Xylitol & Heart Attacks: Should You Worry?

A recent study led by Cleveland Clinic analyzed over 4,000 individuals across multiple clinical sites. Data was collected over several years. The study ultimately found there was an association between blood levels of xylitol and an increased risk of heart attack and stroke.

However, the study did not address food intake by participant, so it cannot be determined if the xylitol levels were based on dietary exposure or endogenously-produced xylitol. Ultimately, the study was not comprehensive at evaluating the long-term effects of xylitol when consumed in moderate amounts.

Since the publishing of the study, many consumers have mistakenly lumped all sugar-free sweeteners together, deducing that all sweeteners should avoided for fear of  heart attack or stroke.

This is a concern as consumers are searching for a sweetener that meets their needs. According to Mintel, “There is an opportunity to help consumers feel informed and in control when making their sugar and sweetener choices.”  Hearing about the downside of an unproven study does not help.

So let’s focus on what we do know about xylitol…

What is xylitol?

Xylitol is a sugar alcohol used as a sweetener in various food and dental care products. It is popular because it has fewer calories than sugar and is known for not causing tooth decay. It is also found in fruit, vegetables, and berries.

Xylitol differs from other sugar alcohols in several key ways, making it unique and beneficial for specific uses. Unlike many sugar alcohols, xylitol has a sweetness comparable to sugar but with significantly fewer calories, making it a popular sugar substitute. It is particularly noted for its dental health benefits; xylitol helps prevent tooth decay by inhibiting the growth of Streptococcus mutans, the bacteria primarily responsible for cavities.

Additionally, xylitol has a lower glycemic index than other sugar alcohols, which means it has a minimal impact on blood sugar levels, making it a suitable sweetener for diabetics and those managing blood glucose levels.

While other sugar alcohols can cause digestive discomfort in large quantities, xylitol is generally better tolerated, though it can still cause issues for some individuals if consumed in excess. Overall, xylitol’s unique properties make it a versatile and advantageous sugar alcohol for both health and culinary purposes.

Products commonly containing xylitol:

  • Gum: brands like Orbit, Trident, and Eclipse
  • Sugar-free candy and mints: Brands like Werthers, Ice Breakers, and Spry
  • Sugar-free or low-sugar baked goods
  • Dental products, like toothpaste and mouthwash
  • Over-the-counter medications and chewable vitamins
  • Low-calorie foods and beverages, like gelatin desserts, condiments, and cereals

Cardiovascular implications

The researchers found a correlation between higher levels of xylitol in the bloodstream and an elevated incidence of these serious cardiovascular health issues outlined below. The study authors hypothesized that xylitol might influence cardiovascular health through mechanisms that are not yet fully understood, warranting further investigation.

Blood clotting

One possible explanation, according to the results, is that xylitol could affect platelet function, which plays a crucial role in blood clotting. Altered platelet activity might increase the likelihood of clot formation, leading to heart attacks or strokes.

Metabolic pathways

Xylitol is also metabolized differently from regular sugar, and this unique metabolic pathway might impact lipid levels, inflammation, and other factors involved in cardiovascular health.

Impact on blood vessels

There is also speculation based the study that xylitol could influence the health of blood vessels, potentially contributing to atherosclerosis (the buildup of fats, cholesterol, and other substances in and on the artery walls). Again, more research is needed here as to the exact levels that can cause these impacts, and over what span of time.


Xylitol’s other health effects

Dental benefits


Cavity prevention: Xylitol is well-documented for its role in preventing tooth decay. It inhibits the growth of Streptococcus mutans, the bacteria primarily responsible for cavities, by reducing their ability to stick to teeth and produce acid.

Saliva production: Xylitol stimulates saliva production, which helps in neutralizing acids and repairing tooth enamel.


Glycemic control


Lower glycemic index: Xylitol has a low glycemic index, making it a popular sugar substitute for people with diabetes. It does not cause significant spikes in blood glucose or insulin levels, which is beneficial for blood sugar management.

Weight management: Due to its lower calorie content compared to regular sugar, xylitol can be useful in weight management and reducing overall calorie intake.


Digestive issues


Laxative effect: At high doses, xylitol can cause digestive discomfort, including bloating, gas, and diarrhea. This is because it is partially absorbed in the small intestine, and the unabsorbed portion is fermented by bacteria in the large intestine, producing gas. Eating more than 30-40 grams of Xylitol is harmful.

Tolerance levels: Individual tolerance to xylitol varies, and some people may experience gastrointestinal issues even at lower doses.

Allergic reactions: While rare, some individuals may have allergic reactions to xylitol, manifesting as rashes, itching, or gastrointestinal distress.


Debunking misconceptions

A common misconception is that all sugar-free options are inherently bad for health. This is not true. Sugar-free products are often great low-calorie options for those looking to lose or maintain weight; they also can serve as insulin stabilizers.

However, be aware of how much of these substitutes you consume and their potential long-term health effects over time. There is currently no limitation nor recommendation on the amount of xylitol that is considered safe for consumption.

Balancing benefits and risks

While it offers significant advantages for dental health and blood sugar control, the recently published study needs to be investigated more thoroughly to determine if there is a real risk. So, what can we do?

Moderation is key

While the study does not specifically support moderation, and does not detail how much we should eat, we do know that any sugar can have adverse effects if eaten in too great a quantity causing inflammation, digestive issues, obesity, metabolic disorders, and so on. Remember for regular sugar, the recommended maximum daily intake should not exceed 9 teaspoons for men and 6 teaspoons for women.

Stay informed

Keep up-to-date with new research on sugar substitutes and their health effects. As more studies are conducted, guidelines on safe consumption levels may evolve.

Have a colorful and varied diet

Eating fruits, vegetables, and protein instead of excess sugar is crucial for maintaining a healthy and balanced diet. Fruits and vegetables are rich in essential vitamins, minerals, antioxidants, and dietary fiber, all of which are vital for overall health.

These nutrients help to boost the immune system, reduce the risk of chronic diseases such as heart disease and cancer, and improve digestive health. Additionally, fruits and vegetables are a great low in calorie option and high in water content, which can aid in weight management and promote a feeling of fullness.

Protein, on the other hand, provides the essential amino acids necessary for building and repairing tissues, supporting immune function, and maintaining muscle mass.

Consuming adequate protein is important for metabolic health, as it helps regulate appetite and stabilize blood sugar levels. Unlike sugary foods, which can lead to spikes in blood sugar and contribute to weight gain and metabolic disorders, protein-rich foods promote satiety and sustained energy levels.

Use common sense

But don’t fret. You certainly are not going to have adverse effects from chewing gum or brushing your teeth given how little xylitol is in these products. Now, eating 5 sugar-free processed muffins daily for an extended period of time might not be the best idea…but that’s for several reasons. Focus on nutrient dense whole fruits, vegetables and proteins!

Bird Flu: Another Pandemic?

As of this writing, in 2024 only three dairy farm workers have caught this virus. However, the concern is that it has been transmitted to humans from dairy cows and could potentially be transmitted from human to human. As of today, there is no evidence that it has transferred from person to person.

We spoke to Dr. Kenneth Odde, veterinarian, beef cattle operator, and former Professor at Kansas State University. who stated:

“The risk of a pandemic is very low. It will never be zero, but with everything I understand, it is low”. 

Let’s start at the beginning…

In 1996, H5N1 was first detected in domestic waterfowl in southern China. It then spread to farmed poultry. A small number of people caught the virus who worked in very close proximity to their birds: touching, feeding, and cleaning their cages.

Over time, 860 people were identified with the virus and there was a 50% death rate.  Governments and companies around the world began preparing for a pandemic.

However, the virus stayed mainly in Asia and was fairly dormant until 2003 when it affected widespread poultry.

Wild birds then spread H5N1 to Africa, the Middle East, and Europe. The H5N1 virus continues to evolve and has become well-adapted to spread efficiently among wild birds and poultry. In 2021, new variants of the H5N1 virus were spread by wild birds in the U.S. and Canada.

Because wild birds easily spread it, commercial poultry flocks have been affected across the country.  H5N1 is highly pathogenic (deadly) to birds, and when one bird gets it, the entire flock is at risk and is culled. While not as prevalent, this has affected backyard poultry operations as well.

In March of 2023, we wrote about how H5N1 has affected mammals all over the country: sea lions, minks, otters, foxes, and even bears.  At the time, the CDC said that these bird flu viruses didn’t have the ability to bind to the human respiratory system.

H5N1 in the news today

The concern today is that the virus has spread from wild birds to dairy cows.

Unlike birds, dairy cows are only mildly sick for about 7 – 10 days. Once a bird infects one cow, the virus spreads from cow to cow by contact with either through their respiratory system and/or unpasteurized milk droplets. For instance, workers could unknowingly spread the unpasteurized milk among cows.  Or the milking equipment and transport vehicles could carry droplets of infected milk.

So far, in 2024, there have been three human cases with dairy farm workers. As a result, two individuals just had a minor eye infection which was easily resolved with antiviral medicine. The third did get flu-like symptoms and recovered with Tamiflu.

Because this is not widely tested among people, it is hard to know if more farm workers have had flu-like symptoms that would be attributed to H5N1. Symptoms can appear to be a mild cold or flu. Neither of these would make one think to go to a Dr. for an Avian Influenza test.

But there are a lot of unanswered questions. Why do some birds and animals react differently to the same virus?  For instance, why do mammals such as sea lions, otters, and bears die from H5N1, and dairy cows can recover?

Dr. Odde explained that there is a difference in how a species receives the virus. Recent research shows that the receptor influences influenza symptoms within poultry or mammals. Receptors are proteins within the body that let a virus enter the cell.  He also emphasized that many studies are being conducted right now to understand how the virus passes between and among species.

As you know, the best way to stay healthy is to wash your hands before touching your nose, eyes, and mouth. This is because humans have receptors in our respiratory system and you can get sick when a virus touches our respiratory system. The same principle applies to H5N1. Dr. Odde also reminded us that we have had much exposure to the flu over the decades so that humans will have some resistance to H5N1.

Chickens seem to be more susceptible as they receive the virus through their trachea in their respiratory system. Ducks do not have the same mortality rate and early studies show that the virus enters the cells through a different receptor.

Dairy cows receive the virus in their mammary glands as well as their respiratory system. This is not common and is a cause for concern for the replication of H5N1. As of this writing, H5N1 has been detected in 12 states and 92 herds.

Sources for USDA data: Commercial flock detections by state; HPAI in domestic livestock

Is our food safe?


There is no need to be worried about the milk from the grocery store. The pasteurization process kills all bacteria and viruses.  99% of all dairy farmers who sell milk for public consumption follow the Pasteurized Milk Ordinance and participate in the Grade “A” milk program.

To be sure this applied with H5N1, the FDA took milk samples from retail locations in 17 states representing 132 milk processing locations in 38 states. H5N1 was not present in any of the samples.

Raw milk poses the danger. Some people think that raw milk has more amino acids, vitamins, and minerals and is a better choice for your immune system. That is not necessarily true as homogenization and pasteurization doesn’t kill the benefits of milk, it only kills the pathogens. Drinking raw milk, can lead to food-borne illnesses, including H5N1 if it is present.

Eggs are safe to eat. Because Avian Influenza rapidly affects a poultry flock, the eggs are not sold on the market. However, like milk, if you cook your eggs properly and do not eat a raw egg, the chance of getting H5N1 is reduced even further.

The USDA is confident that the meat supply is safe. Ground beef samples were collected in states where dairy herds have tested positive for H5N1 and no virus particles were present. Cooking burgers to 120, 145, and 160 degrees Fahrenheit ensures further safety.

The USDA also reminds us that safe poultry follows the same guidelines as all meats. If handled and cooked properly, poultry is safe. As a reminder, CLEAN, SEPARATE, COOK, and CHILL are good guidelines for safe food in your kitchen.

Backyard poultry can also be affected by wild birds. If one of your chickens dies unexpectedly, you should get it tested by your veterinarian. Also, wash your hands after handling your chickens and the eggs. And of course, cook your eggs properly.

How is the government maintaining food safety with H5N1?

Three government agencies are focused on solving Avian Influenza:

  • The FDA is testing milk, poultry, and beef to ensure it is safe
  • The CDC  protects public health, actively monitors the situation, and provides updates
  • The USDA is overseeing dairy producers and proper herd management

In particular, the USDA has added $824 million, to the $1.3 million designed for poultry, to give dairy producers the ability to monitor the health of their herds with continual testing to understand the scope of H5N1.

Once a farm has been disease-free for three weeks, they can then move their animals to different farms.  This will also give the USDA an understanding of how producers with affected herds can show elimination of the virus.

Going beyond just the USDA, we spoke to Dr. Lisa Koonin, Founder and Principal at Health Preparedness Partners which helps businesses, nonprofits and governments plan for future health emergencies. She is also an Adjunct Professor at Indiana University. During her 30+ year career at the CDC, she worked as a Director and Deputy Director of the agency’s Influenza Coordination Unit.

“For every human infection that occurs, we are that much closer to a pandemic because the virus adapts to a human and can spread to other people or to animals and then to people.”

– Dr. Lisa Koonin

Dr. Koonin identified six suggestions for these agencies to prevent H5N1 from a widespread dairy pandemic.

  • Increase virus surveillance. Test dairy workers and cows in both affected and non-affected areas
  • Increase wastewater testing. Sewers that test positive for viruses and bacteria can give us an early warning if it is in the community.
  • Promote worker safety. Make sure that farm workers have protective equipment available.
  • Communicate with farmers and producers. It is important that those who operate dairy production and poultry farms know how to test, prevent and detect outbreaks.
  • Stay away from raw milk. Raw milk can contain a number of disease-causing viruses and bacteria, including H5N1.
  • Communicate with the public. It is important that current information about what is known about the outbreak is provided to the public in a timely way. People should avoid close, long, or unprotected exposures to sick or dead animals, including wild birds, poultry, other domesticated birds, and other wild or domesticated animals (including cows).
  • Prepare vaccines. It is not known if this virus will spread and become a widespread outbreak. However, several countries are developing and procuring vaccines just in case they are needed.

Digging Deeper: Pasteurization

milk being poured into a glass

In the past, some of us drank fresh, raw milk every day. But these days, several factors make raw milk an untenable option, including dairy industry consolidation, food safety concerns, and longer transportation times.

Since milk needs to be packaged and delivered to a grocery store or corner market, it may take several days before it hits your glass. For milk to safely survive the journey from cow to carton, it gets pasteurized, a process that keeps milk safe and lasting longer in your refrigerator.

Pasteurization is the process of heating a substance to kill pathogens, such as listeria, E. coli, salmonella, and the highly-pathogenic avian flu.

Dairy producers pasteurize milk to make it safe for consumers, as well as maintaining its safety during transport and extended storage times. If you drink raw milk straight from a cow, without treating it, you put yourself at great risk.

Some believe this process makes milk harder to digest and is an unnecessary procedure that denies our bodies of nutrients destroyed in the processing. Let’s take a look at this first.

Does Pasteurization Make Milk Harder to Digest?

Many proponents of raw milk products believe that pasteurized milk causes gut inflammation from not properly breaking down these denatured protein compounds.

Scientifically, the heat treatment disrupts the hydrogen bonds in a protein molecule and causes the bonds to be “disrupted.” For reference, when you cook an egg, the proteins also denature.

So, while heating raw milk can cause denaturation of protein, this has only proven to potentially affect immunocompromised patients.

Additionally, how your body digests denatured protein depends entirely on the amount of heat exposure the proteins have had. Typical pasteurization methods generate very few denatured proteins.

Let’s take a closer look at the most common ways to pasteurize milk and milk products.

Pasteurization Methods


Also known as flash pasteurization, this method heats up the milk to 280 degrees for 4-5 seconds. Because the temperature of the milk exceeds 150 degrees, it is possible for the proteins to “denature,” or change from their original structure. Essentially, the heat can cause the protein compounds to break down. It is also argued that this process kills off some of the good bacteria present in raw milk.

High-temperature pasteurization

This is the most commonly used pasteurization technique. This process heats up milk to 161 degrees for 15 seconds.

Like flash pasteurization, some of the micro-life present in raw milk will be killed off through HT pasteurization. Additionally, the proteins in HT-treated milk may experience some denaturation. Heat treatment aside, milk remains a nutrient dense food.

Low-temperature pasteurization

LT heats raw milk to 145 degrees for 30 minutes before chilling it rapidly. Like HT and ultra pasteurization, this process can also kill off some of the probiotics present in raw milk. But, it is argued that LT pasteurization helps maintain milk’s protein quality.

While this process does not “denature” proteins, it can cause protein aggregation, whereby the compounds accumulate and clump together, making the proteins harder to digest. These proteins are harder to digest than its denatured counterpart, making consumption especially challenging for immune compromised or extremely allergic individuals.

Raw or unpasteurized

These products have not been heat-treated and are at much greater risk of carrying harmful pathogens. They also have a significantly shorter shelf life, which contributes to food waste if not consumed within a few days of its production.

Even more options

While heat-treating raw milk will destroy some of its beneficial properties, it’s a high price to pay if it’s contaminated with dangerous pathogens. If you still want to enjoy raw milk for its nutrients, consider purchasing products from dairy companies that add active cultures and probiotics that were affected during heat processing.

One such company taking proactive steps to protect your digestive system is Fairlife. Fairlife milk is flash pasteurized and then ultra-filtered to concentrate the protein content, sterilize the milk, and remove lactose – or milk sugars –  from the final product.

This way, those who suffer from lactose intolerance and/or have a hard time digesting denatured milk proteins can enjoy this dairy product with minimal to no effects.

What about cheeses?

Cheese is another important food when it comes to pasteurization. The U.S. Food and Drug Administration mandates that any cheese produced from raw milk must be held or aged for 60 days and kept consistently at 35-degrees Fahrenheit before it can be sold commercially. This helps ensure that foodborne pathogens are no longer present in the food, as they cannot survive in an environment after 60 days.

Additionally, treating the cheese with salt and curing the rind can also protect from potentially dangerous bacteria, viruses and molds. Like milk, pasteurized cheese can be treated at either a high temperature (174 degrees for roughly 20 seconds) or low temperature (149 degrees for 30-40 seconds).

When you think of pasteurization, you undoubtedly think of milk! However, many other foods that are heat treated, as well. Almonds, sauerkraut, and some kinds of vinegar are pasteurized to sanitize the food and kill harmful bacteria. The pasteurization process keeps consumers safe, so before you dismiss a pasteurized product, also consider what it may be protecting you from.

Are artificial sweeteners bad for us?

examples of alternative sweeteners

You have many choices to satisfy your sweet tooth besides sugar. In fact, almost half of us use sugar alternatives, with 43% turning to sugar substitutes to curb their sugar consumption.

Among sugar substitutes, artificial sweeteners such as Splenda, Equal, and Sweet’N Low are 2023’s most popular choices, with natural alternatives, like Stevia in the Raw and other stevia products, gaining in market share.

Despite our persistent beliefs about how unhealthy these sweeteners are for us, all artificial and natural sweeteners on the market in the U.S. and Europe are Generally Regarded as Safe (GRAS) by the FDA and tested thoroughly by the European Food Safety Authority and the WHO.

Because of the meticulous analysis conducted by such governmental organizations as the FDA, WHO and the European Union, we as consumers can feel confident that these sweeteners have undergone substantial scrutiny before consumption of these products is permitted.

Don’t sweeteners make us sick?

Artificial sweeteners, Splenda, Equal and Sweet’N Low, have a very storied past with the public, with about 40% of us believing sweeteners are generally unhealthy and also that some sweeteners are worse than others. These beliefs are a contributing factor to the recent decline in sales of artificial sweeteners and its associated products, like diet sodas.

Saccharin, the first artificial sweetener on the market, came under scrutiny in the 1970s because of a well-known lab test among rats that resulted in an increased incidence of bladder cancer. However, the results were later dismissed as it was found that saccharin has an entirely different effect on human bladders.

Aspartame continues to have its share of the spotlight with similar cancer concerns, mostly of the brain, but in 2006 the National Cancer Institute conducted a 5-year study of data from almost 500,000 individuals and found that higher levels of aspartame were not associated with elevated risk for brain cancer.

“Although there has been a lot of negative press about artificial sweeteners, there is no evidence that artificial sweeteners cause cancer in humans.”

– Christine Zoumas, MS, RD, Program Director at University of California, San Diego, Moores Cancer Center

The agony and the irony

Surprisingly, some of these artificial, no-calorie sweeteners we use to lose or manage our weight are making us bigger, depending on the amount and duration we use them.

There is a tremendous amount of controversy on how these artificial sweeteners contribute to obesity. It is debated within the scientific community whether regular, long term consumption of artificial sweeteners leads to long-term health benefits or weight loss.

In fact, quite the opposite can be true: a 2017 meta-analysis reported in the Canadian Medical Association Journal found that the consumption of sugar substitutes was associated with increases in weight and waist circumference, and a higher incidence of obesity, hypertension, metabolic syndrome, type 2 diabetes and cardiovascular events.

“Based on all of the research done so far, there is no clear evidence for a benefit, but there is evidence of potential harm from the long term consumption of artificial sweeteners.


-Dr. Meghan Azad, PhD, University of Manitoba

So if sweeteners have zero calories, how in the world is this happening? There may be three reasons for the expanding waistlines and associated illnesses…

Sweetness begets more sweetness

Dr. David Ludwig, an obesity and weight-loss specialist at Harvard-affiliated Boston Children’s Hospital, hypothesizes that those who use artificial sweeteners may end up replacing the lost calories with less nutritious and calorie-dense options, like cake or pizza, thinking that they can “spend” their otherwise consumed 300 calories if they drank two regular sodas.

Another consideration is that hyper-sweetened substances may alter the way we taste our food. Since sucralose is 600 times sweeter than sugar, our brains become more accustomed to this level of sweetness and eventually we find more natural but lesser sweet things, like fruits, less desirable. And vegetables? Forget it!

Lastly, these artificial sweeteners allow the consumer to disassociate sweet with caloric, which can be dangerous as eating sugar and sugar-like substances signal our brain to consume more sugar, thus initiating a vicious cycle. You can blame that on our primate ancestors, as sugar was a scarce commodity way back when!

Other controversies

While the research has not been peer-reviewed or widely accepted by the scientific community, there are several separate research trials of Splenda, Equal, and Sweet’N Low that have shown causal relationships between artificial sweeteners and negative gut microbiome health, stroke and Alzheimer’s disease.

One study conducted by a team of Israeli scientists in 2014 found that artificial sweeteners, such as sucralose, aspartame and saccharin, significantly altered the intestinal bacteria of mice that, in turn, negatively affected their metabolisms, leading to obesity, diabetes, and other related diseases. (If you are unfamiliar with the gut microbiome, also known as our “second brain”, be sure to read our post on gut microbiota.)

Regarding the link of artificial sweeteners to Alzheimer’s disease and stroke, the American Heart Association reported that daily consumption of diet sodas may substantially increase the risk of these diseases. However, it is important to keep in mind that this finding may be a correlation and not causation— meaning that those who drink diet sodas regularly may be in poorer health than those who don’t drink them due to overall poor diet and lack of exercise.

Do diet drinks count?

Some of us may not think we regularly use artificial sweeteners, but don’t discount all those diet drinks and zero-calorie flavored waters!

According to a 2016 study published in the Journal of the Academy of Nutrition and Dietetics, nearly half of adults and a quarter of children in the U.S. consume artificial sweeteners—and the majority do so on a daily basis, with diet drinks making up the bulk of the intake.

Both the American Heart Association and the American Diabetic Association jointly agree that people should use artificial sweeteners cautiously.

Other options are also being added to the grocery store shelves, such as xylitol and stevia-sweetened sodas and drinks.

Because of its taste and its natural origin, stevia sweetened sodas, drinks, and food items are gaining in popularity.

From just 2014 to 2017, the market value of stevia has grown 71% to $578 million from $338 million.

Here’s a list of the most popular diet drinks in the market today and their associated sweeteners:

Splenda (sucralose)

Splenda is an artificial sweetener that is made of sucralose, a synthetically derived compound from sucrose – or table sugar. Sucralose is extremely sweet – it’s about 600 times sweeter than table sugar and three times sweeter than Equal.

Sucralose in your body: Because your body has no use for it, approximately 85% of sucralose does not get digested or absorbed, thus leaving your body unchanged. Most of what remains gets absorbed in the gastrointestinal tract and then leaves the system as urine, but about 5% of the remaining sucralose will metabolize in the body.

Limitation on consumption: As per FDA guidelines, acceptable daily intake of sucralose is 5 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume upwards of 340mg of sucralose per day, which equates to 28 Splenda packets or 9 cans of diet soda. That should leave PLENTY of room for even the sweetest of sweet-tooths! 

Equal (aspartame)

Equal, or aspartame, is made from aspartic acid and phenylalanine, two amino acids that when combined in a specific structure, yield a very sweet substance that’s 200 times sweeter than table sugar.

Aspartame in your body: Unlike sucralose and saccharine, aspartame is fully absorbed in the body given its composition of amino acids, which your intestinal tract breaks down into digestive enzymes the same way it would after consuming common protein sources, such as meats, fish, eggs and dairy. Aspartame does not enter your blood stream. 

Limitation on consumption: The acceptable daily intake of aspartame as determined by the FDA is 50 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume upwards of 3,400mg of aspartame per day. This equates to 18 cans of diet soda or almost 100 blue packets…per day! Keep in mind that your body creates trace amounts of methanol when breaking down aspartame. Though small amounts are not considered toxic and are actually naturally-occurring, larger amounts can lead to headaches, weakness, dizziness and nausea.

Aspartame and health conditions: A very important note about aspartame is that it is not to be consumed by those who suffer from phenylketonuria, a condition in which a person cannot metabolize phenylalanine into tyrosine. Thankfully, in the U.S. and most countries, detection of this condition occurs in the newborn screening panel.

Sweet’N Low (saccharin)

Sweet’n Low is an artificial sweetener made of saccharin, or benzoic sulfimide, which is a synthesized compound of methyl anthranilate, sodium nitrite, hydrochloric acid, sulfur dioxide, chlorine, and ammonia. This yields a very sugary substance that’s 300-400 times sweeter than sucrose. 

Saccharin in your body: Similar to sucralose, saccharin is also not largely stored in the body.

Limitation on consumption: As per FDA guidelines, the acceptable daily intake of saccharin as determined by the FDA is 15 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume upwards of 1,000mg of saccharin per day, which equates to 28 pink packets or 16 cans of Tab (if you’re able to locate the cult fave!)


Stevia is an all-natural sweetener that comes from a shrub called stevia rebaudiana and is primarily grown in South America and Asia. Today, 80% of all stevia comes from China, where they practice strict farming guidelines. These compounds are so sweet that it is actually 200-300 times sweeter than sugar.

Stevia in your body: Stevia has been studied and confirmed that it does not change your glycemic index or glycemic load. Research shows that it is metabolized by the liver, then passes through the body and does not accumulate anywhere.

Limitation on consumption: As per FDA guidelines, the acceptable daily intake of stevia is 4 milligrams per kilograms of body weight per day. So if you weigh 150 lbs., it is safe for you to consume up to 40 packets of stevia per day – every day.

A more “natural” artificial sweetener? There has been some conversation about stevia being considered a natural sweetener. Because there is no real definition of ‘natural’ (read our post investigating the ‘natural’ label here), the word is not meaningful. However, it is not synthetically made like other alternative sweeteners; therefore it is referred to as a ‘natural-origin’ sweetener.

Can we “hack” our gut health?

Hack Your Health: The Secrets of Your Gut, a documentary featured on Netflix, highlights the microbiome, the community of bacteria living inside our bodies, as a crucial player in gut health.

Each person’s microbiome is unique, much like fingerprints. The microbiome consists of approximately 100 trillion microbes, including bacteria, viruses, and fungi, that reside primarily in the intestines. These microbes help break down food, support the immune system, and communicate via the vagus nerve that connects our gut to our brain.

Hack Your Health follows the journey of four individuals, each with distinct gut health challenges. The variability in characters shows the complex nature of the gut and all that it impacts:

Michelin-starred pastry chef Maya learns that her anorexia and restrictive diet have severely impacted her gut health, necessitating a more balanced dietary approach to improve her well-being.


Daniell, the psychology student, discovers that her severe digestive issues and restrictive diet are linked to her gut microbiome, highlighting the need for personalized dietary adjustments.


Kimmie, labeled morbidly obese, finds that her lack of gut bacteria diversity affects her ability to feel full and lose weight, leading to tailored dietary recommendations to enhance her microbial diversity.


Competitive hot dog-eater Kobayashi realizes that his extreme eating habits have disrupted his hunger signals and gut health, prompting concerns about long-term damage and the need for a healthier lifestyle.

What the Documentary Gets Right and Wrong

The documentary is commendable for its scientific accuracy and approachable presentation of complex topics. It avoids the trap of pseudoscience by not offering overly simplistic solutions to complex problems. Instead, it emphasizes that gut health solutions are highly individualized, depending on one’s unique microbiome composition.

The documentary also accurately portrays the emerging science of the gut-brain axis, illustrating how the gut communicates with the brain and influences various bodily functions.

While the documentary is informative, it sometimes glosses over the intricate details of scientific studies, opting for a more infotainment approach. This style might leave viewers wanting a deeper dive into the science behind the microbiome and its broader implications.

Additionally, the documentary faced criticism for promoting untested claims about autism and gut health, which led to backlash from autism advocacy groups.

Scientific Insights & Treatments

To address their gut issues, Maya, Daniell, Kimmie, and Kobayashi send fecal samples for analysis. The results help tailor diets that could improve their microbiome diversity and overall health. One innovative treatment discussed is the “fecal microbiome transplant,” where healthy bacteria from a donor’s stool are transferred to the recipient’s gut.

This procedure has shown promise in treating conditions like Clostridium difficile infections and is being explored for other applications. But more underscore the new ways of diagnostics, such as as fecal sampling for additional information outside of just bloodwork.

What Does the Science Say About Our Gut?

Gut-Brain Axis

The gut-brain axis refers to the bidirectional communication between the gut and the brain. This connection influences various bodily functions, including mood, stress responses, and even cognitive functions.

For instance, the gut produces neurotransmitters such as serotonin, which is crucial for mood regulation. Dysbiosis, an imbalance in gut bacteria, has been linked to mental health conditions like depression and anxiety.

Immune System

Approximately 70% of the immune system is located in the gut. The gut microbiome plays a pivotal role in training the immune system to differentiate between harmful pathogens and harmless antigens. A healthy microbiome can prevent autoimmune diseases by maintaining a balanced immune response.

Metabolism & Weight Management

Gut bacteria are involved in the metabolism of food and the extraction of nutrients. They influence how we store fat, regulate glucose levels, and feel hunger or satiety. Dysbiosis can lead to metabolic disorders such as obesity and type 2 diabetes. Studies have shown that individuals with a diverse microbiome are more likely to maintain a healthy weight.

Inflammation & Chronic Diseases

A balanced microbiome helps control inflammation by producing anti-inflammatory compounds. Chronic inflammation is a risk factor for several diseases, including heart disease, cancer, and inflammatory bowel diseases (IBD). Dysbiosis is linked to increased intestinal permeability (leaky gut), which allows toxins to enter the bloodstream and trigger inflammation.

Digestive Health

The microbiome aids in digesting complex carbohydrates and fibers that the body cannot break down on its own. This process produces short-chain fatty acids (SCFAs), which nourish the gut lining, reduce inflammation, and support overall digestive health. Conditions like irritable bowel syndrome (IBS) and Crohn’s disease are associated with imbalances in the gut microbiome.

Key Takeaways for Consumers

While this documentary is not pseudoscience, it still lacks a bit of scientific depth. But here are some sound takeaways rooted in science from key points in the documentary:

Gut Diversity is Key

A diverse microbiome is crucial for good health. Each person’s microbiome is unique, and having a variety of bacteria can enhance resilience against diseases. Consuming a wide range of foods, especially plant-based ones, can help foster this diversity.

Plants provide different types of fibers, polyphenols, and other bioactive compounds that serve as substrates for various microbial species in the gut, promoting microbial diversity. A diverse diet boosts the production of short-chain fatty acids, such as butyrate, which play a crucial role in maintaining gut barrier integrity, reducing inflammation, and supporting immune function.

Individualized Solutions

There is no one-size-fits-all answer to gut health. Personalized approaches based on microbiome analysis can provide better health outcomes. For instance, Kimmie’s gut analysis revealed a lack of bacteria that help her feel full, leading to personalized dietary recommendations to increase her microbial diversity.

Similarly, Daniell’s restrictive diet was tailored to her specific gut needs. Understanding the unique composition of your microbiome can help in identifying the specific foods and treatments that are most beneficial for you.

Innovative Treatments

Treatments like fecal microbiome transplants (FMT) show promise but should be approached with caution and professional guidance. FMT involves transferring bacteria from a healthy donor’s stool to the recipient’s gut, aiming to restore a balanced microbiome.

This procedure has been effective in treating recurrent Clostridium difficile infections and is being investigated for other conditions such as irritable bowel syndrome and inflammatory bowel disease. However, it carries risks, including the potential transfer of harmful pathogens, and should only be done under medical supervision.

Fiber is Essential

Eating more plants and fibers is universally recommended for maintaining a healthy gut. Fiber acts as a prebiotic, feeding the beneficial bacteria in the gut and promoting their growth. High-fiber foods such as fruits, vegetables, legumes, and whole grains can help maintain a healthy gut microbiome.

The fiber in these foods is fermented by gut bacteria, producing short-chain fatty acids that support gut health and overall well-being. Increasing fiber intake can also improve digestion, reduce inflammation, and enhance immune function.

Hack Your Health: The Secrets of Your Gut is a compelling watch for anyone interested in the emerging science of gut health. While it may not delve as deeply into hard science as some might prefer, it offers valuable insights and practical advice in an engaging and accessible manner.

Grocery Shopping Made Simple

This method, developed by Will Coleman, not only simplifies the shopping process but ensures that consumers maintain a balanced diet rich in essential nutrients. This approach aligns well with the Dirt to Dinner philosophy, emphasizing wallet-friendly trends, beneficial for health, and helpful in making informed, healthful, consumer decisions.

According to the International Food Information Council’s 2023 Food & Health Survey, 76% of Americans say price is highly impactful on their food purchasing decision, and nine out of 10 Americans have noticed an increase in the overall cost of food and beverages.


Besides cost being a driver of purchases, taste still ranks number one and healthfulness is important for 62% of Americans.

Shopping Method Countdown

The 6-to-1 grocery shopping method is a strategic approach to grocery shopping that encourages shoppers to purchase items across six distinct categories for every one discretionary item: 6 vegetables, 5 fruits, 4 proteins, 3 starches, 2 spreads and 1 treat.

The focus is on filling the cart with essentials that ensure a well-rounded ratio of nutrients, thereby simplifying decision-making.

So let’s start from the top…

Six Vegetables

Choose six vegetables to put in your cart!

The recommended daily intake of vegetables can vary based on factors like age, sex, and level of physical activity, but a general guideline from health authorities such as the U.S. Department of Agriculture (USDA) suggests that adults consume between 2 to 3 cups of vegetables per day. This is part of their broader recommendation for a healthy eating pattern.

For instance, specific guidelines suggest:

  • Women aged 19 to 50 years should aim for at least 2.5 cups of vegetables daily.
  • Men in the same age range should target at least 3 cups daily.
  • Older adults or those less physically active might need slightly less.

These servings should include a variety of vegetables from different subgroups, including dark green, red and orange, legumes (beans and peas), starchy, and other vegetables, to ensure a diverse intake of nutrients.

Here are some of our favorite nutrient-dense options that are tasty in all sorts of recipes:

Download printable here.

Health Benefits

Vegetables are critical for preventing chronic diseases thanks to their high nutrient density. For example, high intakes of leafy greens like spinach are associated with a lower risk of diabetes, cardiovascular diseases, and cognitive decline due to their rich content in antioxidants, vitamins, and minerals.

Cruciferous vegetables like broccoli and cauliflower are linked to a decreased risk of cancer, particularly colorectal cancer, through mechanisms involving the regulation of enzymes and inhibition of tumor growth. Much like the healthy plate suggests, vegetables should be your largest daily food group ratio.

Five Fruits

Choose five of your favorite fruits! Aim to add about 1.5 to 2 cups of vibrant, delicious fruits to your daily diet.

Whether you’re filling your basket with tangy oranges, crisp apples, or exotic mangoes, each fruit offers a unique burst of flavor and essential nutrients. By hitting these fruity targets, you’re not just satisfying your sweet tooth—you’re fueling your body in the most delicious way possible!

Download printable here.

Health Benefits

Fruits are a powerhouse of antioxidants, vitamins, and fiber which help reduce the risk of developing various diseases. Consuming a variety of fruits is associated with a reduced risk of chronic conditions such as heart disease, cancer, and Alzheimer’s disease.

Berries, for example, have high levels of flavonoids, which have been shown to enhance brain health and prevent age-related memory loss. This should make up a similar portion of your plate to protein.

Four Proteins

Adults should aim for a range of protein sources to meet their daily needs, typically about 5 to 6.5 ounces depending on your age, sex, and activity level. From the lean cuts of meat in the butcher section to the versatile beans and lentils in the dry goods, protein is your body’s building block.

Why not grab some salmon for those omega 3s, or perhaps some chicken for a lean, mean dinner option? Don’t forget plant-based stars like tofu and tempeh, which can be fantastic in stir-fries or salads.

Download printable here.

Health Benefits

Protein is essential for muscle repair, immune function, and overall growth and development. Foods rich in omega-3 fatty acids, like salmon, are linked to reduced inflammation and lower risks of heart disease.

Plant-based proteins such as lentils and black beans offer cardiovascular benefits and are associated with lower cholesterol levels and improved gut health.

Three Starches

Depending on your overall dietary needs, aim to incorporate about 5 to 8 ounces of starches into your daily meals. Explore the world of whole grains like quinoa, barley, and whole wheat bread that keep you feeling full and energized. Or indulge in the hearty comfort of potatoes and sweet potatoes, perfect for roasting, mashing, or baking.

And don’t overlook the pasta and rice – versatile staples that can be the foundation of countless delicious dishes. Tip: When you are in the store, avoid all white starches as possible; seek brown options—they are likely more balanced and lower in sugar!

Download printable here.

Health Benefits

Starches are a key source of energy and play a crucial role in maintaining blood sugar levels. Whole grains like quinoa and oats are linked to reduced risk of heart disease, diabetes, and certain types of cancer due to their high fiber content which aids in digestion and promotes satiety.

Two Sauces or Spreads

Download printable here.

Health Benefits: Sauces and spreads can enhance the flavor of meals while contributing to nutrient intake. For example, olive oil in pesto is rich in monounsaturated fats, which are beneficial for heart health and may reduce the risk of heart disease.

One Fun Treat

While generally limited in nutrients, allowing for occasional treats like dark chocolate can aid in sticking to a healthy eating plan by reducing feelings of deprivation. Dark chocolate is known for its cardiovascular benefits due to its high flavonoid content.

Here are a few treat examples and nutrients:

  • Square of dark chocolate: Flavonoids, iron, magnesium
  • Pack of sugar-free gummy bears: Sugars, small amounts of juice (if used)
  • A small serving of corn chips: Sodium, calories

By organizing shopping into six straightforward categories, Coleman’s method helps individuals make healthier food choices, reduce food waste, and save money—all of which are essential for maintaining a balanced diet and lifestyle in today’s fast-paced world. The method not only supports physical health by ensuring a nutritious diet but also promotes mental well-being by simplifying decision-making and reducing the stress associated with meal preparation.