QUESTION: “Hey Dr. Neal, I absolutely love your show. It's super motivating and very informative. I always listen on my way to work as like a daily motivation to stay healthy on track, especially with working out and eating healthy. I love all the information. So now to my question. I am just curious if there are any side effects to using monk fruit sweetener and Stevia sweetener because I drink protein shakes. I eat protein powder daily and they both have monk fruit sweetener and Stevia sweeteners. I'm assuming they're the safest form of artificial sweetener. I'm just not sure if they make you crave more things that are sweet because I've have noticed I've been craving sweeter things. As well as if it affects your microbiome, or if it affects your health negatively. Thank you for your time. I hope that you get the chance to answer my question. Thank you.”
DR. NEAL: Thank you so much for your kind words and for being a regular listener. It makes me so happy to know that you find the show helpful.
I’ve shared this story before, but I’m going to share it again because it’s so perfect for this question.
Years ago, when I served a health educator for a weight loss program, I would always tell my patients that if they wanted to satisfy their sweet craving, diet soda and other foods with these alternative sweeteners were a good option. This was especially true for those with diabetes.
Why would we recommend the consumption of artificial sweeteners? It was because these foods typically had no (or very few) calories and no real sugar. This means that they could consume as many sodas and sugar-free hard candies as they would like, still satisfy their sweet craving, but without worrying about getting off track with their weight loss or blood sugar goals.
But was this really the best advice?
Sugar Options Are Not All Equal…
There are so many artificial sweeteners available at your local market now, it’s hard to keep track. While some of them have been sold commercially for decades, others are rookies and newer to the game.
What we’re learning is, not all of these sugar substitutes are created “equal.”
Get it? Because Equal® is one type of sugar substitute?
Ok, I’ll stop.
Monk Fruit Extract
I’ll start by talking about monk fruit extract. Monk fruit is an actual fruit that’s naturally grown in China (also known as luo han guo). It has been used in China for hundreds of years as a natural remedy for the common cold, a sore throat, coughs, and congestion.
In the United States, the Food and Drug Administration (or, FDA) has labeled monk fruit extract as “generally recognized as safe” for human consumption. This means that there doesn’t appear to be any major negative health effects associated with its consumption. But there are some other organizations that disagree with the FDA. The Center for Science in the Public Interest believes monk fruit extract should be used with caution. This is because they believe there aren’t enough human studies to know whether long-term use is safe. But we’ll come back to that idea a little later.
Now, I should mention what monk fruit extract is just that – an extract from the monk fruit. But when we add this extract to our foods, it doesn’t mean that we are getting a fruit serving at the same time. Instead, the actual extract is made up of these compounds called mogrosides. It turns out these mogrosides make monk fruit extract taste 200 times sweeter than sugar. So, as you can imagine, monk fruit extract is becoming popular as a sugar substitute. And like many other sugar substitutes, it contains zero calories.
Next, Stevia®. Stevia is sometimes, but not often, called “Rebiana.” This sweetener comes in different forms like Truvia, PureVia, and SweetLeaf. Each is a little different in their chemical compositions. Stevia itself comes from the leaves of the yerba dulce plant. For now, like monk fruit extract, Stevia is also generally recognized as safe by the FDA.
This means that, at this time, there’s not enough scientific evidence to show that Stevia consumption may harm us. But I should mention that there are some studies that have shown Stevia may lead to genetic mutations, but these studies were performed in a lab and not with actual living humans.
So what we’re learning is that while these sugar substitutes add sweetness and save calories initially, some studies are finding that after consuming these zero calorie sweeteners, folks tend to make up for those calories by eating other sweet foods throughout the day. It’s like they just don’t seem to satisfy the same way as regular sugar does.
So, here’s what I would suggest. Right now, most health experts agree that sugar alcohols are safe to use on a regular basis. These would be things like sorbitol and mannitol. Early studies are finding that Stevia seems to be quite safe as well. But when it comes to monk fruit extract, it might be worthwhile to consume in small amounts until we know a bit more about it.
I would feel more comfortable with monk fruit extract when, for example, the Center for Science in the Public Interest agrees with the FDA that it is safe to consume.