Erythritol, which often has Stevia and Monk Fruit added linked to high risks for heart attack & stroke

This article came out today, very disturbing: Erythritol: Zero-calorie sweetener linked to heart attack, stroke, study finds - CNN

If TLDR, it basically states that Erythritol, Stevia and Monk Fruit are all linked to increased risk for Heart Attacks, Strokes etc.

I use all of those products, they are essentially my saving grace for sweeteners. They are tolerable (for me) and they work to keep my BG at bay. Curious if anybody had any additional information or thoughts on the matter. There are at least two previous posts on the topic: Stevia and Erythritol possible cause of heart attack stroke

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I’m also wondering if the same is true for allulose as I totally switched from Stevia and monk fruit.

@rcarli Great question, I don’t consume as much Allulose as I do the others, it might very well be a safer alternative. Personally, I am a believer in the principals of moderation no matter what. What I would likely do is use all three so as not to over consume any one in particular.

Maybe I didn’t read the article well, but my impression was that stevia and monk fruit products contain a lot of erythritol, not that they themselves cause the heart/stroke issues that erythritol may cause.
It might seem like a distinction without a difference, but I have a vested interest. I use liquid stevia. Looking at the ingredient list, there is no erythritol listed, though the product is 11% cane alcohol on one of the brands I use and 11% alcohol (no modifier) on the Trader Joe’s brand.
For the more scientifically knowledgable among you, do you think that cane alcohol is sugar alcohol and therefore likely to have similar negative effects to its cousin sugar alcohol erythritol?
I guess I took a little comfort in the idea that erythritol is used to “bulk up” stevia and that the liquid stevia doesn’t need as much bulking up…? Maybe I’m kidding myself because I want to keep using it.


I think you did a good reading and understanding of the article. I never thought that Stevia and monk fruit alone were implicated in cardiovascular events. But that erythritol was used in some of those products to bulk them up.

Hobson’s choice, I think. Elevated BGs, elevated A1c, while not the only factors, also increase risk of heart attack / stroke. The food industry is NOT thinking about those with T1DM or DM, or pre-existing cardiovascular risk factors. Food industry, across the board, is thinking about marketing for profits. Food industry substitutes are marketing to the Giant Weight-loss industry. The fact that those with T1DM / DM find a quality of life factor in the sugar substitute domain is important, though. Humans have a propensity to find joy in sweet foods and this has to count for something even if there is risk.


I use date syrup or pure maple syrup to sweeten some foods. They have a lovely taste.

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So if it isn’t Stevia and Monk Fruit by themselves but rather something that is added to “bulk up” those products then how is one to know exactly what contains the offending additive? Do food labels have that information?

I am not familiar with monk fruit but stevia is hundreds of times sweeter than sugar. To make a teaspoon of stevia equal to a teaspoon of sugar erythritol is added to bulk up. Here’s the label of Splenda Stevia. You can see erythritol is one of the ingredients along with stevia leaf extract.

It’s erythritol, a sugar alcohol that’s the issue, not stevia or monk fruit.

It’s just erythritol is put into a lot of sugar free products that also use stevia or monk fruit. It’s also used in a lot of Keto products because it had been considered the safest of the sugar alcohols to not raise blood sugar levels. The other sugar alcohols have more carbohydrates in them.

I love stevia!

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If I am lost to ravages of Truvia, please remind my wife and testify in her extensive litigation. She is gonna be rich.


@Marilyn6 Great points here. I guess I am now on the hunt for a list of good “non-erythritol” products to change over to. Disappointing because I was using a lot of food products that contained it and my diet was working really well (along with meds and exercise of course) to control my BG. Feels a bit like starting over.

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@mwilson53 Already made food products will be a little harder as erythritol was/is used a lot. Stevia has a bitter flavor, so combining it with erythritol helped the flavor profile. But a lot of food products also use the sugar alcohol malitol, but malitol and xylitol still actually have carbs. It is supposed to move through your system so fast it doesn’t boost your Bg levels. That’s not really accurate as a lot of people are effected, and type 1’s who make no insulin commonly are.

Wisdom of the Ancients/Sweetleaf makes stevia without erythritol in any of them. Always check the ingredients as I haven’t looked at everything. I love their drops. Kal makes powder and liquids without erythritol too.

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@Marie20 Doing a cursory look through the cupboards, I already found two items that list it as an ingredient, Sola brand bread and a snack bar called a Think bar.

I have alternatives for the bread, not really a big deal. The Think bars are a blow for me because I consume at least one, sometimes two a day. My wife bakes for me, she makes muffins that she can sweeten without using the erythritol-based products so, it’s manageable for the most part. Somewhat expensive because alternative sweeteners are expensive and hard to find sometimes.


I skimmed the study to check the cohort size, characteristics, endpoints and read the intro and conclusion. I admit the middle was over my head.

In my opinion the study population was big enough however the population was not healthy to start with. So they are finding these results in people with other cardiovascular issues.

The article appears to sensationalize a well run study. Near the end of the Discussion section the study authors write “In summary, the present studies suggest that trials investigating the impact of erythritol specifically, and artificial sweeteners in general, with appropriate duration of follow-up for clinically relevant outcomes, are needed.”. I agree.


Everyone should relax on this a bit. In time, this study will be processed and dissected and more will be revealed from it.

Some of the limitations of the study are that the majority of participants either already had cardiovascular disease or already had risk factors for cardiovascular disease.

You look at people who generally would be more inclined to take these sugar substitutes. Who does this? Uh… a lot of people with diabetes use them. So those people are already going to be in a higher risk group.

Like doing a study of smokers who ride in in elevators, and saying they are more likely to have cardiovascular disease. It’s the elevators!

Just wait until this gets reviewed and digested.


I think sugar substitutes are bad for us not just for the heart issues. I use real fruit and if I want sugar, then I use it. we can Weanourselves off the sweet foods we got used to.
Artificial sweeteners cause havoc in our bodies because it fools our taste, out bodies still expect a sugar surge when we eat it , then our bodies do not get the surge it’s expecting, and our metabolic rate is decreased. this horrible cycle causes weight gain, which is the reason most people consume them in the first place.
I used them for many years because I was so used to sweetening everything. After a short while of not sweetening coffee and tea, I no longer want it.
I also became turned off by most commercially produced sweets because they are so concentrated with sugar that it makes no sense to me.

It took me a very long time to realize that there are no corners you can cut and nothing comes free and without consequence’s . I realize not everyone can just give up on sweet things, but maybe you can try to eat real sweets, but a small amount when youreally want it, then dose accordingly.
I think we are better off. When I want a cookie, I’ll eat one, I won’t apologize and I won’t feel bad. but I’m going to eat a real one or I’ll pass entirely. most of the time I eat healthy Whole Foods, and I do the best I can


Does the sweetener Erythritol cause Heart Disease?? | New study - YouTube.

I find this medical doctor, science researcher to be extremely bright and very fair. He breaks studies down very well. He did not like the erythritol study, so I think he is worth listening to.


@Timothy I think you are hitting on the most important point in all of this. That being that everybody has different circumstances and we all have to choose our own best path, regardless of whatever we find out about some additive/chemical that may or may not cause harm. I think dealing with all aspects of the problem are important, specifically how we are personally handling sweeteners in general terms.

If a diet is completely dependent upon these sweeteners then in all likelihood, said diet is probably not very sound to begin with. Just an opinion.

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@Marilyn6 Thank you so much for this link! This video is the result of “cooler heads prevailing…” I would recommend anybody with an interest take the time to watch it.

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