Erythritol is a sugar alcohol used as a food additive and sugar substitute in a wide variety of products, especially foods that focus on sugar or overall calorie reduction. Erythritol occurs naturally in small amounts in some fruits, such as watermelon, pears and grapes, and in fermented foods, such as cheese and soy sauce, but is typically produced on a larger scale through fermentation.
Erythritol is quickly absorbed by the body in the small intestine, after which it enters the bloodstream. Once erythritol reaches a person's blood, the sugar alcohol is largely eliminated from the body through urine without being metabolized. This unique metabolic pathway allows erythritol to deliver the sweet taste of sugar, with almost zero calories and no effect on glucose or insulin levels.
Erythritol offers several potential benefits that contribute to its widespread use in nutritional products, says Alex Foxman, MD, a board-certified physician in internal medicine and founder and medical director of the virtual medical weight management program Achieve Health and Weight Loss.
Potential benefits of erythritol include:
- Control of blood sugar levels. Unlike sugar, erythritol does not affect blood sugar or insulin levels, which could potentially be beneficial for individuals who monitor their blood sugar levels, such as people with diabetes.
- Calorie management. Erythritol provides an estimated 0.2 calories per gram, compared to 2.4 calories per gram from other sugar alcohols (such as xylitol) and 4 calories per gram from sugar. This low-calorie feature can be beneficial for weight management efforts
- Improved oral health. Chews or tablets containing erythritol have been shown to inhibit plaque formation and improve oral health in both children and adults.
The Food and Drug Administration (FDA) classifies erythritol as a "generally recognized as safe" (GRAS) substance that is generally well tolerated by most people. However, erythritol may pose potential dangers and side effects for some individuals, explains Sarah Stombaugh, MD, a board-certified family physician, diplomate of the American Board of Obesity Medicine, and owner of a private weight loss clinic in Charlottesville, Virginia.
Possible side effects and risks of consuming erythritol may include:
- Gastrointestinal effects. Although generally better tolerated than other sugar alcohols such as xylitol and sorbitol, erythritol can lead to gastrointestinal side effects, such as nausea, bloating and diarrhea.
- Increased risk of cardiovascular events. Some research suggests that there is a link between erythritol consumption and the increased risk of blood clot formation and serious cardiovascular events, such as heart attack or stroke. However, additional research is needed to further investigate this relationship.
There is limited data on whether erythritol interacts with medications. Dr. However, Stombaugh advises individuals with underlying health conditions or those on a medication regimen to consult their healthcare provider before incorporating erythritol or any other sugar substitute into their diet on a regular basis.
In addition to its use in commercial products, erythritol is also available in granular or powder form for home uses, such as in cooking and baking, says Dr. Stombaugh. Due to its minimal aftertaste, it can also be combined with other sweeteners to mask any unwanted flavors from the other sweeteners.
Erythritol is about 70% as sweet as sucrose. This percentage may vary slightly per brand. That's why Dr. Stombaugh recommends checking the product packaging for specific conversion instructions if you want to adjust ingredient ratios. She adds that erythritol is often used as a 1:1 substitute for sugar in recipes for a slightly less sweet taste.
Products that often contain Erythritol
Erythritol can be found in a wide range of products, especially in sugar-free and low-calorie varieties, says Dr. Foxman. Examples of products that often contain erythritol include (but are not limited to):
- Baked goods, such as cookies, pies and cakes
- Chewing gum
- Desserts, such as ice cream and pudding
- Jam and jelly
- Sweets
"Food labeling guidelines make it difficult to know at a glance whether a food contains erythritol or other artificial sweeteners," explains Dr. Stombaugh out.
Although not required, food manufacturers may voluntarily list the amount of sugar alcohols in a food product under the total carbohydrates on the nutrition facts label. The manufacturer may also choose to list the specific sugar alcohol used if only one is added to the food. However, the FDA does not require sugar alcohols to be listed unless the manufacturer makes a statement on the product packaging about the health effects of sugar alcohols or sugar when sugar alcohols are present.
"If it tastes sweet, look for the sweetener in the ingredients list," says Dr. Stombaugh, who adds that you may need to contact the manufacturer directly for more complete nutritional information.
