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Jul 07, 2023

Erythritol — Healthy Sweetener or a Big, Fat Lie?

Erythritol is a sugar alcohol used as a low calorie sweetener. Eating a large

Erythritol is a sugar alcohol used as a low calorie sweetener. Eating a large amount of it may cause digestive issues, including nausea. Sensitivity and symptoms can vary.

The low calorie sweetener erythritol may seem too good to be true.

It's natural, doesn't cause side effects, and tastes almost exactly like sugar — without the calories.

Basically, it has all the positive aspects of regular sugar without any of the negatives, although some media outlets question its benefits.

This evidence-based article reviews the benefits and possible side effects of erythritol.

Erythritol belongs to a class of compounds called sugar alcohols (1).

Food producers use many sugar alcohols such as xylitol, sorbitol, and maltitol.

Most of them function as low calorie sweeteners in sugar-free or low sugar products.

Most sugar alcohols are found in small amounts in nature, especially in fruits and vegetables.

Because of the way these molecules are structured, they can stimulate the sweet taste receptors on your tongue.

However, erythritol appears to be quite different from the other sugar alcohols.

To begin with, it contains many fewer calories:

With only 6% of the calories of sugar, it still provides 70% of the sweetness.

In large-scale production, erythritol is created when a type of yeast ferments glucose from corn or wheat starch. The final product looks like powdery white crystals.

Erythritol is a sugar alcohol used as a low calorie sweetener. It provides only about 6% of the calories found in an equal amount of sugar.

Overall, erythritol appears to be very safe.

Multiple studies on its toxicity and effects on metabolism have been performed in animals. Erythritol has been found safe for both human and animal consumption (2).

However, there is one major caveat to most sugar alcohols: They can cause digestive issues.

Because of their unique chemical structure, your body can't digest them, and they pass unchanged through most of your digestive system until they reach your colon.

In your colon, they’re fermented by the resident bacteria, which produce gas as a byproduct.

Consequently, eating large amounts of sugar alcohols may cause bloating and digestive upset. In fact, sugar alcohols belong to a category of fibers known as FODMAPs.

But erythritol is different from the other sugar alcohols. Most of it gets absorbed into your bloodstream before it reaches your colon (3).

It circulates in your blood for a while and is eventually excreted, unchanged, in your urine. About 90% of erythritol is excreted this way (3).

Most of the erythritol you eat is absorbed into your bloodstream and then excreted in your urine. Erythritol seems to have an excellent safety profile.

Erythritol has come under fire recently because of several new studies showing a noticeable correlation between adverse cardiac events and thrombosis.

One small study involving eight healthy people suggested that erythritol consumption could increase the chance of blood clots. And two larger studies involving 1,157 and 2,982 people from the United States and Europe showed a noticeable correlation between elevated erythritol and risk of cardiovascular events and increased blood clot formation (4, 5, 6).

Further research is needed to find out whether these potential side effects of erythritol are a valid concern.

About 90% of the erythritol you eat is absorbed into your bloodstream. The remaining 10% travels undigested down to your colon.

Unlike most other sugar alcohols, erythritol seems to be resistant to fermentation by colon bacteria (3).

Feeding studies providing 0.7 to 1 gram per kilogram (2.2 pounds) of body weight show that it is very well tolerated (7).

However, one older study showed that 50 grams of erythritol in a single dose increased nausea and stomach rumbling (8).

Unless you’re eating massive amounts of erythritol at a time, it's unlikely to cause a stomach upset. However, erythritol sensitivity may vary from person to person.

About 10% of ingested erythritol is not absorbed into your blood and travels down to your colon. For this reason, a very high intake of erythritol may cause some digestive side effects. New studies have found a correlation between high levels of erythritol and cardiac and clotting issues, which need further research.

Humans don't have the enzymes needed to break down erythritol.

It's absorbed into the bloodstream and then excreted, unchanged, in the urine.

In animal studies, erythritol was found to inhibit the increase of blood sugar and insulin levels (9).

For people who are overweight or have diabetes or other issues related to metabolic syndrome, erythritol appears to be an excellent alternative to sugar.

Erythritol does not raise blood sugar levels. This makes it an excellent sugar replacement for people with diabetes.

One common negative effect of excessive sugar intake is poor dental health, including cavities and tooth decay.

The harmful bacteria in your mouth use sugar for energy. In the process, they release acids that can erode tooth enamel.

As a result, sweet-tasting sugar alcohols such as xylitol and erythritol have found their way into "tooth-friendly" products, as mouth bacteria cannot use them for energy.

Xylitol and erythritol also suppress the growth of bacteria directly. However, erythritol does a better job. According to a 2016 review, erythritol is more effective at inhibiting the growth of oral bacteria than other sugar alcohols, including xylitol (10).

Multiple studies have examined the effects of erythritol on cavities, and the results are mixed.

Some studies show a reduction in plaque and harmful bacteria, while others show no reduction in cavities. However, a 3-year study in 485 schoolchildren found that erythritol was even more protective against cavities than xylitol and sorbitol (11, 12).

The authors of a 2016 research review also concluded that erythritol is more effective against dental plaque and cavities than xylitol or sorbitol (10).

Erythritol may suppress the growth of bacteria in the mouth. Also, unlike sugar, it doesn't feed the bacteria that cause cavities.

Overall, erythritol appears to be a good alternative sweetener for several reasons:

Health-conscious people might choose to sweeten their food with stevia or honey. However, honey contains calories and fructose, and many people don't appreciate the aftertaste of stevia.

Erythritol appears to be generally safe, though more studies are needed.