Erythritol: Health Pros and Cons

Alfredo Valdés 9 min. of reading Carbohydrates Leave a comment

Erythritol has become a major player in the search for healthier sugar substitutes. What does scientific evidence say about its properties? In this post, we take a look at the benefits and potential drawbacks of erythritol.

Pros	Cons
Natural origin. Provides no calories. Does not raise insulin levels. Does not raise blood glucose levels. Better digestive tolerance than other polyols. Contains compounds with antioxidant activity currently under investigation.	High amounts may have a laxative effect.

Discover everything you need to know about a sweetener that can be an alternative to table sugar as part of a balanced diet.

Erythritol is a polyol, a type of low-calorie sweetener obtained through the fermentation of sugars using fungi. Its production process is more expensive than that of other sweeteners, resulting in a distinctive tolerance profile and nutritional characteristics.

Properties of erythritol supported by studies

Available evidence indicates that erythritol is better tolerated than other sugar alcohols such as xylitol or sorbitol.

1. Provides no calories

One of the main characteristics of erythritol is that it provides no calories, making it an alternative to sugars and other caloric sweeteners as part of a diet aimed at controlling energy intake.

A study conducted by Arrigoni, Brouns and Amadò (2005) analysed the digestion, absorption and excretion of erythritol compared with other polyols, such as xylitol and sorbitol.

Erythritol provides no calories.

The study found that erythritol is rapidly absorbed in the small intestine and largely excreted through urine without being metabolised or providing energy.

2. Does not raise insulin levels

One of the most extensively studied characteristics of erythritol is that it does not cause an increase in blood insulin levels. This is relevant as part of a balanced diet for those looking to moderate their sugar intake.

A 1994 study conducted by Tetzloff et al. investigated the impact of erythritol on blood glucose and insulin levels. This randomised, double-blind, placebo-controlled clinical trial involved 15 healthy volunteers who consumed either erythritol or a placebo.

The results showed that erythritol did not significantly affect blood glucose or insulin levels.

3. Does not increase blood glucose levels

It is a sweetener that does not raise blood glucose levels, making it an option to consider as part of a balanced diet for those who are mindful of their sugar intake.

One study supporting this claim was conducted by Ishikawa et al. in 1996.

The study by Ishikawa et al. (1996) showed that erythritol did not cause a significant increase in blood glucose levels compared with other sweeteners such as xylitol, lactitol, maltitol and glucose.

4. Good digestive tolerance compared with other polyols

Studies show that it is tolerated 2.5 times better than xylitol and almost 4 times better than sorbitol.

A study by Hiele et al. (1993), involving 24 healthy volunteers, demonstrated that erythritol was significantly better tolerated than xylitol and sorbitol, causing fewer gastrointestinal symptoms and being tolerated at doses 2.5 times higher than xylitol and almost 4 times higher than sorbitol.

Digestive discomfort is less likely to occur when erythritol is consumed as a sweetener compared with other polyols.

5. Studies in the field of oral health

Some studies have analysed the role of erythritol — in the form of sweets or chewing gum — in relation to dental mineral density and bacterial plaque. It is important to note that these studies were carried out using specific products (sweets/chewing gum), meaning their results cannot be directly extrapolated to other forms of consumption, such as powdered sweetener.

Mäkinen et al. (2005) and Honkala et al. (2014) studied adolescents who consumed sweets containing xylitol, erythritol or sorbitol daily for 6 months and 3 years, respectively.

In these studies, the group that consumed erythritol sweets had less dental plaque and fewer cavities than the control group, within the specific context of the format studied.

6. Antioxidant activity under investigation

Preliminary research has explored the potential antioxidant effect of erythritol, related to its ability to neutralise hydroxyl radicals at the cellular level. This is an ongoing area of research; there is currently no health claim authorised by EFSA for this effect, so it should be understood as an area of study rather than a guaranteed benefit.

Disadvantages and potential side effects of erythritol

Although its use is considered safe, some individuals may experience mild gastrointestinal discomfort.

Even though erythritol is better tolerated than other sugar alcohols, some people may experience abdominal bloating, gas or diarrhoea, particularly when consumed in excess. This is because some erythritol is not absorbed in the small intestine and reaches the colon, where it is fermented by intestinal bacteria.

The World Health Organization does not classify it as “healthy” per se, but neither does it consider it a risk. EFSA periodically assesses the safety of sweeteners and establishes intake limits.

EFSA has established a daily intake limit for erythritol of 1 gram per kilogram of body weight.

Overall, the available evidence supports its use as a safe and well-tolerated sweetener within the established intake limits.

Erythritol vs. sugar: quick comparison

	Erythritol	Sugar (sucrose)
Calories (per 100 g)	~20 kcal	~400 kcal
Glycaemic index	0	~65
Relative sweetness	~70%	100%

Erythritol supplements at HSN

Discover erythritol, an alternative to sugar as part of a balanced diet. By incorporating this sweetener into your daily meals, either by completely or partially replacing sugar, you can reduce your calorie intake without giving up a sweet taste.

Buy 100% powdered erythritol

Conclusions

Among the main characteristics of erythritol consumption, we can highlight:

It is a sweetener with a taste similar to sugar, providing twenty times fewer calories.
Some people may experience mild side effects related to gastrointestinal discomfort, particularly at high doses.
It comes from plant-based sources and is obtained through fermentation.
Research is ongoing into its potential role in oral health and antioxidant activity, although there are currently no EFSA-authorised health claims for these effects.
Its safety has been assessed by regulatory agencies such as EFSA, within the established intake limits.

References

Pariona, Ameber. (2019, March 18). Countries That Eat the Most Sugar. Retrieved from https://www.worldatlas.com/articles/top-sugar-consuming-nations-in-the-world.html
Institute of Medicine (US) Committee on Diet and Health; Woteki CE, Thomas PR, editors (1992). Eat for Life: The Food and Nutrition Board’s Guide to Reducing Your Risk of Chronic Disease. Washington (DC): National Academies Press (US). Chapter 5, Calories, Energy Balance, And Chronic Diseases.
World Health Organization (2015)Guideline: Sugars Intake for Adults and Children.
Flint, N., Hamburg, N. M., Holbrook, M., Dorsey, P. G., LeLeiko, R. M., Berger, A., … Vita, J. A. (2014). Effects of erythritol on endothelial function in patients with type 2 diabetes mellitus: a pilot study. Acta Diabetologica, 51(3), 513–516.
Mickenautsch, S., & Yengopal, V. (2012). Effect of xylitol versus sorbitol: a quantitative systematic review of clinical trials. International Dental Journal, 62(4), 175–188.
Runnel, R., Makinen, K. K., Honkala, S., Olak, J., Makinen, P.-L., Nommela, R., … Saag, M. (2013). Effect of three-year consumption of erythritol, xylitol and sorbitol candies on various plaque and salivary caries-related variables. Journal of Dentistry, 41(12), 1236–1244.
Honkala, S., Runnel, R., Saag, M., Olak, J., Nommela, R., Russak, S., … Honkala, E. (2014). Effect of erythritol and xylitol on dental caries prevention in children. Caries Research, 48(5), 482–490.
Kawanabe, J., Hirasawa, M., Takeuchi, T., Oda, T., & Ikeda, T. (1992). Noncariogenicity of erythritol as a substrate. Caries Research, 26(5), 358–362.
Arrigoni, E., Brouns, F., & Amado, R. (2005). Human gut microbiota does not ferment erythritol. The British Journal of Nutrition, 94(5), 643–646.
Lifschitz, C. H. (2000). Carbohydrate absorption from fruit juices in infants. Pediatrics, 105(1), e4.
Rzechonek, D. A., Dobrowolski, A., Rymowicz, W., & Mirończuk, A. M. (2018). Recent advances in biological production of erythritol. Critical Reviews in Biotechnology, 38(4), 620–633.
Hashino, E., Kuboniwa, M., Alghamdi, S. A., Yamaguchi, M., Yamamoto, R., Cho, H., & Amano, A. (2013). Erythritol alters microstructure and metabolomic profiles of biofilm composed of Streptococcus gordonii and Porphyromonas gingivalis. Molecular Oral Microbiology, 28(6), 435–451.
Makinen, K. K., Saag, M., Isotupa, K. P., Olak, J., Nommela, R., Soderling, E., & Makinen, P.-L. (2005). Similarity of the effects of erythritol and xylitol on some risk factors of dental caries. Caries Research, 39(3), 207–215.
de Cock, P. (2018). Erythritol Functional Roles in Oral-Systemic Health. Advances in Dental Research, 29(1), 104–109.

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