What Is Erythritol and Is it Safe to Eat?

What Is Erythritol? 

Erythritol is a non-nutritive, zero calorie sugar substitute that’s derived from the fermentation of glucose. Chemically speaking, it’s a sugar alcohol (a polyol), and it has zero impact on blood sugar due to its inability to be metabolized. Other common polyols include mannitol, sorbitol, and xylitol, which are less well-tolerated and do contain a small amount of digestible sugars, thus a small amount of calories.

The use of erythritol has become more widespread with increased popularity of the ketogenic diet (a diet characterized by consuming no more than 20-50 net carbs per day) and other versions of low carbohydrate diets. Erythritol allows the freedom to eat healthier versions of foods that we typically enjoy on a standard American diet, while staying within the bounds of the low-carb doctrine.

Erythritol and Digestion

The majority of consumed erythritol (80-90%) is quickly absorbed in the small intestines, but it’s not actually metabolized; it’s simply excreted in urine. Tetzloff et al. 1996 investigated whether consuming erythritol would impact other urinary metabolites such as creatinine, citrate, urea, and electrolytes, but they found no change in excretions.¹ Calcium excretion was only slightly higher, but not beyond a point that is considered outside a normal range. 

A small percentage (about 10-20%) of consumed erythritol reaches the colon where it simply passes through the remaining digestive tract. The colon houses the majority of the microbiota that are responsible for digesting foods through a process of fermentation. Most foods are partially digested in the small intestines and are then further digested by microbes in the large intestines, but erythritol behaves differently. Not only is it resistant to human digestion, but it’s also resistant to fermentation meaning that it has no impact on the bacteria that reside in the gut. This is not necessarily the case for xylitol that has been shown to impact the microbiota of mice. 

Tolerability

In general, erythritol is well-tolerated and even more so than other polyols such as xylitol. This is likely due to its structure and having a much lower molecular weight compared to other sugar alcohols. Studies have shown that erythritol can be easily tolerated in doses as high as 1g/kg of body weight (that’s approximately 80g of erythritol for a 150lb human). Xylitol, on the other hand, has been shown to be tolerated at doses as high as 200 g per day for extended periods (1 -2 years), which leads me to believe that erythritol could be tolerated at much higher doses as well.

There are instances in which erythritol can cause diarrhea and nausea in some individuals. These effects are more common with xylitol and other polyols that draw water into the stool, resulting is osmotic diarrhea, but it happens occasionally with erythritol as well. Erythritol (and all sugar alcohols) should be avoided by people who are sensitive to FODMAPs – Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols. All polyols will cause digestive distress ranging from mild to severe in these individuals. 

Possible Benefits of Erythritol 

Chris Kresser, one of the leading figures in alternative healthcare, points out that not only is erythritol well-tolerated, but that it may actually have some benefits. His argument lumps all sugar alcohols together, but he states that they could be especially beneficial for diabetics or those interested in losing weight. Xylitol, specifically, has been show to not only prevent tooth decay, but actually has properties shown to support dental health and even improve cavities. Furthemore, Kresser states that

In addition to the potential metabolic, dental, and prebiotic benefits already discussed, xylitol shows promise for preventing age-related decline in bone and skin health. One interesting study found that 10% xylitol supplementation over 20 months increased collagen synthesis in the skin of aged rates, resulting in thicker skin. Preliminary rat studies have also shown that xylitol can increase bone volume and mineral content and protect against bone loss.”²

A 2018 study published in Scientific Reports showed that when combined with zinc, erythritol was capable of destroying bacterial biofilms.³ With ever increasing antibiotic resistance, treatments like zinc-erythritol that can degrade and penetrate the resistant “shells” (biofilms) of bacteria colonies will be hugely beneficial in treating antibiotic resistant infections. 

A Word of Caution

Many brands of erythritol are created through the fermentation of genetically modified (GM) cornstarch. There is a complete lack of scientific evidence supporting the safety of GM foods, and I therefore avoid these at all costs. The Institute for Responsible Technology is one of the best resources to access information regarding GMOs, and their unanimous message is that GM foods should not be allowed into the food chain. Be sure to buy a certified non-GMO brand of erythritol to avoid purchasing a potentially harmful food.

As part of my research into erythritol, I wanted to know the opinions off some of the leading public figures in alternative health such as Chris Kresser, Dr. Axe, and Wellness Mama. They all seem to agree that there’s little apparent risk involved in consuming erythritol (although Dr. Axe doesn’t seem to be a big fan), but Wellness Mama brings up an interesting point, which is that even though you’re consuming a naturally occurring compound, you’re consuming it in quantities much greater than would be found in nature. Her thoughts around eating erythritol certainly gave me pause. Furthermore, I believe that whole foods have a benefit beyond their individual components (for example, isolating vitamin C as the beneficial component in goji berries) and that it’s more likely that there are energetic and synergistic benefits of eating whole foods that are lost when parts of those foods are isolated and eaten alone. When we isolate erythritol and use it in such high quantities, we may be losing the benefits of eating that food in a more natural state. AND, I’m not sure that we can say with 100% certainty that eating such a large quantity is safe. 

Lastly, mammals are extremely motivated by the taste of sweetness. Studies show that cocaine-addicted mice choose sugar or artificial sweeteners over cocaine when given the choice. Some scientists hypothesized that this intense drive for sweetness was a mechanism to obtain calories, but this isn’t likely given that the mice also preferred the calorie-free artificial sweeteners. They chose sweetness regardless of whether the food contained calories. It’s more probable that our brains experience a heightened sense of reward when our palates detect sweetness. Whether eating erythritol and these other polyols will also cause cravings for sweets is hard to say, but I think it’s worth using some caution.

Moderation is Always Key

In summary, erythritol proves to be a safe and generally well-tolerated sugar substitute that may even have the added benefit of preventing cavities and improving collagen synthesis. I believe it to be an acceptable sugar replacement for those who can tolerate it. However, moderation is always key. We are a sweet-obsessed society and these latest trends in dietary approaches often result in people replacing one unhealthy food for another. I’ll be experimenting with erythritol this holiday season so that I’m able to prepare a handful of sweet desserts with the kids, but I will continue to focus on preparing and eating the most nutrient dense foods in existence – whole foods from healthy sources. The more sweet treats you eat, the less room you have for these better foods. Sweets, even healthier versions, equate to wasted calories that could be used on more nutritiously dense options.  So, have your cake, eat it, but then get back to nourishing your family with optimal nutrition. 

References

1. Tetzloff, W., F. Dauchy, S. Medimagh, D. Carr, and A. Bar. 1996. “Tolerance to sub-chronic, high-dose ingestion of erythritol in human volunteers”. Regulatory Toxicology and Pharmacology 24(2 pt. 2): S286-95.
2. Chris Kresser. “Are Xylitol, Sorbitol, and Other Sugar Alcohols Safe Replacements For Sugar?”. June 13, 2014. Accessed on November 27, 2018 from < https://chriskresser.com/are-xylitol-sorbitol-and-other-sugar-alcohols-safe-replacements-for-sugar>.
3. Lim, J.H., Y. Jeong, S.H. Song, J.H. Ahn, J.R. Lee, and S.M. Lee. 2018. “Penetration of an antimicrobial zinc-sugar alcohol complex into Streptococcus mutans biofilms”. Scientific Reports 1(8): 16154.

Bibliography

1. Arrigoni, E., F. Brouns, and R. Amado. 2005. “Human gut microbiota does not ferment erythritol”. British Journal of Nutrition 94(5).
2. Makinen. 2016. “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: 5967907
3. Storey, D., A. Lee, F. Bornet, and F. Brouns. 2007. “Gastrointestinal tolerance of erythritol and xylitol ingested in a liquid”. European Journal of Clinical Nutrition 61(3): 349-54.
4. Tamura, M., C. Hoshi, and S. Hori. 2013. “Xylitol affects the intestinal microbiota and metabolism of daidzein in adult male mice.” International Journal of Molecular Sciences 10(14): 23993-4007.