Erythritol & Other Sugar Alcohols: A Common Ingredient With a Side Effect You Probably Didn’t Know About
ErythritolEveryone, including the food industry, is looking to cut back on our sugar intake these days.1 You may have noticed that many products now include sugar alcohols, in place of, or in addition to sugar, in order to give sweet taste with fewer calories. There are several different sugar alcohols out there, including mannitol, sorbitol and xylitol. But what about erythritol?
Erythritol is fairly new to the food scene, but lately it’s been getting a lot of press. Erythritol, like other sugar alcohols, is typically added to products as a low-calorie sweetener or it can be bought in powder form (Swerve is a popular sugar-substitute that is comprised of erythritol) and used in everything from baking to sprinkling it in your coffee.2 But why is it getting so much attention?
Sugar alcohols are everywhere. Chewing gum, energy bars, low-calorie/low-sugar products, candy, desserts, jams and even mouthwash and medicines are just a few places you may find some.
First Things First: What Exactly Is Erythritol?
In order to answer this question, let’s discuss what sugar alcohols are. Sugar alcohols are carbohydrates, but provide a minute amount of calories per gram. Depending on which one, you’re looking at anywhere between 0 and 3 calories per gram.3
Here’s a quick glance at what this looks like for some of the common sweeteners:
• Sucrose (or table sugar) provides 4 calories per gram
• Xylitol provides 2.4 calories per gram
• Erythritol provides only 0.24 calories per gram
So as you can see, using a sugar alcohol like xylitol or erythritol will drastically reduce your calorie intake compared to using plain old sugar.
There are several reasons why we are seeing more and more use of sugar alcohols lately.4 They are typically added to products for bulk and texture, to prevent browning, to give a cooling sensation in products such as gum, mouthwash or mint candies, and of course, to replace sugar in low or sugar-free products. Sugar alcohols don’t cause cavities either.5
In addition, sugar alcohols aren’t as sweet as artificial sweeteners (which can be overwhelming in their sweetness), and erythritol in particular, has a comparable sweetness to sucrose (60 to 80 percent as sweet), meaning you can use it in a one-to-one ratio to replace sugar in recipes.6 Other sweeteners, like Splenda, for example, need to have something else (usually fillers) added in order to make it so we can use them like we use sugar.7 Erythritol also improves “mouthfeel” of food products, making it a desirable addition to products.6
What Are the Benefits of Using Erythritol Over Other Sugar Alcohols?
Here is the bad news: Because sugar alcohols are not completely absorbed in the intestines (contributing to their low-calorie effect), they go on to be fermented by bacteria in the large intestine, which can cause gas, bloating, diarrhea and abdominal discomfort. In fact, the FDA (U.S. Food and Drug Administration) states that products containing sorbitol or mannitol must include a warning that excessive consumption may have a laxative effect.
However, in various studies, erythritol has proven to be better tolerated than other sugar alcohols in the digestive system.6 This is partially because human gut bacteria do not ferment erythritol. Another reason is that most of it is actually absorbed into the bloodstream before making it into the colon.8
In fact, about 90 percent of the erythritol you eat is absorbed into your bloodstream and is excreted right away by the kidneys without being metabolized or changed in any way.8 Better yet, the erythritol that does make it into the bloodstream doesn’t directly affect glucose or insulin levels. The other 10 percent does make it down to your colon.6 But, like I just mentioned, gut bacteria don’t ferment erythritol.
Because of the effects (or lack thereof) of sugar-alcohols and erythritol in particular on the body, erythritol shows promise as a better sugar substitute, especially for people with type 2 diabetes or pre-diabetes. Believe it or not, there are also some early indications that erythritol may have positive effects on heart health, especially in individuals with type 2 diabetes.9
What’s the Catch?
The downside of erythritol consumption is not as bad as you might think. Symptoms of overconsumption include flatulence and a possible laxative effect, however, compared to other sugar alcohols, this effect is much less intense.6 Other sugar alcohols, including mannitol, sorbitol and xylitol, may cause gastrointestinal (GI) problems with much smaller amounts such as bloating, abdominal pain, excessive gas, loose stool and diarrhea.
So how much is too much? Studies suggest that up to 50 g of erythritol has been shown to be tolerated fairly well (with just some nausea and stomach rumbling reported), whereas even 35 g of xylitol can cause diarrhea.10 In general, erythritol has so far been classified as non-toxic when consumed, but depending on your sensitivities and how much you consume at any given time, you could experience GI discomfort regardless.11
The Bottom Line?
• Erythritol is approximately 70 percent as sweet as regular table sugar.
• Erythritol is easier to tolerate than other sugar alcohols in your digestive system.
• Erythritol consumption won’t raise your insulin or blood sugar levels.
• Erythritol is generally considered as safe for consumption.
• Erythritol may be beneficial as a sugar substitute for those with diabetes or pre-diabetes.
However, it is now being added to many product to increase sweetness, thereby permitting companies to add less “added sugar” to their product. Since the Nutrition Facts label now requires companies to indicate how much added sugar is in the product, many companies are reformulating their products so that number can lower.12 With erythritol finding its way into so many products, it may be easy to overconsume it. Check ingredients labels to be sure you aren’t having too much in your diet.
References:
1 Heart.org (2018). Tips for Cutting Down on Sugar. Retrieved from: www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/tips-for-cutting-down-on-sugar.
2 American Diabetes Association. Understanding Carbs: You’re your balance. Retrieved from: www.diabetes.org/nutrition/understanding-carbs.
3 Food Insight (2017). 2017 Food and Health Survey: “A Healthy Perspective: Understanding American Food Values. Retrieved from:https://foodinsight.org/2017-food-and-health-survey-a-healthy-perspective-understanding-american-food-values-2/.
4 Sollid K. Food Insight (2017). Sugar Alcohols in Gum: A Wad Full of Benefits. Retrieved from: https://foodinsight.org/sugar-alcohols-in-gum-a-wad-full-of-benefits/.
5 Van Loveren C. Sugar Alcohols: what is the evidences for caries-preventive and caries-therapeutic effects. Caries Research. 2004; 38(3):286-293. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/15153702/.
6 Regnat K, Mach RL, Mach-Aigner AR. Erythritol as sweetener – wherefrom and whereto? Applications of Microbiology and Biotechnology. 2018; 102(2): 587-595. Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC5756564/.
7 Schiffman SS, Rother KI. Sucralose, A Synthetic Organochlorine Sweetener: Overview of Biological Issues. Journal of Toxicology and Environmental Health. Part B, Critical Reviews. 2013; 16(7): 399-451. Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC3856475/.
8 Arrigoni E, Brouns F, Amado R. Human gut microbiota does not ferment erythritol. British Journal of Nutrition. 2005; 94(5): 643-646. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/16277764/.
9 Flint N, Hamburg NM, Holbrook M, Dorsey PG, LeLeiko RM, Berger A, de Cock P, Bosscher D, Vita JA. Effects of erythritol on endothelial function in patients with type 2 diabetes mellitus: a pilot study. Acta Diabetologica. 2014; 51:513-516. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/24366423/.
10 Mäkinen KK. Gastrointestinal Disturbances Associated with the Consumption of Sugar Alcohols with Special Consideration of Xylitol: Scientific Review and Instructions for Dentists and other Health-Care Professionals. International Journal of Dentistry. 2016; 2016:5967907. Retrieved from: www.ncbi.nlm.nih.gov/pmc/articles/PMC5093271/.
11 Boesten DMPHJ, den Hartog GJM, de Cock P, Bosscher D, Bonnema A, Bast A. Health effects of erythritol. Nutrafoods. 2015; 14: 3-9. Retrieved from: https://link.springer.com/article/10.1007/s13749-014-0067-5.
12 U.S. Food and Drug Administration (2021). Changes to the Nutrition Facts Label. Retrieved from: www.fda.gov/food/food-labeling-nutrition/changes-nutrition-facts-label.
Dr. Nicole Avena is a research neuroscientist and expert in the fields of nutrition, diet and addiction, with a special focus on nutrition during early life and pregnancy. Her research achievements have been honored by awards from several groups including the New York Academy of Sciences, the American Psychological Association, and the National Institute on Drug Abuse. She is an assistant professor of neuroscience at the Ichan School of Medicine at Mount Sinai, in New York, NY and is a visiting professor of health psychology at Princeton University in New Jersey. Dr. Avena has written several books, including What to Eat When You’re Pregnant and What to Feed Your Baby and Toddler. She regularly appears as a science expert on the Dr. Oz Show, Good Day NY and The Doctors, as well as many other news programs. Her work has been featured in Bloomberg Business Week, Time Magazine for Kids, The New York Times, Shape, Men’s Health, Details, as well as many other periodicals. Dr. Avena blogs for Psychology Today, is a member of the Penguin Random House Speakers Bureau and has the No. 2 most watched TED-ED Health talk, “How Sugar Affects Your Brain.” You can follow Dr. Avena on Twitter (@DrNicoleAvena), Facebook (www.facebook.com/DrNicoleAvena) and Instagram (@drnicoleavena), or visit www.drnicoleavena.com.
