WHAT ARE MONK FRUIT SWEETENERS?

Monk fruit, also known as lo han guo or Swingle fruit, is a small round fruit native to southern China. Monk fruit sweeteners are no-calorie sweeteners that can be used to lower one’s intake of added sugars, while still providing satisfaction to enjoy the taste of something sweet. Some types of sweeteners in this category are considered low-calorie — such as aspartame, and others are no-calorie (e.g., monk fruit sweeteners, stevia sweeteners and sucralose). However, collectively they are often referred to as sugar substitutes, high-intensity sweeteners, nonnutritive sweeteners, low- and no-calorie sweeteners or simply low-calorie sweeteners.

Like other no-calorie sweeteners, monk fruit sweeteners are intensely sweet. Monk fruit sweeteners range from being 150-200 times sweeter than sugar, and as such only small amounts are needed in a product to equal the sweetness provided by sugar. Monk fruit sweeteners can be used in a wide range of beverages and foods like soft drinks, juices, dairy products, desserts, candies and condiments. Because they are stable at high temperatures, monk fruit sweeteners can be used in baked goods. However, a recipe that uses monk fruit sweeteners in place of sugar may turn out slightly different because in addition to sweetness, sugar plays several roles in recipes related to volume and texture, but this varies based on the type of recipe.

Several brands, such as Monk Fruit In The Raw®, Lakanto®, SPLENDA® Monk Fruit Sweetener, SweetLeaf® and Whole Earth® use monk fruit sweeteners in granular and liquid forms.

HOW ARE MONK FRUIT SWEETENERS PRODUCED?

Monk Fruit has been used for centuries in Eastern medicine as both a cold and digestive aid. Extracts from monk fruit are also being used in tabletop sweeteners and to sweeten packaged foods and beverages. Monk fruit sweeteners are produced by removing the seeds and skin of the fruit, crushing the fruit, and then filtering and extracting its sweet portions into liquid and powdered forms. During the production of monk fruit sweeteners, monk fruit extract is often blended with erythritol in order to taste and look more like table sugar. Erythritol is a type of polyol, also referred to as a sugar alcohol, that contains zero calories per gram.¹

WHAT HAPPENS TO MONK FRUIT SWEETENERS AFTER CONSUMPTION?

The compounds that give monk fruit extract its sweetness are called mogrosides, which consist of a backbone structure called mogrol with glucose units (glycosides) attached to it. The main mogroside in monk fruit sweeteners is mogroside V.

Most of what is known about how mogrosides are metabolized comes from studies done in animals. Animals are thought to metabolize mogrosides the same or similarly to humans. Mogrosides are not absorbed in the upper gastrointestinal tract, thus they do not provide calories. When mogrosides reach the colon, gut microbes cleave off the glucose molecules and use them as an energy source. The mogrol and some metabolites are then primarily excreted from the gastrointestinal tract, and minor amounts are absorbed into the bloodstream and excreted in the urine.^2-4

Some monk fruit sweeteners contain erythritol. Erythritol is rapidly absorbed in the small intestine and the majority — 80-90% is excreted in the urine within 24 hours.^5,6

ARE MONK FRUIT SWEETENERS SAFE TO CONSUME?

YES. Extracts from monk fruit are Generally Recognized As Safe (GRAS),⁷ a regulatory review process category used by the U.S. Food and Drug Administration (FDA). The FDA also lists erythritol as GRAS for use in a variety of foods and beverages.⁸ GRAS requires expert consensus that a food ingredient is safe for its intended use. In 2010, the FDA responded with no objections to the first GRAS notice submitted on extracts from monk fruit — whose scientific name is Siraitia grosvenorii. For more on the GRAS process, see the “What is GRAS?” sidebar.

The scientific opinion of the European Food Safety Authority (EFSA) published in 2019 stated that data was insufficient at that time for EFSA to make a conclusion on the safety of using monk fruit extracts in foods.⁹ The safety of monk fruit extract has been confirmed by health agencies in countries around the world, including: China, Japan’s Ministry of Health, Labour and Welfare, Food Standards Australia New Zealand (FSANZ) and Health Canada, which permit it in tabletop sweetener packets only. In its approval of the use of monk fruit extracts as a sweetener, FSANZ cites a history of safe use in China, Canada, Japan and the U.S., and no evidence of adverse effects in human studies from consuming up to 60 milligrams (mg) of monk fruit extract per kilogram (kg) of body weight per day.¹⁰ In animal studies, feeding extremely high levels of monk fruit extract (e.g., 2,500—7,000 mg of monk fruit extract per kg of body weight per day), adverse effects have not been clearly demonstrated.^11-13

Monk fruit extract is currently permitted for use in more than 60 countries, however an acceptable daily intake (ADI) has not been established. The ADI typically represents an amount 100 times less than the quantity of a substance found to achieve a no-observed-adverse-effect-level in toxicology studies. According to the FDA, there are several reasons why an ADI might not be established for a substance, including evidence of safety at consumption levels that are well above the amount needed to sweeten a food or beverage.¹⁴ For more on ADI, see the “What is an ADI?” sidebar.

WHAT IS ADI?

The acceptable daily intake, or ADI, is the average daily intake over a lifetime that is expected to be safe based on significant research.¹⁵ It is derived by determining the no-observed-adverse-effect-level, or NOAEL, which is the highest intake level found to have no adverse effects in lifetime studies in animal models, divided by 100.¹⁶ Setting the ADI 100 times lower than the upper level found to have no adverse effects in toxicology studies adds a margin of safety that helps to ensure that human intakes will be safe.

WHAT IS GRAS?

Food ingredients permitted for use in the U.S. fall into one of two categories: food additives, which require review prior to approval from the FDA; or Generally Recognized as Safe (GRAS) ingredients. Whether GRAS or a food additive, food ingredients must be safe and must meet the same high food safety standards. To be considered GRAS, an ingredient must meet one of the following two conditions:

1) A history of safe use has been established and a significant number of people consumed the ingredient prior to the enactment of the Food Drug and Cosmetic Act of 1958; or

2) Scientific data and information about the safety and use of the ingredient are widely known and publicly available in scientific articles, position papers, and the like, with consensus among scientific experts that the ingredient is safe for its intended use.

CAN CHILDREN CONSUME MONK FRUIT SWEETENERS?

YES. While no research has been published on monk fruit sweetener intake in children, no negative effects on health have been demonstrated in animal models or adults.¹⁰ Monk fruit sweeteners can add sweetness to a child’s foods and beverages without contributing to calories consumed or added sugars intake. Monk fruit sweeteners are not fermentable like sugars and erythritol is noncariogenic,¹⁷ meaning it does not promote tooth decay.

With a focus on reducing consumption of added sugars in recent decades, the number of food and beverage products containing low-calorie sweeteners has increased. Observational research among U.S. children and adults has shown an increase in the percentage of people reporting daily consumption of products containing low-calorie sweeteners;¹⁸ nevertheless, current intake of each low-calorie sweetener is considered to be well within acceptable levels, both globally and in the U.S.^19,20

The American Heart Association (AHA) advises against children regularly consuming beverages containing low-calorie sweeteners; instead the AHA recommends water and other unsweetened beverages such as plain milk.²¹ One of the notable exceptions in the 2018 AHA science advisory is made for children with diabetes, whose blood glucose management may be benefitted by consuming low-calorie-sweetened beverages in place of sugar-sweetened varieties. Citing an absence of data, the 2019 policy statement from the American Academy of Pediatrics (AAP) does not provide advice on children under two years of age consuming foods or beverages that contain low-calorie sweeteners.²² The 2019 AAP policy statement does, however, acknowledge the potential benefits of low-calorie sweeteners for children; those benefits include reducing calorie intake (especially among children with obesity), incidence of dental caries and glycemic response among children with Type 1 and Type 2 diabetes. The 2020-2025 Dietary Guidelines for Americans (DGA) do not recommend the consumption of low-calorie sweeteners or added sugars by children younger than two years of age.²³ This DGA recommendation is not related to body weight, diabetes or the safety of added sugars or low-calorie sweeteners; instead it is intended to avoid infants and toddlers developing a preference for overly sweet foods during this formative phase.

CAN PREGNANT AND BREASTFEEDING WOMEN CONSUME MONK FRUIT SWEETENERS?

YES. Although no published research has examined possible effects of monk fruit sweeteners on pregnant and lactating women, several studies in animals have demonstrated no adverse reproductive or developmental effects to a mother or offspring, even when animals were exposed to very high levels of monk fruit sweeteners every day over long periods of time.¹⁰ All women who are pregnant or nursing need the necessary nutrients and calories for their baby’s optimal growth and development, while taking care not to exceed their needs.

CAN PEOPLE WITH DIABETES CONSUME MONK FRUIT SWEETENERS?

YES. Foods and beverages made with low- and no-calorie sweeteners such as monk fruit sweeteners are frequently recommended to people with dia