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Posted on / Dr. Zoë McMillen

The Sweet & Sour Scoop on Nonnutritive Sweeteners

With many of us trying to manage our weight and follow guidelines to limit sugar intake, nonnutritive sweeteners (NNS) have become increasingly popular. With so many alternatives to sugar these days it’s no surprise that most of us are confused about what they are and if they are truly safe. Some NNS are naturally occurring, plant-derived products, while others are synthetic. Here I will breakdown the differences, effects, recommendations and my personal preferences.

What You Need to Know About NNS

All NNS available are considered safe by the FDA, but the Environmental Working Group (EWG) still have reservations about their safety. Interestingly, The American Academy of Pediatrics recommends avoiding NNS except for special circumstances, such as type 1 diabetes. There are some known positive health effects of NNS such as fewer dental caries. Regarding some other outcomes the data is mixed:


What is the effect of NNS on cardiovascular outcomes?

It is still not clear. There is limited, high-quality data on the long term effects of the consumption of NNS on glucose metabolism, which shows adverse glycemic effects, including glucose intolerance, increased insulin resistance, and development of type 2 diabetes mellitus.


Do NNS help you lose weight?

The evidence is mixed and provides no clear answer.


What are potential negative side effects of NNS?

They may cause a disruption in the normal gut microbiota and aggravate symptoms in individuals with various types of bowel disorders, including malabsorption syndromes, inflammatory bowel diseases (such as Crohn disease, ulcerative colitis), irritable bowel syndrome, celiac disease, gluten sensitivity, small intestinal bacterial overgrowth, and dumping syndromes.

While there is no perfect substitute to sugar, some are better than others. Future research should clarify the positive and negative implications of NNS.

Monkfruit & Pure Stevia

Monkfruit and pure stevia are most likely the safest alternatives with the least downsides.

Monkfruit, also known as lo han guo or “Buddha fruit”, is a small, round fruit grown in Southeast Asia. Monkfruit has been used for centuries in Eastern medicine as a cold and digestive aid. The sweetener is created by removing the seeds and skin of the fruit, then crushing it to collect the juice, which is dried into a concentrated powder.

As with stevia, monkfruit is often combined with other products such as erythritol to reduce the intensity of the sweetness and create a more usable product, since otherwise it is up to 250 times sweeter than sugar. You can purchase pure monkfruit, just remember to use 200 times less than you would sugar for a similar sweetness level. Otherwise, there are multiple products combining monkfruit with erythritol to create a 1:1 sugar substitute - just keep in mind that erythritol can cause digestive issues.

My Personal Sweetener Preferences

After completing our Integrative and Functional Dietician, Dana Bosselmann's, Reset and Renew Program, I have easily trained myself to not crave sugar and to be more sensitive to sweetness by mostly avoiding processed, sweet products.

If I am baking for a special occasion, I personally prefer to use organic cane sugar because in my experience erythritol + monkfruit produces a different consistency in my baked goods, but I still need to experiment more. Also, I use on average 1/3-1/2 less than traditional recipes call for given my taste buds are more sensitive to sweetness.

Otherwise, for sweetening drinks or non-baked goods, I like to use very small amounts of pure monkfruit. It is becoming more popular and easier to purchase, but pure monkfruit can be difficult to work with given such small amounts are required.

To my dismay, after I made a carrot cake for my father’s birthday recently using an erythritol/monkfruit mix, my Dad’s first experience with erythritol was bloating and abdominal pain despite only having a small amount…not a great birthday gift! Learn from my mistake! As Dana will often inform her clients, everyone is different and digestion, tolerance and allergies can vary by individual.


Common sweeteners

Brand names

x Sweeter than sugar

Can use in baking

Naturally occurring


Canderel, Equal, NutraSweet










Sweet ‘N Low




















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Health, Nutrition & Diet

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