Thanks that was very good. I tend to take articles in the popular press about scientific studies with a sack of salt. They seem to grasp on whatever will set people’s hair on fire.
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You need to look carefully beyond stories that report risk, at their sources.
It want a clinical trial but a retorspective analysis and the cohorts compared were overweight and older with +70% of them having existing coronary artery disease and hypertension. The risk here was highER, not high.
What was found was an association between heart attacks and elevated levels of erythritol. That’s not causality. It could be that whatever lead to a heart attack causes the level to rise, like having diabetes causes blood glucose to rise.
So "further studies are warranted. "
To determine objective risk and causality , it would be necessary to compare incidence in a cohort without erythritol use and compare it to one using it over time.
If you are worried about artifical sweetners, they aren’t found in most natural fruits or vegetables, and the sweetner most studied is saccharin.
This article is very poorly worded regarding Stevia and Monk Fruit. " Erythritol is also the largest ingredient by weight in many “natural” stevia and monkfruit products, Because stevia and monkfruit are about 200 to 400 times sweeter than sugar, just a small amount is needed in any product. The bulk of the product is erythritol, which adds the sugar-like crystalline appearance and texture consumers expect."
This is NOT true for all Stevia and Monk Fruit products! I use Better Stevia … unless the label is lying, there is no Erythritol in it. Same for my Organic Monk Fruit by NOW … says 11% cane alcohol, but does not say Erythritol.
I do think Truvia and some other Stevia and Monk Fruit products do contain Erythritol … so just check the labels. Truvia’s label:
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Timothy, I – and the registered dietician at my Endo’s office – agree with you. I have not used ANY artificial sweeteners for the last 30+ years, and I am getting along just fine. The dietician told me, “If you need to sweeten something, use natural ingredients (i.e. honey, pure maple syrup, fruit juice, cane sugar) and take the insulin you need to cover it. That will be far more healthy for you than anything that is a synthetic sweetener.” Like you, Timothy, I am not terribly interested in lots of sweet foods, but if I want a cookie, I’ll just count the carbs and eat it. No one has to eat something artificial or synthetic. Those words alone should be a red flag that the product probably is not the healthiest choice.
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That’s fine advice for those with type 1 diabetic without inherited cellular insulin resistance.for those of us with type 2 diabetes and those type1s with double diabetes doing a bolus to cover sugary carbs doesn’t always work well. And many type 2s are not using insulin or if they are it is a basal long insulin.
Even if those with insulin resistance can adequately cover sugary food with a bolus, the downside are elevated triglycerides and fat accumulation.
Having a bit of something sweet that won’t send you out of range is nice. I avoid most sugar alcohols because they have unpleasant side effect. Sweeteners like Splenda and stevia do not cause me any issues.
Aspartame is not an option for me as it caused nerves in my feet and legs to be hyper reactive. This may or may not be an issue of other people. It is not peripheral neuropathy, but like the nerves are overly sensitive. Eliminating this ubiquitous no-caloric sweetener has improved the problem immensely.
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If something that’s not essential to eat for health and survival is unpalatable without added sugar or sweetning, why eat it?
Most likely it’s a habit. Habits can be changed.
I’ve been living with T1D for 45 years and accidentally acquired many food addictions. One of them was to sweet.
Before I was diagnosed I rarely ate candy, cake, soda, pancakes, cereal with sugar, french fries, soda or preprepared processed food. I had never eaten a hamburger on a bun…
These weren’t the majority of my diet but one year ago there was some of them in nearly meal. I never went through a day without one of them.
I think I was trying to be “just like everyone else, not different because I had diabetes”. So I gradually started doing what everyone was being perdusded to do by advertisers.
Over the past year I’ve weaned myself off of most of these. Instead of them being an unconscious staple, sweetened foods are now a treat. I’m down to two:. dark chocolate and one half cup of low calorie pudding at dinner. And I’m consciously trying to make them less frequent by buying them less frequently.
My weight is back down to where it was before I was diagnosed. I lost 10%. I’m eating more natural carbohydrates then I had been and using less insulin.
I’m eating more, better quality food then I did before, enjoying it more and spending less on food.
Yes, I know that this is extreme. My point is that you do not need to eat sweetened foods. You’ve been conditioned to want them.
regarding safety, unless you are allergic to something, the amounts of that what you eat is more important than the components. The amount of an artificial sweetener you eat per is more important then which one you eat.
So before you start looking for a different artificial sweetener question why you need it in the first place.
Availability isn’t a good excuse for eating anything unless there’s no alternative. There’s a huge quantity of free things lying on the ground that I never eat.
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Excellent critique of this study here: Video Podcast #130 - Erythritol Study, 4th Anniversary, Keto at Risk - YouTube
Watch this and I think you’ll stop worrying - I did.
That’s now two comprehensive video critiques of the original study/article. I think I will “Keep Calm and Carry On.”
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Hello,
I am interested in this topic because from time to time I (attempt to) do diabetic education with some patients. While I have never been comfortable recommending sugar alternatives to people since I do not consume them myself, as I am wary of something I don’t totally understand and would personally rather limit my intake of real sugar, it is recommended that we suggest diet alternatives. I finesse the issue by generally recommending limiting all sweets where and when possible, but this may just come off as wishy washy, I don’t know. At any rate, there is now and has been for a while debate on the true effect of the sugar alternatives on PWD. For instance, it’s been known or suggested for some time now that anything sweet regardless of the source will trigger a release of insulin and according to this line of thinking, insulin resistance can develop over time. Additionally, I am now reading [here - above] that 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. Yikes.
It’s likely that different people will react differently to the alternatives. Many on this site will likely be able to limit and control their intake of most sweet items. I work with a population (almost exclusively T2DM) that often cannot, so while I don’t anticipate a definitive “answer” any time soon, I would appreciate input on this second concern about insulin release.
Thank you.
Because of this post, I took a close look at all the foods I eat for erythritol. I found that it is an ingredient in Qwest bars which were my go to protein bars. I was able to bolus and eat these bars without any issues.
Ah well I had a couple of issues that I was blaming on Metformin, flatulence and diarrhea. The gas was pretty constant and the diarrhea was only in the morning.
Since I eliminated Qwest bars, both those things have improved considerably. I know that sugar alcohols are notorious for causing gastric distress, but somehow I missed seeing that erythritol was an ingredient in Qwest products.
I don’t know if erythritol leads to cardiovascular disease, but I do know that all sugar alcohols cause gastric problems, and they are not free foods for those of us with diabetes.
Stevia is not usually 1oo times sweeter than sugar. That is probably some of the stevia extract concentrates out there. I also expect the strength will depend on the company making it. I included a conversion chart from one company. Stevia in it’s raw form is very bitter, so generally the sweet part of stevia is taken out to avoid that. But most stevia products are about 8 times sweeter than sugar?
Stevia doesn’t quite hit the palette the same way as sugar, there is a taste difference. That is also one reason companies will mix other things with it. (Mixing some real sugar with it, helps give it the same sugar flavor.)
I have no idea if it triggers a release of insulin. Those things have a tendency to come out after time. I know malitol was promoted at first as not spiking your blood sugars because of the way it metabolizes, but it does in a lot of diabetics and it actually does have carbs. I’m not sure you can go by what any specific company says, they will post what is in their best interest.
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