Doctor's Note

Check out these other videos on artificial sweeteners:
Neurobiology of Artificial Sweeteners
Unsweetening the Diet
How Diet Soda Could Make Us Gain Weight

For further context, also see my associated blog posts: The Best Foods: test your nutrition knowledgeHibiscus tea: flower powerSoy milk: shake it up!Vitamin B12: how much, how often?Aspartame: Fibromyalgia & Preterm Birth; and Is There a Safe, Low-Calorie Sweetener?

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  • JJ

    I appreciate that this kind of video has to be short and can only cover so many topics. However, I have a nit to pick on the topic of xylitol.

    The gist of the video seems to be that since xylitol can have a laxative effect, it falls into the harmful category. Well, prunes can have a laxative effect if you eat too much of them. Surely you wouldn’t put prunes in the harmful category?

    I believe that there is a safe level of xylitol under which there is not a laxative effect. I believe that not only because of all the websites which claim this to be true, but because I suck on xylitol mints and chew xylitol gum all day long and am not aware of any harmful effects.

    The reason I am nit picking on this is that it is my understanding that xylitol can have some very positive health effects: (I’m probably getting the details wrong here, but the gist is:) the bacteria or whatever that cause cavities can not east xylitol and having it in your mouth can help prevent cavities.

    One website even said that Finland? gives out xylitol gum to kids to help prevent cavities. And other websites talk about the ability of xylitol to help control or prevent ear infections in kids.

    Is all that BS? Or could xylitol be beneficial when taken in safe amounts?

    Since stevia recently seemed to be getting a nod from you as ‘safe under a certain amount’ and yet stevia can actually be turned into mutagenic(sp?) compounds!, surely a substance that might have some mere laxative effects and yet also has some positive effects might also be deemed as safe under a certain amount?

    What are your thoughts?

    I’m also very curious about the statement that sorbitol and xylitol are the same. Everything I’ve read said that they are both _something (sugar?)_ alcohols, but that they were slightly different. Thoughts on this?

    Thanks for any clarifications you care to provide. I really do appreciate the information and do not mean to be too critical. I’m very interested if you know something I do not about xylitol not really helping teeth or ears. Thanks.

    • Michael Greger M.D.

      Not nit-picking at all JJ–thank you so much for question. You’re right: the mantra of the field of toxicology is that it’s the dose that makes the poison, and so in small amounts (like gum and little candies) the industry can get away with using sugar alcohols such as sorbitol and xylitol (different, but have same effect, as they are not absorbed into the blood stream and so draw water in the bowel). But it’s not a realistic sweetener for things like sweetened beverages, which would have levelss that would have people running to the bathroom. Bottomline: sorbitol and xylitol are safe in small amounts, but I recommend erythritol instead, since it is in the same class of compounds, but does not have that unpleasant effect even when taken in even relatively large doses. More on sweeteners here.

      • JJ

        Thanks for the clarification. That helps. And since I drink flavored green teas (another question coming to you on another video), I should be OK sucking on my xylitol “mints” and chewing my xylitol gum.

        I’m going to look into seeing if I can get mints and gum made out of erythritol, but I wonder if erythritol has the same protection against cavities as xylitol. While cavities can be fought other ways, I appear to need all the help on fighting cavities as I can get. If sucking on some xylitol mints does the trick but erythritol does not, I’ll probably stick with the xylitol. (On the other hand, if reports of xylitol’s effect on cavity prevention has been exaggerated, then I will definitely re-think which gum I chew.)

        Thanks again for taking time to reply. It’s going to get tougher the more popular this site gets. :-)

        • Michael Greger M.D.

          Helping so many people that I don’t have time to help people more is not the worst problem to have, but I will keep it up as much as I possibly can. Erithritol does seem to help prevent cavities as well, but the latest review found that the evidence supporting the use of sugar alcohol for caries (cavity) prevention is not strong.

      • Trig Trigger

        Dr. Black at Cedar Sinai keeps away from all artifical sweeteners.

      • cyndishisara

        It never had that effect on my and consumed 3 tablespoons or more per day. It xylitol might help rebuild bone. What a bonus to throw out?

      • Heather

        During my dietetic internship I completed a rotation in oral health. Xylitol, while efficient in fighting cavities, is often only found in trace amounts in many brand name gum and mints. The marketing can be confusing and requires buyers to do their research. While there are mints and gum with the necessary amount of xylitol available, they are often found at specialty stores or through a dentist’s office. Spry and Xylit are too well known brands. So while they are appropriate for fighting cavities, as a sweetener it would most likely result in an uncomfortable situation. There is some great information about a number of sweeteners in this video. I would check it out.

        • meows

          I’m personally a big fan of xylitol. I use Hager Pharma Dry Mouth Drops sweetened only with xylitol. It has 2g of xylitol per drop and it’s the first item in the ingredients list. I’m so glad I found it. My mouth gets very dry when I sleep and I start coughing and wake up. Xylitol increases saliva production to keep mouth moist and I no longer have the waking up coughing problem! I also pop a drop when I go running and it really works to avoid a dry mouth (so I don’t need to carry water on shorter runs). Works great. Sometimes I need to pop drop after drop throughout the day because I’m stuck at the airport or on a flight with bad air circulation otherwise I start coughing. And I grab a xylitol drop after each meal to reduce bad oral bacteria. I have to say, I’ve never had an “uncomfortable” situation. I wonder how many grams of xylitol it takes to create a laxative effect.

          Before these wonderful drops, I was getting extreme teeth sensitivity from using generic “sugar-free” cough drops (even though I was using Sensodyne toothpaste for sensitive teeth at the time). When I told my dentist, she said it couldn’t be the cough drops. I said my sensitivity started when I began using the cough drops extensively and got better after I stopped because I suspected it was the culprit. She didn’t buy it. So I found a study which concluded that sugar-free cough drops sweetened with a mixture of Isomalt and sorbitol have been shown to produce such low pH that it’s sufficient for bacteria to grow and produce acid to demineralize dental enamel:

          I looked at the ingredients of my cough drops and there was in fact isomalt and sorbitol. I emailed my dentist the study and all she said was, Oh, I didn’t know. Just goes to show, you have to take personal responsibility when it comes to your own health, whether it’s nutrition or oral health.

          Since then, I have paid close attention to what sweeteners I use. I have also adopted a xylitol mouthwash because I read of its association with inhibiting harmful oral bacteria growth and thereby reducing dental caries. As a note, my dental hygienist has commented on my healthy gums, saying I didn’t really need a cleaning but since I was there she’ll do a once over and asked what my routine is… since I started using xylitol regularly. I love it!

          Of course, as a mouthwash, you’re not swallowing the sweetener! But I fear many people will be deterred from considering xylitol for anything at all based on this video. I definitely think xylitol can be a valuable player in the oral health care industry.

        • meows

          I’m a big fan of xylitol. I use Hager Pharma Dry Mouth Drops sweetened only with xylitol. (Found it online at Walgreens.) It has 2g of xylitol per drop and it’s the first item in the ingredients list. I’m so glad I found it. My mouth gets very dry when I sleep and I start coughing and wake up. Xylitol helps increase saliva production to keep mouth moist and I no longer have the waking up coughing problem! I also pop a drop when I go running (so I don’t need to carry water on shorter runs). Works great. Although this product is marketed as a dry mouth drop, I also grab a xylitol drop after each meal because I read it helps reduce bad oral bacteria. Sometimes I pop one drop after another throughout the day because I’m stuck somewhere indoors with bad air circulation (like at the airport or on a long flight) otherwise I start coughing. In my personal experience, I’ve never had an “uncomfortable” situation. I wonder how many grams of xylitol it takes to create a laxative effect…

          Before these wonderful drops, I was getting extreme teeth sensitivity from using generic “sugar-free” cough drops (even though they’re supposed to be tooth-friendly and I was using Sensodyne toothpaste for sensitive teeth at the time). When I told my dentist, she said it couldn’t be the cough drops. So I found an article which suggested that sugar-free cough drops sweetened with a mixture of Isomalt and sorbitol have been shown to produce such low pH that it’s sufficient for bacteria to grow and produce acid to demineralize dental enamel:

          I looked at the ingredients of my cough drops and there was, in fact, isomalt and sorbitol. I emailed my dentist the study and all she said was, Oh, I didn’t know. Just goes to show, you have to take personal responsibility when it comes to your own health, whether it’s nutrition or oral health.

          I have also adopted a xylitol mouthwash (Epic xylitol spearmint mouthwash, a 25% xylitol solution — from Vitamin Shoppe or Amazon). As a note, my dental hygienist has commented on my healthy gumline, said I didn’t really need a cleaning but since I was there she’ll do a once over, and asked what my routine was… all since I started using xylitol regularly. I didn’t get that before. I love it!

          Of course, as a mouthwash, you’re not swallowing the sweetener! But I fear many people will be deterred from considering xylitol for anything at all based on this video. I think xylitol can be a valuable player in the oral health care arena.

      • rix

        Boy I’m glad you clarified the stance on Xylitol. I too have been using it for years and have long learned that you do not go above a certain (low amount) limit unless you are prepared to dash to the restroom. But for that morning coffee with one teaspoon, I have no issues with it at all and it does NOT have that nasty aftertaste of Stevia. As for Xylitol gum, while miles better than that poison Aspartame for sugar-freeness, the flavor goes dead almost as fast as it hits your mouth. Perhaps when it comes to ‘gum’, the amount of real sugar may be low enough that going sugar-free is really a non-issue?

    • Susan

      I have consumed Sweet Leaf stevia for years before I decided to simply drink beverages and eat foods that did not need to be artificially sweetened. Therefore, I eliminated the need to such sweeteners.

      Since I’ve been eating vegan, I’ve reduced my consumption of grains to eating them only to balance my amino acids, and have reduced or eliminated cavities and gum disease by simply brushing correctly and flossing.

    • Roberta

      I used to have terrible tarter buildup at the gum line of my teeth. Here is what has made such a difference for me: I mix xylitol with cinnamon and clove powder and use to brush my teeth. It tastes so good, that I love to brush. I never have bad breath and most importantly, my dental hygienist, always reports on how little tarter buildup there is to remove.

      There are expensive toothpastes with xylitol but I prefer the jar with cinnamon and clove I mix myself. I once read that xylitol was natural in strawberries and that in the Middle Ages strawberries were considered the fruit of lovers since strawberries kept the mouth clean and breath sweet.

      • Dohduh

        in what quantities do you mix your toothpaste? Does the type of cinnamon matter?

    • cyndishisara

      Xylitol rebuilds bone (in rats) at a concentration which is biologically absorbable at 5% of calories consumed with a diet of a 0.05% daidzein from soy. Xylitol has a nice pleasant taste. It is worth investigating especially for post menopausal women. It is most interesting that the authorizes of the research propose that xylitol gut flora. Apparently for the better. Human gut flora is notoriously hard to alter compared with rats. So this needs to be tested in humans.

  • wickedchicken

    I wouldn’t classify “a laxative side effect” and “bladder cancer” in the same category i.e. harmful. Bladder cancer is harmful, laxative effect is a nuisance. I understand there’s no in-between category, but if there was one I would keep “laxative effect” in a “Not harmful but there are side effects” category!

  • Iggyputty

    I use citrucel sugar free, which has aspartame. How much of a disservice am I doing to myself by not using the sugar one? Or are both evil, and I need to find a different, unsweetened product? (obviously any laxative effect is not a bad thing.) thanks!

  • MelanieP

    Anyone know the temperature that erythritol dissolves at? I’ve read that the cooling sensation disappears when erythritol is dissolved (and that it dissolves at a high temperature), but I can’t seem to find the specific temperature.

  • mmccleery4099

    Does erythritol stimulate appetite? I have “heard” that sweets (fruit, cookies, candies, gum, etc) stimulate appetite.

    • Megann19

      I have not heard of any appetite-stimulating properties of erythritol. I have, however, heard of some of the artificial sweeteners being capable of this, and definitely high fructose corn syrup (contains an abnormally high amount of the monosaccharide, fructose). On the other hand, any of the sugar alcohols can cause flatulence and have a laxatrive effect, in larger quantities. Erythritol is less likely than other sugar alcohols to have this effect, and everyone’s threshold is different.

    • Mae Blue

      all those things increase my appetite, sadly…

  • data

    I thank you for just being alive and contributing all of the wonderful wisdom you share with us daily! Cant thank you enough Dr. Greger!!

    What is your take on the following substances?

    Gymnema Sylvestre (Gurmar)

    Eugenia Jambolana (Jamun) ( This is a purple coloured fruit found extensively in India and something I often picked up and ate as kid as it fell of a tree. Was told it is highly prized as a curative fruit for Diabetes.

    Momordica Charantia (Karela bitter melon ). This is something my father ate every other day as a curative fruit for diabetes. I never liked the taste, but once my mother got it suitably spiced up and with some sweetener, ( I would use only Zsweet now since seeing your video on artificial sweeteners being lousy food substitutes )

    Trigonella Foenum Graeceun (fenugreek) Commonly used in India curry recpies……and for many remedies…including spicing up a man’s sex life.

    Lastly, Dr. Gerger what do you think of Citruline and L Argenine in their role as helping out in repairing the endothelium cells ( Citruline ) and the later helping in promoting Nitrous Oxide formation if one used the drug versions instead of Citruline absorbed thru Watermelon rind where a large portion of citulline is usually discarded?

    Thank you again for all the wisdom you expound here…thanks and Namaste…..Data

  • Michael Greger M.D.

    So glad you find my work useful! I’ll have to look into gurmar and jamun; as for citrulline and watermelon, I cover that in my video Watermelon as Treatment for Erectile Dysfunction, which is chapter 33 of my Latest in Clinical Nutrition DVD, volume 8, and should air here at by the end of the month. I’ve also got upcoming videos on fenugreek, so I leave you in suspense (*spoiler alert*: fenugreek seeds appear to have both muscle-building and anti-cancer properties, but do have an unusual side effect: they may make your armpits smell like maple syrup!).

    I’ve often wondered about bitter melon myself (Momordica charantia, also known as karela, or bitter gourd). I’m glad you brought it up to give me an excuse to look into it. I’ve seen it at the Indian spice stores I frequent (looks kind of like a ridged warty cucumber), but never tried it. I hear it lives up to its name, though. In fact the more ripe it gets, the more inedibly bitter it evidently becomes! But with enough heavy spicing I guess anything can be made palatable (the best way to mask the taste appears to be tomato-based sauces).

    A study published just a few days ago found that an extract of the fruit appeared to slow the growth of a rare cancer in a petri dish (adrenocortical carcinoma, an aggressive 1 in a million cancer of the adrenal gland), something that extracts of blueberries, zucchini, and acorn squash couldn’t do. Similar findings were reported in 2011 with prostate cancer cells and in 2010 with breast cancer cells. Traditionally, bitter melon has been used to lower blood sugars in diabetics, though most of the studies to support this use have been small and methodologically weak. There was a randomized controlled study published in 2007 that found no significant improvement in long-term blood sugar control in diabetics, but there have also been case reports of children having hypoglycemic seizures (and one even sinking into a coma) after drinking bitter melon tea, so presumably there is some blood-sugar-lowering effect there somewhere. If you are going to try it, I would recommend eating the fruit itself, not some extract. For example, there is a published report of a man who started throwing up blood after chugging two cups of bitter melon juice, which apparently ate through the wall of his stomach.

  • johnduda

    Dear Dr. Greger, given that ZSweet is a combination of Erythritol and Stevia, shouldn’t we be eating pure erythritol instead, until we get definitive results for stevia? Thanks so much for your wonderful website.

  • Michael Greger M.D.

    For some context, please check out my associated blog post The Best Foods: Test Your Nutrition Knowledge!

  • Dohduh

    Have you seen any studies or information about coconut sap?  I have used it in baking (I didn’t know about erythritol until now) successfully (as opposed to Stevia – ick).  The only info I find online is positive from the Philippines, the location of its manufacture.  It is reported to be low glycemic.  I use Coconut Secret, whose label has the Non-GMO verfied stamp.  Also claims 100% organic, GF, unbleached, unrefined, and vegan.

    •  I have not been able to find any studies on coconut sap. I would employ the “precautionary principle” and avoid any food or substance that hasn’t been studied especially since there are options available which have been studied as Dr. Greger’s videos point out. The high low glycemic incidence scale needs to be viewed with caution. Fructose for instance doesn’t increase the glucose in body but is metabolized by the liver to uric acid, cholesterol, fatty acids and inflammatory compounds. Consumption should be confined to natural sources such as fruits and vegetables. Be well.

  • Gayle

    My daughter recommends erythitrol found in Zsweet, but I have always used KAL brand Stevia with Luo Han.  According to Life Extension magazine the properties of Stevia actually are good for the pancreas.  I do not get inflammation in my joints as I do in sugar alcohols.  I have never tried erythitrol so I don’t know how that may effect them.  If it is acidic, it will make my arthritis flare up.  Stevia does not do that.  I have never heard that health care was up in the air about Stevia.  Never.

  • rinths laby

    I don’t see much risk from sucralose. The only reports I see on PubMed that connect sucralose with migraine are case reports, not real studies. Maybe people who suffer from migraine have reason to avoid sucralose but I don’t get migraine. In my mind that’s roughly in the same category as the fact that some people have food allergies. Doesn’t mean I have reason to abstain. 

    • beccadoggie10

      Sucralose was created to be a pesticide. When told to test it, the tester misunderstood and tasted sucralose and found it to be sweet. Hence, his company made it into an artificial sweetener.

      Rinths laby, the only side effect I knew l had from aspartame was vision problems. I could not see with or without my bifocals. My Preventive Ophthalmologist retested my eyes and found nothing wrong. I wondered if it could be aspartame. And at the time, I was on a Multiple Chemicals Sensitivity discussion list and so was a tenacious nurse who started researching the health damaging effects of Equal/aspartame. One of many side effects was vision problems.

      Taking the precautionary approach, I discarded all aspartame and never purchased it again, or any synthetic sweetener, and my vision improved to the point that I did not even need eye glasses for several decades.

      Headaches or vision problems may mean that the chemical compound may be damaging the brain. A brain is a terrible thing to lose!

  • Healthy Mother

    Great Info Dr. Greger, thank you!
    The best TASTING sweetener my family ever used is LAKANTO.
    Made from Erythriol and Monk Fruit. It has been sold in Japan for 15 years! Now it’s finally available for us in US!

  • What’s wrong with Cane sugar in moderation? harmless or harmfull

    • Susan

      Cane sugar is grown with the herbicide that regulators have found whenever they are searching for something else and it’s in the tapped water of most Americans and people worldwide. The name of the chemical is:
      Atrazine and it has been banned in Europe.

      “Atrazine, which is produced by the Swiss agrochemical company Syngenta,
      was first registered for use in the United States in 1959. The herbicide
      has been banned in the European Union since 2004 — individual countries
      in Europe banned Atrazine as early as 1991—but 80 million pounds…is used each year in the United States.”

      Syngenta is one of the corporations who helped fund the No right to know about GMO’s in food campaign in California against the passage of citizens ballot initiative, Proposition 37, which lost by a very narrow margin, but would have given California citizens mandatory labeling and the right to know about GMO’s in food. Where California goes, so goes the country. The right to know is temporarily dead, as more and more citizens across the USA are putting the matter on the ballot repeatedly. I urge you to become involved.

    • Cane sugar in small amounts should be fine. Sucrose is half glucose(our bodies primary fuel source and fructose metabolized by the liver into uric acid see…, cholesterol, triglycerides and fats… so we should use the latter with some caution. There are no phytochemicals in sucrose and if you go a bit without using sweeteners in beverages most of my patients are able to develop a taste for non-sweetened beverages.

  • What could possibly be wrong with stevia?, they use it to heal

    • Mae Blue

      truvia is not just stevia, beware

  • BB

    Truvia is GMO

    • Steve

      What about dry organic stevia leaves; either made at home or Frontier Organic’s Coop product? Are there any studies of material
      available? Thank you-Steve

  • Sarah Rishel

    Although Truvia does contain stevia, the number one ingredient is erythritol! I almost didn’t buy it… luckily I had a smartphone, googled erythritol, and decided it sounded good. Since they don’t sell that Z stuff at my local grocery store, I guess I will take my chances with the stevia. After all, don’t some people take it as a supplement? Also, it could be like the pomegranate juice and not actually contain stevia anyway :) By the way… I really like this website. It’s addictive.

  • hcousar

    I was wondering what would be a good sweetener to use for making tea. I have been using Walmart version of Splenda. I have recently been reading online that this could be the culprit of pain and inflammation and believe I am suffering from it. I have osteoarthritis and just recently been diagnosed with fibromyalgia if it is the artificial sweetener causing these problems then I am gonna stop. Problem is I am over weight so I know sugar is not good either. So what would be a better alternative for tea and coffee? I can’t stand the taste of them or any thing else unsweetened. Please help with any information.

    • johan003

      I love carbonated water; give that a try. When I was on the South Beach Diet and they suggested using Splenda I got so sick feeling from it – just felt awful and my eyes were very light sensitive. I finally figured out what was causing it and haven’t used artificial sweeteners since.

  • Candace Lee

    Any thoughts on “Swerve”?

  • jlikenutrition

    Dear Dr. Greger,
    Thanks for all the great work and videos. I have a question about sweeteners.
    Where would maltitol fall in this category? I came across this and other videos while searching for sugar alcohols. Do you think you’ll be doing anything on them soon? Thanks!

  • Kunga

    Hi.. I am new to your site and have found it very helpful. recently I have been trying to make better health choices and have watched a few health shows that have really opened my eyes to what could be harmful to my body. Currently I use Sugar Twin but would like to try something else. I like Truvia and believe it is a more natural sugar. You didn’t mention it in your video “A harmless artificial sweetener” unless i missed it? I believe that some of the side effects I am experiencing is from using sugar twin! any advise would be great….I find that I am now ready every label b4 I put the food in my mouth.. thx! I will continue to use your site…..

  • Aaron Hollander

    Except in rare cases, why would anyone avoid sugar?

    • aprolifer

      1) It’s addictive, in a way that things like xylitol and erythritol aren’t. 2) It makes my joints hurt. 3) It’s contaminated with Roundup, both cane sugar (they use Roundup to ripen it, like they do wheat) and beet sugar (sugar beet has been genetically modified to tolerate Roundup as a pesticide.) In countries more advanced than the USA, Roundup is acknowledged to be carcinogenic.

  • SFChutzpah

    Oh, God! I just bought 1500 packets of Splenda at Costco.

    • Jentle72

      Don’t worry about it. Go eat your ton of sucralose. This video doesn’t back up supposed sucralose dangers with any legitimate scientific data. I came here hoping to be enlightened about sucralose and all I get is “it may trigger migraines”. The verdict (based on that one claim): HARMFUL. This video seems like it was made for people with little to no scientific background who automatically think anything made in a lab is the devil’s work. Depressing.

      The first thing this doctor does is poison the well with the fact that sucralose was accidentally discovered in a lab while trying to make an insecticide. And your point is???

      Cornell? Seriously? This doctor must be a brilliant man to have gone there (seriously, I am not being sarcastic). Why would he make something so silly? DANGER! DANGER! RED LIGHT! RED LIGHT! Geez, my husband gets migraines from mangoes. Conclusion: MANGOES ARE HARMFUL!

      Sucralose is safe. Take note that many of the studies that found sucralose to be toxic where done by (surprise, surprise) the sugar industry!

      • Tania

        I’d be interested to hear your response to this Dr Gregor. I have greatly valued your contribution that helps clarify the mass of confusion that exists about nutrition…I was disappointed when I discovered the magnesium supplement that I purchased from a naturopath had sucralose in it. What is your response to the link posted by Jentle72 supporting her/his claim that “Sucralose is safe.”

        I am inclined to avoid it, which isn’t so hard for someone committed to a wholefood plant based diet anyway…but I was after some sound research to share with my naturopath in case she says something to the effect that “there is nothing wrong with it and is no problem in the amount found in the supplement.” I found this article which looks supportive, but not a research paper as such:

  • Daver

    I appears this video on “safe” artifical sweeteners is a few years old…so it may be time to take another look at this topic. I was excited that FINALLY find that there was an artifical sweetener that was shown to be safe and have been using erythritol since seeing this video. However, I just ran across a story on erythritol that would be worth investigating a bit more. Here is the link:

    The gist of the story is that erythritol has shown to be an effective pesticide for fruit flies… which now possibly puts into question the health impact on humans.

    I would interested in your thoughts on this.

    • Toxins
      • JesusChild

        Ok Toxins, definitely appeciate the reply to Daver, but the link you have is to a video that’s at least 2 years old. I agree with Daver, it would definitely be nice to have another more recent look at the topic.

        I read the article Daver linked to and it talked about the erythritol used being a GMO product from Truvia and it being interesting if the non-GMO product didn’t produce the same effect. It was a good little article in my opinion.

        • Toxins

          2 years old does not mean irrelevant, the foundation of good nutrition rests upon studies that are decades old. I am all for more studies on erythritol but for the time being its effects in humans are positive as studies have shown. In addition, GMO bears little weight on whether a food is healthy or not.

  • Maryann Gianantoni


    • vphelps

      I, too, would be interested to know if there is a difference between consumption of the refined stevia powder and the whole leaf. I grow it in my garden. In the summer I use a few fresh finely chopped leaves in sweet salads containing other fresh herbs, fruits and nuts. In the fall I harvest and dry the remaining leaves, then pulverize them in a coffee grinder. With the whole leaf still in the mix, it’s use is limited to primarily salad dressings and other foods with flavors that either compliment or mask the “green” taste so I’m not inclined to over-do it with whole stevia. But still, I would also like to protect my DNA. Have any studies been done on the people in South America who have been using stevia for centuries?

  • Anisa Marie

    Xylitol, perhaps with Laxative effect, … is that the ONLY bad effect it has on people ? If one is constipated, could Xylitol not be beneficial for some people ?

  • Anisa Marie

    I am thinking to keep Xylitol and Erythritol always on hand, and to finish the use of Stevia since your recent research shows some effect of steviosides not being healthy after certain amounts. I have used Stevia in liquid form since 1997 and have been fond of it in liquid form, ordering it from Swanson Vitamins in the 8oz size.

  • Anisa Marie

    It is true, Dr Greger, that Americans have a “sweet tooth” and I am among those, since I was a child. I have tried, but cannot banish it from my tongue. While eating mostly vegetarian fresh veggies, occasionally I love and recommend sweet things, and use only organic healthy sweets such as fresh fruits, manuka honey and maple syrup, and until now, Stevia. It is why I use coconut sugar in my organic, fiber packed, gourmet, double chocolate brownies, using four fibers (flax, wheat bran, almond flour, buckwheat flour) and grass fed butter and eggs. I have now read your research on Date Sugar being at the top of the healthy list, and will attempt to make the brownies with that. I am not sure that Erythritol will do well in the brownies, since the science of baking has much to do with the reaction of traditional granulated sugars to oven heat. Such is the experimentation of the Test Kitchen. Thank you for everything you do.

  • alittleluckwouldbenice

    I find this a bit ironic. Johnson & Johnson just hired GS to ‘explore the sale’ of their sweetener Splenda, determined to have NO nutritional value and considered ‘HARMFUL based primarily on the role it may play as a migraine trigger’ Hasn’t Goldman Sachs given us enough migraines already?

  • Natalya

    Dr. Greger, I was so excited about the cranberry drink you suggested with erythritol. But when I told my dietician about it, she recommended that I return the erythritol back to the store right away. She said it used to be in many products but it has been removed because we cannot digest erythritol and it can cause diarrhea. If it was a great replacement, it would be in more products she says. What do you think?

    • Usually not a problem as almost all of it is absorbed in small intestine with only small amount about 10% reaching colon. Most folks don’t notice a problem. As with many things it is related to dose and individual variability. High doses can lead to diarrhea, nausea, gas and bloating. The fact that it is not included in most products doesn’t mean it isn’t useful. Erythritol has less diarrhea effect than other sugar alcohols but is not as sweet. A bonus is that it doesn’t appear to contribute to tooth decay as does sugar. What many of my patients find is that after time they can get use to less sweetness in their beverages. The nice thing about having the erythritol at home is that you can control the amount you use and see if you tolerate it. Next time you see your dietician you might suggest that s/he subscribe to the best way to keep up with the latest science and it’s free…. except for the time invested. You might be interested in the other 7 NutritionFacts video’s related to Erythritol…. go thru Health Topics link. Bon Appétit!

  • joyce gem canete

    please update your facts. my textbook says acesulfame-k, aspartame, and other sweeteners are already safe for consumption. Thanks for this vid though!

  • Technus

    All zero calorie sweeteners are harmful because they produce the same reaction in the brain by overstimulating nuerons to death. ALL of them give me seizures, even the Natural Stevia that everyone is obsessed with these days. You just can’t cheat in this world. If you want your sweets, just stick with fruits or sugar.

  • Nate Macanian

    I was wondering what your thoughts were on using the sugar alcohol Lakanto as a substitute for sugar or artificial sweeteners. I can’t seem to find any body of evidence showing detrimental side effects, but then again, I know it’s a relatively new product to the American market. Any input would be helpful, thanks!


  • Uncle Siam

    Could you cover Monk Fruit as well? I just tried some and it it indeed sweet , I am liking it over Erythritol but I am still comparing it price-wise. Sucralose has always been my mainstay and I like things really sweet unfortunately. I’ve been trying to find a good alternative. I’ve been using it in my Water/Cacao drink (no milk) when I’m not drinking Hibiscus Tea.

  • Will Fagg Rn

    Anyone know anything about swerve brand sweetener ? The Ingredients are Erythritol, oligosaccharides and natural flavors. Are oligosaccharides unhealthy ?

  • sfr53

    Trident gum says on the package – ‘Cleans and Protects Teeth’
    But it contains sorbitol, xylitol, mannitol, sucralose and red 40 lake along with acesulfame potasium, bht, soy lecithin among other things.
    After reading this article I guess I should not use this anymore?
    Has this type of gum been studied by anyone?

  • Karen Anderson

    Is Monk Fruit sweetener harmful?

  • Annetha

    Barring info to contrary, we should keep erythritol away from our dogs? Apparently, another sugar alcohol can poison dogs:

    “When dogs eat something containing xylitol, the xylitol is more
    quickly absorbed into the bloodstream, and may result in a potent
    release of insulin from the pancreas. This rapid release of
    insulin may result in a rapid and profound decrease in the level of
    blood sugar (hypoglycemia), an effect that can occur within 10 to 60
    minutes of eating the xylitol. Untreated, this hypoglycemia can quickly
    be life-threatening. ”

    Xylitol and Your Dog: Danger, Paws Off

    (Treatment for hypoglycemia might be to feed the dog something sweet, like sugar or honey?)

  • meows

    Here is an article regarding “The effect of xylitol on dental caries and oral flora”:

    I don’t know if evidence has been disproved in any way since its publication, but in my opinion, there’s enough positive associations to incorporate xylitol into my daily routine. Here are dosage recommendations for oral health:

    “Habitual xylitol consumption may be defined as daily consumption of 5–7 g of xylitol at least three times a day. The recommended dose for dental caries prevention is 6–10 g/d… At high dosages, xylitol can cause diarrhea in children at 45 g/d and 100 g/d in adults. The amount tolerated varies with individual susceptibility and body weight. Most adults can tolerate 40 g/d.”

    Please refer to the article for more intriguing details. They conclude that properly designed randomized controlled clinical trials are needed. I certainly agree.

  • Edd

    I wish you would do a update vid like the Traffic light system one you did 5 years back. Is there any good news for pure Stevia without adding a lot of the other bad sweetener stuff?

  • Bruce

    When I look at the ingredients list on “Z Sweet and Truvia they are virtually identical, both list erythritol first, then stevia and then natural flavors. Why then is Z Sweet considered a erythritol sweetener and Truvia categorized as stevia?

  • Debbie Danielson

    What is lucuma powder and is it healthy?