Erythritol vs Monk Fruit Extract: which is worse?

What is Erythritol?

Erythritol is a four-carbon sugar alcohol naturally occurring in small amounts in fruits, fermented foods, and mushrooms. Commercially produced via fermentation of glucose by yeasts such as Moniliella pollinis, it has approximately 70% of sucrose's sweetness, provides 0.24 kcal/g, and has a glycemic index of 0. It is nearly completely absorbed in the small intestine and excreted unchanged in urine, which explains its unusually low laxative effect compared to other polyols.

What is Monk Fruit Extract?

Monk fruit extract is derived from the fruit of Siraitia grosvenorii, a melon native to southern China. Its sweetness (150–250 times that of sucrose) comes from mogrosides, particularly mogroside V, rather than simple sugars. It has been used in traditional Chinese medicine for centuries. The FDA granted GRAS status in 2010.

Documented risks

Erythritol: A 2023 observational study published in Nature Medicine (Hazen et al., Cleveland Clinic) found that elevated blood erythritol levels were associated with increased risk of major adverse cardiovascular events (MACE), including heart attack and stroke. Additionally, erythritol was found to enhance platelet aggregation in vitro. This study was widely reported and has generated significant scientific debate; critics note that it was observational (not causational), and that the study population had pre-existing cardiovascular risk factors. Regulatory agencies have not changed their approval status. The long-term cardiovascular implications require further research.

Monk Fruit Extract: Currently considered safe with no significant adverse effects reported in human studies. Animal studies have shown mogrosides to have antioxidant, anti-inflammatory, and possible anti-diabetic properties. No carcinogenicity, mutagenicity, or reproductive toxicity has been identified. Due to its relatively recent introduction as a food additive in Western markets, long-term human safety data are more limited compared to older sweeteners. Overall, the safety profile is favorable.