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Natural ways to add a touch of sweetness to your favorite foods and beverages

Expertly reviewed by Molly Bremer

Why everyone is talking about erythritol

Recently, there has been a lot of interest and discussion about a study published on Feb. 27 in Nature Medicine. The study concluded that erythritol, a sugar substitute, is associated with major adverse cardiac events and fosters enhanced thrombosis. In short, it's being reported that using this keto-friendly sweetener is linked to heart attacks.

However, the World Health Organization approved erythritol nearly a quarter century ago and the Food and Drug Administration approved it over 20 years ago. How could something so deadly have slipped by both of these organizations?

In this article: Nature Nate's 100% Pure, Raw and Unfiltered Honey, Madhava Organic Light Agave and 365 by Whole Foods Market Organic Dark Maple Syrup.

Just how dangerous is erythritol?

Erythritol isn't new. It's a sugar alcohol that is naturally occurring in plants but commercially produced by fermentation. Another study, published on Jan. 1 in the National Library of Medicine, said it was a safe and non-nutritive sugar alcohol. This conclusion was reached because "compared to other sugar alcohols, evidence from human studies indicate that it is mostly absorbed and excreted in urine unmetabolized." In other words, the body doesn't process it — it leaves in pretty much the same state it enters.

Some medical sites argue that erythritol is a good alternative for people with diabetes because it has no effect on glucose or insulin levels. The FDA concluded that sugar alcohols such as erythritol can slow the growth of bacteria and decrease the amount of acid that leads to tooth decay.

However, the new study concluded that high levels of erythritol can be linked to higher chances of heart attack, stroke or death.

BestReviews' nutrition expert weighs in

With recent conflicting studies on the safety of erythritol, we asked Molly Bremer, M.S., R.D., director and dietitian at Mosaic Nutrition, for her thoughts on the topic.

"There is definitely more research needed on non-nutritive sweeteners like erythritol," Bremer states. "But I will say that this study's results seem to be conflated. There were only eight participants in this study who drank 30 grams of erythritol in water in two minutes (much more than the average consumption). The study also didn't control for preexisting heart disease symptoms."

Best natural alternatives to artificial sweeteners

As with many dietary questions, the medical community needs to perform more studies with better controls to get answers. If you want to err on the side of caution and stay away from artificial sweeteners, here are a few natural alternatives.


Nature Nate's 100% Pure, Raw and Unfiltered Honey

The only ingredient in Nature Nate's honey is raw, unfiltered honey. This 16-ounce squeeze bottle ensures it's easy to pour.

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Madhava Organic Light Agave

Madhava's organic agave is independently tested for over 130 toxins and contaminants. It's vegan, gluten-free and non-GMO. One cup is equivalent to 1.5 cups of sugar.

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365 by Whole Foods Market Organic Dark Maple Syrup 

This Whole Foods option is tapped from certified organic trees. It's fat-free, vegan, non-GMO, certified kosher and certified organic.

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Madhava Organic Coconut Sugar 

Madhava coconut sugar is sourced directly from two non-GMO and organic co-ops in central Java. The co-ops are made up of hundreds of family farms that have been harvesting for generations.

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Date Lady Organic Date Syrup

Date Lady's company exists because of her own obsession with dates and date syrup. Her products can be added to coffee, smoothies, waffles and more.

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Other natural sweeteners worth checking out 

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Allen Foster writes for BestReviews. BestReviews has helped millions of consumers simplify their purchasing decisions, saving them time and money.

BestReviews spends thousands of hours researching, analyzing, and testing products to recommend the best picks for most consumers.

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