall people are better off with a small amount of sugar (I use honey) instead of the artificial sweeteners. The problem is that packaged goods have been stuffed with sugar for many years that people got used to it and think that something that is not sweet is no good. Also if you look at recipes they tell you to use a ton of sugar. I make my own pies and other desserts: I use a regular recipe and skip the sugar; the fruit gives it enough sweetness without the added sugar.
Patricia
Melbourne, FL
Disagnosed with hypoglycemia years ago and told to avoid sugar. It was an easy order to obey. Eating anything with sugar sets off problems of dizzyness; can’t sleep, yet tired all the time; and no ambition to do anything as far as house or yard work. I also limit anything remade that is sugar free, as it all includes Spenda which is made from sugar. I sparingly use the generic Equal in the blue packs. Years ago with a family of five who all had sweet tooths, I cut sugar in half in all recipes calling for sugar. (No one in all these years has ever said something I baked wasn’t sweet enough). I do use Splenda when family coming and limit what I eat. Other than taking a .75 mg pill every day for low thyroid, I am one of the healthiest 82 year olds you will see.
John
North Carolina
Why is it so difficult for the FDA and responsible testing groups to determine if and what effects using the various artificial sweeteners individually, have on our bodies??
Kassy
WI
I would be interested in more information COMPARING different non-sugar sweeteners. Which are safest? What are the consequences of each specific kind?
Rich
Kassy, I believe the answer is money. The researchers themselves say that the studies are flawed in that the data is inconclusive. From the article: quote “The researchers point out that these studies did not adequately address questions of safety. They call for longer-term, better-designed trials to establish clearer conclusions on safety and effectiveness of sugar substitutes.” My question is why conduct a study that does not satisfy the desired outcome? Were the researchers that ignorant of the original problem? Answer: Probably not. I believe they just want to do a longer-term and better-designed trial afterwards that will cost even more money.
Peggy Brayfield
IL
This article mentions Sucralose, but not any other non-sugar sweeteners. I’m curious about the research on stevia, which I believe is not produced artificially but is made from plant material. Is there any evidence that it causes metabolic changes or other bad effects?
John
Croydon, PA
There is a table in the BMJ review article, which shows that sugar alcohols are not classified as non-sugar sweeteners. Good to know.
Hank Roberts
left coast
Stevia?
Terry Graedon
There were only a few studies of stevia included in the analysis. Here’s one comment from the research: “There seemed to be no consistent difference in effect between studies using aspartame, stevia, or a combination of sweeteners as the intervention.”
Susan
Gloucester VA
I eat xylitol sweetened mints and chewing gum for my teeth. My dentist advised it.. she said it makes your mouth basic instead of acid..I could feel a difference in my teeth after using it
Bob
SC
No mention about natural sweeteners like Stevia. Any concerns about this or similar products?
Sheri
Seattle
Has stevia been tested to see if it also has negative effects on inflammation and metabolic processes?
Isabel Leonard
NEAR SAN FRANCISCO
You don’t mention stevia. I have looked at several websites, but there doesn’t seem to be clear evidence that it’s safe. (Maybe no one knows yet.)
After several unsuccessful attempts, I succeeded two years ago in totally eliminating added sugar from my diet. I did it by two months of no sugar whatsoever – not even fruits or beets. I was uncomfortable for the first two days but OK after that with only occasional, manageable longings. After two months sugar-free, I was not even interested in sugar. If it had disappeared from the planet, I wouldn’t have noticed.
After two years, I was able to eat the occasional cookie or pastry at a party without re-activating the cravings.
I occasionally get a craving for chocolate, which I satisfy with a few squares of Lily’s dark chocolate, made with stevia and no added sugar. I plan not to eat this regularly though, even though chocolate in moderation is supposed to be good, for fear of reactivating the old sugar cravings (even with stevia – not physical, but psychological).
Terry Graedon
Nutrition Action has looked at the safety of sugar substitutes and opined that stevia, so far, appears to be OK. Monkfruit has not been studied well enough yet to tell if it is safe.
Patricia
NC
Does red wine contribute to the amount of sugar one ingests? I do not drink soft drinks but I do like a glass of wine or two in the evenings.
Terry Graedon
It was not included in the analysis, so we can’t answer.
Carol Kenzy
PA
We don’t drink sugary drinks or use much sugar in our household.
What about the sweetener, Stevia? We have been using it for a couple years and felt it was a safe choice. Your comments, please. Thank you!
diana
florida
I wish there was more detail on the types of NSS used: did these studies include xylitol, malitol, stevia, agave?
Amy
CA
When you refer to non-sugar sweeteners, do you mean artificial sweeteners? Or are you including non-sugar products such as stevia? Please clarify. So far, the only negative with stevia would appear to be allergy (it’s evidently part of the ragweed family, so anyone with that specific allergy could be affected).
David LANE
NC
What about STEVIA ? ANY OTHER sweeteners-monk fruit etc? I wish articles named sweetener KINDS by name, at least.
Andy
Colorado
What about Stevia ?
Terry Graedon
Only a few of the studies in the analysis compared stevia to placebo or other sweeteners. ie, need more data.
James
Raleigh, NC
I have been using Stevia for about four years. At the time, I was told that it is a plant-based product and is safer. It is the nearest thing to a sugar taste that I have experienced. In that time, I have lost about 40 pounds and my blood sugar has dropped considerably. I drink a lot of iced tea sweetened by Stevia. Unless someone convinces me that the negatives are greater than the positives, I will continue as I am doing now.
Bob
SC
Is stevia, a natural low calorie sugar, acceptable, e.g. no negative side effects?
Donna
I stopped using artificial sweeteners over 5 years ago and switched to natural sweeteners (stevia and monk fruit). I’m wondering if there have been studies done with natural sweeteners.
Patti
NC
Is Stevia included in this? I thought that one was safe.
Lydia Jasper
VA
What about Stevia? Is that safe? We’ve stopped using Splenda as that apparently is not good for an ailing thyroid.
Pat
Dallas, TX
I have yet to see any studies examining Stevia. Several people have told me it is the only safe alternative. Yet I never see it mentioned in articles concerning sugar alternatives. Any idea why?
Janet
NJ
What do the researchers propose to all the T1DM people who use artificial sweetners to sweeten beverages, cereal and other food items that need sweetness to be more flavorful?
I’ve been using artificial sweeteners for over 65 years. I am normal weight, my c-reactive protein level is extremely low and most importantly my diabetes is under control. Last A1c 6.4.
I’ll take my chances and keep using equal and sweet ‘ low thank you very much. I would be in far greater danger of ill health by not controlling my sugar than I am from using artificial sweeteners.
Jesse
Texas
Stevia is a plant, so it is not an artificial sweetener but does it cause the same affect?
Jan
I am convinced different people respond differently to nearly everything, and I definitely do not respond to artificial sweeteners the way this (and other recent) research claims. As a child, I was overweight. As a teen, I was obese. I decided not to end up morbidly obese like my grandmother and 4 of her 5 sisters. I went on a diet I don’t recommend, but lived primarily on diet sodas. I lost 57 1/2 pounds in 3 months. Over the last nearly 60 years, while I adjusted to a healthier approach to keeping my weight under control, I found that every time I tried to stop drinking diet soda, I ate more and gained weight. When I allowed myself to have diet soda, I ate less and lost weight. Contrary to the claim that it causes one to crave sweets, I don’t eat sweets at all, have no desire to eat them, and have found I am reducing and even eliminating the non-caloric sweetener amounts I use in things like coffee because my taste for sweets has been diminishing over the years. Contrary to many who diet, I have never regained the weight I lost on that crazy diet; I currently weigh what I did at the end of that diet. I would never recommend the diet I used, but am glad I did it, and am convinced that while the research may well have validity for some, even for most, some people will find the results don’t hold up for them personally.