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Now that sugar has become the devil behind many chronic health issues, health conscious people are turning to natural sugar alternatives. Erythritol is a sugar alcohol gaining popularity as a sugar alternative because it doesn’t have the after taste of stevia or the gastrointestinal side effects of xylitol.
Because erythritol has the mouthfeel and taste of sugar, it is tempting to use it by the cups in baking recipes, but that might not be a good idea. Have you ever wondered if erythritol is safe?
What Is Erythritol?
Erythritol is a sugar alcohol naturally found in small amounts in some fruits and fermented foods. This includes wine, sake, beer, watermelons, pears, grapes, and soy sauce. Some scientists also detect it as naturally occurring in low levels in the human body.
Its chemical properties are similar to sugar but it has several alcohol groups, which is why it is called a polyol. (Erythritol is a smaller molecule than xylitol which might explain why it causes less problems than xylitol.)
The erythritol used today is produced by fermenting corn or wheat using the fungi Moniliella pollinis or Trichosporonoides megachliensis.
While real sugar has 4 calories per gram and xylitol 2.4 calories per gram (60% of the calories of sugar), erythritol is much lower in calories at 0.24 calories per gram (6% that of sugar). This means it has about 60 – 80% sweetness of glucose for the same volume.
Because it is not very sweet on its own, it is often mixed with another sweetener like allulose or monk fruit.
Is Erythritol Safe or Dangerous?
The safety of erythritol is controversial for many reasons:
- When used as an ingredient, we tend to use a much higher dose of it than the dose found in nature.
- The toxicology studies are mostly conducted in healthy people or animals, which means that it may still be harmful to people with chronic health issues.
- There are concerns with it being a fermented grain-based product, as well as the potential for some on the market being genetically modified.
Toxicology studies have reported no adverse effects in mice, healthy people, or diabetics except in very large doses on empty stomach. In fact a high percentage is rapidly absorbed in the upper intestine and pass through our system unchanged, with around 90% of it excreted intact in the urine.
So with all the controversy why are people choosing it?
Health Benefits of Erythritol
A few of the reasons people are choosing this alternative sweetener….
Erythritol May Help with Diabetes and Weight Loss
Unlike sugar and many artificial sweeteners, erythritol does not induce an insulin response or change glucose metabolism in the body. This is true both for healthy and obese people. In diabetics, replacing sugar with erythritol seems to improve blood sugar levels and some other clinical outcomes.
It does somewhat change hormones that control gut movement, so that food takes longer to move from the stomach to the small intestine. Another study also showed that non-obese people who consume a meal with erythritol feel more satiated than those who had a meal with real table sugar.
Erythritol Is Good for Dental Health
Sugar alcohols like xylitol and sorbitol are well known for their ability to help kill bad dental bacteria. However, erythritol is even more powerful than xylitol for dental health.
Erythritol can suppress bad bacteria growth, reduce acids in the mouth that can cause tooth decay, and inhibit biofilm formation. Therefore, sugar-free sweets sweetened with erythritol are considered safe for the teeth, and some dentists are even using it as a disinfectant.
It Is an Antioxidant
A cell-based study showed that erythritol can quench a reactive oxygen species (a chemically reactive chemical species that can cause cell damage). In addition, the study was able to show that it protected blood vessels of diabetic rats against oxidative chemicals and hardening of the arteries. This might be another reason why erythritol seems to help with diabetes.
Side Effects of Erythritol: The Dose Makes the Poison
Unfortunately, there are also some cautions to be aware of with the sweetener.
High Doses Can Cause Digestive Problems
In adults, consumption of erythritol at a high dose can cause uncomfortable stomach rumbling, nausea, and gas. This only happens when adults ingest a high dose, like at 50 grams (about 3.5 tablespoons) in one sitting.
In children, the dose that can cause diarrhea is lower, at around 0.71 grams per kilogram of bodyweight. The same study concluded that erythritol may only be safe for children at around 0.59 grams per kilogram of bodyweight.
In beverages, the safe concentration for children should not exceed 2.5% (6.25 grams in one cup), which means that it may be safer to mix erythritol with another natural sweetener like stevia.
It Can Aggravate Gut Infections
While normal human gut flora doesn’t ferment erythritol, unabsorbed erythritol in the small intestine can cause a problem for people with small intestine bacterial overgrowth. Polyols like erythritol can trigger symptoms of irritable bowel syndrome (IBS), including gas, diarrhea, and malaise.
Those with IBS, SIBO, or who have had bad reactions to it should avoid this sweetener.
Donna Gates of the Body Ecology diet does recommend using it as an alternative sweetener for people on the candida diet for those who tolerate it.
There are a few case reports of allergic reactions, including a case of hives and another of anaphylaxis. Interestingly, based on the first case study, it is still possible to be allergic even though the skin prick test comes back negative.
A Potent Insecticide
A group of researchers in Philadelphia tested various non-nutritive sweeteners on fruit flies, and found that erythritol in Truvia is the only sweetener that robustly kills the flies. Because it tasted sweet, the fruit flies would readily eat it.
(Now, until we understand how it kills the fruit flies, we don’t know how this impacts human health as some other species of insects can eat it and do okay.)
Concerns with GMOs and Grains as Raw Material
Because genetically modified products like corn syrup are cheap, many food products on the market that contain erythritol definitely contain GMO crops, which means that these foods are bad for the environment. In addition, non-organic foods that contain GMOs, even ones that are highly processed, can contain pesticide residues.
If you avoid gluten, you will have to be careful with residual gluten in erythritol that may be made from wheat or gluten-containing grains. You want to pick a good company that produces their product only from gluten-free sources. Ideally, get a certified organic one, and avoid non-organic products that contain erythritol.
Should You Use Erythritol?
At the time of this post, Wellness Mama medical reviewer Dr. Ann Shippy advised that she isn’t recommending sugar alcohols like erythritol based on research that shows they may alter the gut microbiome and cause unwanted symptoms even at a very low dose. However, unless a person has digestive problems like IBS, SIBO, or other bad reactions, using erythritol as a treat once in a while may be okay.
This article was medically reviewed by Dr. Ann Shippy, who is Board Certified in Internal Medicine and a certified Functional Medicine physician with a thriving practice in Austin, Texas. As always, this is not personal medical advice and we recommend that you talk with your doctor.
Have you tried alternative sweeteners? Which have worked for you and which haven’t? Share below!
- Ruiz-ojeda FJ, Plaza-díaz J, Sáez-lara MJ, Gil A. Effects of Sweeteners on the Gut Microbiota: A Review of Experimental Studies and Clinical Trials. Adv Nutr. 2019;10(suppl_1):S31-S48.
- Munro, I.C., et al. (1988, December). Erythritol: an interpretive summary of biochemical, metabolic, toxicological and clinical data. Food and Chemical Toxocology 36(12).
- Cock, Peter de, et al. (2016). Erythritol Is More Effective Than Xylitol and Sorbitol in Managing Oral Health Endpoints. International Journal of Dentistry 2016.
- Shin, D. H. et al. (2016, August). Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance. Diabetes Metabolic Journal 40(4).
- Wölnerhanssen, B. K., et al. (2016, June 01). Gut hormone secretion, gastric emptying, and glycemic responses to erythritol and xylitol in lean and obese subjects. American Journal of Physiology – Endocrinology and Metabolism 310 (11).
- Ishikawa, M., et al. (1996, October). Effects of oral administration of erythritol on patients with diabetes. Regulatory Toxicology and Pharmacology 24(2).
- Overduin, J., et al. (2016, December 01). Failure of sucrose replacement with the non-nutritive sweetener erythritol to alter GLP-1 or PYY release or test meal size in lean or obese people. Appetite 107.
- Hartog, G. J. gen, et al. (2010, April). Erythritol is a sweet antioxidant. Nutrition 26(4).
- Yokozawa, T., Kim, H. Y., & Cho, E. J. (2002, September 11). Erythritol attenuates the diabetic oxidative stress through modulating glucose metabolism and lipid peroxidation in streptozotocin-induced diabetic rats. Journal of Agriculture and Food Chemistry 50(19).
- Storey, D., Lee, A., Bornet, F., & Brouns, F. (2007, March). Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid. European Journal of Clinical Nutrition 61.
- EFSA Food Panel.(2010, July 09). Statement in relation to the safety of erythritol (E 968) in light of new data, including a new paediatric study on the gastrointestinal tolerability of erythritol. EFSA Journal 8(7).
- Arrigoni, E., Brouns, F., & Amadò, R. (2005, November). Human gut microbiota does not ferment erythritol. British Journal of Nutrition 94(5).
- Body Ecology. Erythritol: What You Need to Know about This Natural Sugar Substitute & the Better Choice Available. Accessed March 23, 2017.
- Hino, H., et al. (2000, March). A case of allergic urticaria caused by erythritol. The Journal of Dermatology 27 (3).
- Kurihara, K., et al. (2013, November.) Case of 5 year-old boy with anaphylaxis due to erythritol with negative prick test and positive intradermal test. Arerugi 62(11).
- Baudier, K. M., et al. (n.d.). Erythritol, a Non-Nutritive Sugar Alcohol Sweetener and the Main Component of Truvia®, Is a Palatable Ingested Insecticide. PLOS, June 4, 2014.
Discussion (47 Comments)
This week I tried 80% pure Monk fruit powder with dextrose in in my chocolate, chocolate chip cookies. I used a 1/4 tsp of Monk fruit powder per cup of dextrose and that brought the sweetness to that of sugar. No after taste like the stevia that I have tried before, and the Monk fruit doesn’t kill the flavor of the cocoa like stevia does. Great if you’re concerned about refined fructose.
I have been using agave as a sweetener for awhile. Now I have been told IT’S bad. What can I read to substantiate this news? Thanks!
Katie - Wellness Mama
I actually wrote about it here: https://wellnessmama.com/2457/agave-healthy/
Its a high fructose syrup, its the nature of the plant. This is digested differently–thru your liver, contributing to fatty liver.
This can be as confusing as Stevia. Evidently, there is a rise in the use of erythritol in many sweetened drinks, sweetener products and sugar-free foods. It appears that much of the erythritol that is being used in these products is being derived from GMO cornstarch, which, in essence, would be taking a step in the wrong direction. So, “if” using an erythritol sweetened product I will be extra cautious as to which one is at least, GMO free. One that is not derived from a GMO corn grain product as is the sweetener I’ve used for years, As a Type II, I generally try and stay away from corn products, especially ones that are GMO derived. I just want a healthy sweetener that doesn’t affect my blood sugar nor affects my overall health adversely.
The “if” is also because a chemical company has found that it may be a safe insecticide for future use in pest control.* That alone, doesn’t it make it bad, necessarily, but it would very much depend on the way in which erythritol affects the insects. So, more testing may be underway. Here’s an article that explains it more: https://drexel.edu/now/archive/2014/June/Researchers-Find-Sweetener-is-Safe-Insecticide/
I do want to try “monk fruit”. I have seen it in a few health food stores in powder form, however, I will need to be sure that it is not mixed with erythritol and is non GMO. Till then, I pretty much stay w/my pure green leaf stevia liquid. I also have some organic stevia leaves that I use in my tea and will now use in my coffee when I use my french press. I’ll update as to how well monk fruit does in my coffee, tea and possibly, puddings. I don’t think it has the structure for baking. I’ll also update on the use of the organic stevia leaf use in my pressed coffee. I will try to detach the leaves from the small stems in the hopes that the bitter taste will not be present should I grind it for the coffee. Hopeful.
Just be careful about monk fruit. It is from China and don’t know the regulations of what happens there. They own the genetics and processing of it all…
Not all Monk Fruit is from China.
Much of it comes from SE Asia.
Thrive Market has non GMO verified and organic brand.
It will not dissolve, how will you utilize it in the coffee I sure would like to know? I grew my own stevia plant once it was amazing however when I dried and ground the leaves into a powder they did not dissolve but it was great for baking, except for the bitter taste and the green color, lol and what is a French press?
Always seemed suspect to me since I first heard of it. Same with xylitol. As for stevia, forget the after taste (which I agree is horrendous), I think it taste horrible beginning to end. IF I feel the need to add a sweetner to anything (which is very rare), its raw local honey, real maple syrup or unsulfered blackstrap molasses for me. While I know some people (auto-immune sufferers and whatnot) should avoid it, and diabetics must severely limit it (I read that blackstrap in small amounts is ok for some), I am fortunate enough to not have an issue with either. Use a mixture of the 3 in homemade chocolate (vitually my only use of any sweetner. That and the Apple Cider Vinegar/Honey drink I make) & tastes amazing. Plus they all have a good vitamin/mineral spectrum, as well as other benefits. (the blackstrap is a great and tasty source of iron, for those with iron deficiencies).
I understood this type of sugar is not burned off or utilized by the body. Until proven otherwise I will stay away from it.
I’ve wondered about this product and am not fond of the minty taste when used by itself. I mix it with coconut sugar which helps. I also have not ever noticed an after taste with stevia but hear people say that often.
Thank you for your diligence.
I wondered if erythritol was actually good for teeth, like xylitol! Altho xylitols not all that dentists claim it to be either…
Do you have an opinion on trehalose. It’s about half as sweet as sucrose but looks and tastes the same. From what I’ve read, it is not only not unhealthy but actually good for you.
Sugars, carbohydrates, proteins and fats are predominantly a means of energy storage. Some are good for immediate use and others for long term energy needs. When you look at them objectively, it’s easier to utilize them effectively.
In my late teens, after trying vegetarianism, blowing up like a BALOON and then several diets, regular appointments with acclaimed nutritionists and weight watchers meetings, I decided to stay away from “diets” and just eat the regular stuff that people have eaten for millennia. Bread, butter, sugar, honey, wine, cheese, beer, meat, veggies and fruits potatoes and grains. Nothing low-fat or diet (It’s a four lettered word!). I’ve come to the conclusion that being healthy is not synonymous with being waif thin. I’d rather be considered a little overweight, than slowly kill myself with chemicals in my food.
My Great-grandma, raised as a frontier’s woman, would scoop bacon grease out of the coffee can under the sink and eat it when she thought no one was looking. She didn’t ever drive a car, but daily walked across town, up a huge hill to church then back down to the grocery store and home. At the end of the day, when she thought I was fast asleep in bed, she’d have one small glass of wine or two fingers of whiskey. She lived to a ripe old age….90 something. We believed she was about 10 years younger until we found her actual records! She was older than my great-grandfather (if he ever knew, he never told). She was always trying to fatten us up. Because in the bitter cold and hard work she grew up with, skinny kids died…they just weren’t hardy enough.
Recently, I heard a report that said it’s a myth that red meat, fats and sugars are bad for you. The myth was promoted to encourage a diet that would cause more passivity…along with the educational changes of the 1930s it helped to foster contentment in urban factory working populations.
Perhaps if we consumed a proper amount of proteins, carbs and fats, the negative aspects of moderate sugar consumption would be mitigated and we would not need to subject our bodies to Frankenstein-sugars?
But it also takes being comfortable in ones own skin.
Just a thought…..
I think you make some very good points Kate! Anxiety about the foods we eat can cause a lot of problems – but it’s the anxiety that’s causing it, not the food. There’s a lot to be said for the old adage – ‘don’t eat anything your grandmother (or your grandmother’s microbiome) wouldn’t recognise as food’. As much as possible avoid refined carbs and refined fats, veg oils and transfats, avoid processed meats and ready meals – eat real fats, plants, meat, fish, real dairy (aged cheese not processed) and unrefined carbs, prebiotics and fermented food, a little sugar, as a treat – simply exercise it off. This is what my grannies had to eat (92 and 97 respectively – that’ll do for me!) If you really do feel better without dairy and/or gluten fine, don’t eat – but the scientific evidence suggests that few of us truly are allergic/intolerant of these foods – what we need to do is look after our micro-biomes. This is the advice from The Diet Myth – a great book IMO. Apart from these guidelines we need to start trusting our bodies. I’ve tried eliminating just about everything at different times – and what I find is that the anxiety of messing with my diet makes thing much worse. So – I follow the above, I’m fine with a little cow’s milk if I don’t go overboard, fine with cheese, fine with a couple slices wholemeal spelt bread a day – I keep refined sugar intake as low as possible. If I struggle to digest I kinda can’t digest anything – and its always cos of stress. Likewise, if I’m calm I’m ok with most things (apart from too much onion, garlic and leek, beans and pulses, and no peppers and cucumbers). Relaxing about my diet – other than the guidelines above – has freed me up and calmed my down and I now put much more of my focus on mental health with meditation, prayer etc. It’s been the way to go for me.
I loved your comment. Common sense wins. And, all the worrying about it steals joy and causes more health problems. Thank you!!
Sandra Mullins, Ca.
I agree with you, I try to eat like I did growing up(born 1953) and stick with home cooking, as far as regular sugar I’ve given up adding to my coffe , tea, cereal, etc. if I want sweet add a little honey, and really don’t miss sugar that much. I have also given up soda too! 🙂
I agree with you. My grandfather was a farmer. Ate what he wanted, not in excess and did hard physical work everyday of his life. He farmed the old fashioned way, just two tractors and their attachments…no big fancy equipment. He renderered his own fat and that is what they cooked in. Had their own chickens, pigs and cows, plus his crops. He still didn’t wear glasses except for reading sometimes, had a memory like you can’t imagine…and lived to be 97. He was not a super thin man….but he wasn’t fat either. I think as long as we eat, drink, exercise in moderation and eat the REAL stuff…we are better off. I would rather eat what God created naturally than what man created chemically any day. Just practice moderation.
I appreciate your article on erythritol. I have just begun using it because it is hard to get some things sweet enough with pure Stevia alone. We try not to use any form of sugar, including honey, because of the inflammatory aspects. We have totally stopped using “artificial” sweeteners such as Nutrisweet and Aspertame. So erythritol seems to be our best alternative, along with pure stevia.