People who are cutting calories for weight loss or monitoring their sugar intake may need to replace sugar in their diet. There are a variety of options to choose as sugar substitutes, both natural and artificial, erythritol being one of these.

Nonartificial sugar substitutes include sugar alcohols and natural sweeteners, such as stevia, monk fruit extract, and more. These options contain half or less of the calories of regular sugar.

The fermentation of wheat or corn starch produces sugar alcohol, which is a crystalline product people can add to foods for flavor in a similar way to sugar. Erythritol is a type of sugar alcohol.

Erythritol occurs naturally in some fruits and fermented foods, while manufacturers add a industrially fermentated version to low sugar and sugar-free food and drink options.

The United States Food and Drug Administration (FDA) approved erythritol for use as a food additive in the U.S. in 2001.

In this article, we look at the research for and against using erythritol and how to identify this sugar alcohol in food products.

Erythritol sugar substitute.Share on Pinterest
Erythritol may appear in sugar-free food and drink options.

Erythritol has benefits as a sugar replacement. However, many studies describing these benefits are older, with newer studies contradicting their findings.

People with diabetes manage their condition by following a diet that is low in sugar. Alternative sweeteners such as erythritol can make this easier by replacing sugar without sacrificing sweetness.

Older studies from 1994 and 2003 suggest that erythritol does not have a significant effect on blood sugar levels.

A 2019 study suggested that replacing sugars such as glucose, fructose, and sucrose with erythritol could improve post-meal blood pressure.

A 2010 study in rats with diabetes went so far as to suggest that erythritol could serve as an antioxidant that may protect the blood vessels against damage from diabetes.

The 1994 study also found no significant link between erythritol and changes in cholesterol, triglycerides, or carbohydrate metabolism.

A more recent study from 2017, however, associated erythritol blood levels and increased adiposity in young adults. Adiposity is being severely or morbidly overweight.

This study said the body creates erythritol from glucose, and that some people may genetically convert more glucose to erythritol than others do. Also, it was unknown if and by how much the ingestion of erythritol containing foods affects body composition.

Erythritol has the lowest calorie content of any sugar alcohol at 0–0.2 kilocalories per gram (kcal/g). This measure means it could serve as a beneficial substitute for sugar in a calorie controlled diet.

A 2014 study suggested that erythritol is harmful to fruit flies. As such, agricultural companies may be able to use it as an effective pesticide that is safe for human consumption.

Erythritol is unlikely to be harmful when people consume it in moderation as part of a balanced diet. Despite this, there is a need for more research.

Read about a different type of artificial sweetener, aspartame.

Some sugar alcohols can cause gastrointestinal distress, as the body does not fully absorb these alcohols. However, erythritol seems to cause fewer of these problems in comparison to other sugar alcohols.

This advantage may be because the upper small intestine absorbs about 90% of the erythritol from where it passes to the bloodstream before the body excretes it in the urine.

Erythritol does not attract water into the small intestines, leading to osmotic diarrhea, as other sugar alcohols do. Also, gut bacteria do not ferment it in the colon.

One 2007 study compared the digestive effects of table sugar with erythritol and another sugar alcohol called xylitol.

The study subjects consuming xylitol experienced diarrhea, nausea, and bloating. Those who took erythritol experienced significantly fewer symptoms.

Participants taking 20 grams (g) and 35 g of erythritol did not experience adverse digestive effects. In the U.S., a person consumes 13 g of erythritol on average every day, which is far less.

The European Commission’s Scientific Committee on Food released an opinion statement in 2003, concluding that erythritol may have a laxative effect in some people. However, someone would need to consume more erythritol to experience this side effect than other, similar sugars.

Food products labeled “sugar free” or “low sugar” may contain a sugar substitute, such as erythritol. A quick look at the ingredient list can confirm this or not.

These foods may contain other sugar alcohols or substitutes, including:

  • glycerol
  • isomalt
  • sorbitol
  • xylitol

These ingredients may have different effects on the body, particularly on digestion.

Erythritol is most common in sugar substitutes, such as those that use stevia, a naturally sweet plant.

A person might also find erythritol in the following:

  • sugar free gum
  • sports drinks
  • sugar free candies and chocolates
  • lozenges
  • bakery products, including fondants and creams

Erythritol may serve as a lower calorie option for people who wish to consume less sugar with minimal adverse health effects.

People can make a habit of reading food labels to know which additives are present in a particular product.

Knowing about food and its content can help a person make the best decisions for their diet and overall health.

Q:

Can a person be allergic to sugar alcohols?

A:

While a sugar alcohol allergy could technically exist, scientists have not published any reports of this type of allergy.

The digestive symptoms people experience from consuming sugar alcohols aren’t classified as an allergy because the immune system is not involved. Most sugar alcohols, except for erythritol, attract water into the intestines, loosening stool, and are fermented by gut bacteria in the colon, resulting in IBS-like symptoms.

Since symptoms are not a result of an allergy, keeping intake at low to moderate levels daily or below your individualized tolerance level is key.

Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.