What Is Erythritol?
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Medically reviewed by Barbie Cervoni, MS, RD, CDCES, CDN
Erythritol is a type of sugar alcohol commonly added to sugar-free products and used as a blood sugar-friendly alternative to table sugar in foods and drinks.
Diets high in added sugar are linked to several health issues, including an increased risk of diabetes, heart disease, and obesity, which is why many people choose to use sugar alternatives, like erythritol.
Sugar alcohols, also known as polyols, are sugar derivatives that naturally occur in some foods and are also commercially produced for use in the food industry.
There are many types of sugar alcohols, but erythritol is one of the most commonly consumed in the United States. Erythritol provides 0.2 calories per gram—3.8 calories less than table sugar—and is about 70% as sweet as sugar.
Erythritol is naturally found in a number of foods, such as fruits and fermented foods, and is commercially produced by fermentation from a corn-derived sugar called dextrose.
Using erythritol as an alternative to table sugar and other sweeteners may have some health benefits, but it’s more recently been linked with serious health concerns.
Benefits of Erythritol
Erythritol has a similar structure to sucrose, or table sugar, and stimulates sweet taste receptors in the body. It's low in calories and doesn’t impact blood sugar or insulin levels. As an alternative to regular sugar, erythritol has been linked to a few health benefits.
May Promote Healthy Blood Sugar Levels
Foods and drinks high in sweeteners like table sugar, agave, and corn syrup significantly impact blood sugar and insulin levels. It’s recommended that everyone, including people with prediabetes and diabetes, limit their intake of added sugar in order to promote healthy blood sugar regulation.
Choosing erythritol-sweetened products over those containing table sugar and other sweeteners may help improve both short-term and long-term blood sugar control. Unlike other sweeteners, your body absorbs erythritol through the small intestine and then excretes most of it unchanged through your urine.
The glycemic index (GI) is a measure of how quickly a food or drink raises blood sugar levels. Erythritol has a glycemic index of zero to one, meaning it has little to no impact on blood sugar. For reference, the GI of sucrose or table sugar is 65.
Though studies are limited, findings suggest replacing sugar with erythritol may help improve glycemic control in people with diabetes. It could also help reduce a person's overall consumption of sugar and its adverse effects on health.
Studies suggest erythritol slows gastric emptying and sugar absorption from the small intestine, which may help lower blood sugar levels over time. However, more human studies are needed to fully understand how erythritol impacts both short- and long-term blood sugar control.
May Help Reduce Calorie Intake
Erythritol contains only 5% of the calories found in sugar, so using erythritol in place of table sugar can help you cut back on your calorie intake.
In addition to being much lower in calories than table sugar and other sweeteners, erythritol may help reduce hunger levels after eating, helping you eat fewer calories.
A small study that included 20 healthy people found participants who received 50 grams (g) of erythritol 15 minutes before eating a meal consumed significantly fewer calories compared to participants who received table sugar, the artificial sweetener sucralose, or tap water before eating.
The erythritol treatment led to a significant increase in the secretion of the satiety hormone cholecystokinin (CCK), which helps promote feelings of fullness after eating. The erythritol treatment also had no effect on blood sugar or insulin levels.
Could Protect Dental Health
A high-sugar diet damages the teeth and gums. Cavity-promoting bacteria like Streptococcus mutans (S. mutans) feed on sugar and produce acids that break down tooth enamel, which is why dietary added sugar intake is considered the most significant risk factor for cavities.
Replacing sugary foods and drinks with those sweetened with sugar alternatives like erythritol may help improve dental health and protect against cavities.
Studies lasting two months to three years show consuming products like gum and candy containing 5-7.5 g of erythritol per day inhibits the growth of dental plaque in both children and adults.
Although the sugar alcohol xylitol is most commonly used in sugar-free chewing gum, erythritol has been shown to have more powerful plaque-preventing powers than xylitol. Erythritol prevents plaque by passing through bacterial membranes and interfering with growth pathways, which prevents the growth and spread of plaque.
Has Fewer Gastrointestinal Side Effects
Sugar alcohols can cause digestive upset when consumed in larger doses. This is because most sugar alcohols are poorly absorbed, drawing water into the intestines. They are also fermented by bacteria in the large intestine, which causes symptoms like diarrhea, bloating, and gas.
Unlike other sugar alcohols, erythritol is absorbed through the small intestine before being excreted from the body through the urine.
Only a small amount of erythritol reaches the large intestine, which is why erythritol is better tolerated and associated with fewer digestive symptoms than sugar alcohols like sorbitol and xylitol.
How to Use Erythritol
Erythritol is found in a number of products, including sugar-free candy, drinks, and foods. It’s commonly added to low-carb and keto-friendly foods and beverages like cookies, sweets, and sugar-free sodas, as it provides a sweet taste without impacting blood sugar levels.
For use in cooking and baking, erythritol can be purchased in granulated, powdered, and liquid form.
Erythritol is commonly used in combination with other zero and low-calorie sweeteners like monk fruit and stevia to create sweetener blends that closely resemble the taste of sugar. It's the main ingredient in the popular sweetener blend Truvia, which also contains stevia.
Erythritol can be used to sweeten drinks like coffee and tea, and also works well in low-sugar recipes for baked goods, like cakes and breads.
Dosage
Erythritol is generally considered safe and isn’t associated with adverse short-term side effects, even in high doses.
Experts suggest men and women keep their daily intake of erythritol under 0.66 and 0.80 grams (g) per kilogram (kg) per day, respectively. This equates to around 54 g, or about 13 teaspoons, of erythritol per day for a 150-pound woman.
Although higher doses have been reported to be well-tolerated, consuming doses higher than the recommendations above increases the chances of experiencing digestive side effects, such as diarrhea, gas, and bloating.
Is Erythritol Safe?
While erythritol has generally been considered safe for human consumption, recent research has linked long-term erythritol intake to an increased risk of heart attack and stroke.
A recent study that included over 3,000 U.S. and European adults found people with the highest levels of erythritol in their blood were about twice as likely to experience cardiac-related events, such as heart attacks, over three years compared to participants with the lowest blood levels of erythritol.
Additionally, the study found erythritol may speed up the formation of blood clots and artery blockages by triggering changes in platelet function. However, this finding is based on in vitro (test tube) research.
Other studies have linked high blood levels of erythritol to an increased risk of abdominal fat gain and type 2 diabetes.
However, more research is needed to assess the safety and long-term health effects of this popular sugar alternative.
Where to Find
Erythritol is found in a number of pre-made foods and drinks and can also be purchased in granulated, liquid, or powder form for use as a sugar replacement.
In addition to being a common food additive and low-calorie sweetener, erythritol is naturally found in small amounts in certain foods, like watermelon, grapes, pears, cheese, and soy sauce.
Can You Have Too Much?
To avoid digestive symptoms like bloating and diarrhea, it’s recommended men and women keep their daily intake of erythritol under 0.66 and 0.80 g per kg per day, respectively.
Consuming doses higher than this could cause digestive symptoms in some people.
Some recent research has linked long-term erythritol consumption to serious health concerns. However, more research is needed to fully understand the long-term effects on overall health.
Side Effects of Erythritol
When consumed in doses higher than 0.66 g for men and 0.80 g for women per kg per day, erythritol may lead to digestive symptoms such as:
A Quick Review
Erythritol is a sugar alcohol that’s 70% as sweet as table sugar yet contains 95% fewer calories.
Because it doesn’t impact blood sugar levels, erythritol is a popular choice amongst people following low-carb diets and those with diabetes.
Replacing sugar with erythritol may help reduce calorie intake, prevent blood sugar spikes, and protect dental health. Consuming more than the recommended amount of erythritol may cause side effects like bloating, gas, and stomach pain.
Some recent research has linked long-term erythritol consumption with an increased risk of heart-related conditions, such as heart attack and stroke. However, more studies are needed to fully understand it's long-term effects.
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