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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.
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.