Erythritol is a sugar alcohol and one of the most commonly used artificial sweeteners with good reason. It has a low calorie content and minimal effect on blood glucose (sugar) levels for most people.
However, the potential effects of erythritol on the risk of cardiovascular events remain a topic of debate. A recent study on erythritol found it could increase the risk, with researchers discovering that individuals with increased blood erythritol levels tended to have a higher risk of cardiovascular events, although the intervention study did however only involve eight healthy people. But should we be a little more cautious when using erythritol?
Cardiovascular diseases are a significant global health concern, with risk factors, such as obesity, diabetes, and metabolic syndrome contributing to their development. The use of low-calorie sweeteners instead of sugar can be very beneficial, especially for individuals with diabetes and those seeking to reduce caloric intake. While we know high doses of erythritol can cause symptoms, such as bloating, gas, and diarrhea, are there any potentially more dangerous impacts on cardiovascular health that we need to look at?
Erythritol, a sugar alcohol also known as a polyol, is derived from fruits and fermented foods. It is approximately 70 percent as sweet as table sugar (sucrose), with a low caloric value of 0.24 kcal/g. Erythritol is primarily absorbed in the small intestine and excreted unchanged in the urine, and is unique among sugar alcohols because it is not metabolized by the body and therefore does not raise blood sugar or insulin levels.
This makes it an attractive sweetener for individuals with diabetes or those looking to reduce their sugar intake. Erythritol occurs naturally in a variety of foods, including fruits, vegetables, and fermented products. Some examples of erythritol-containing foods are grapes, pears, watermelon, and mushrooms. It can also be found in fermented foods like cheese, wine, and soy sauce. In these cases, it is a byproduct of the fermentation process carried out by certain types of yeast and bacteria.
Although erythritol is present in these foods, the concentrations are relatively low. Therefore, to produce erythritol in larger quantities for commercial use, manufacturers rely on industrial processes. The most common method involves fermenting glucose from corn or wheat starch using a specific yeast called Moniliella pollinis. Once the fermentation is complete, the resulting solution is purified and crystallized to create the final erythritol product. This process allows manufacturers to produce erythritol that is virtually identical to the naturally occurring form found in foods — but they are producing it artificially.
Personally, I always prefer natural sweeteners like honey, coconut sugar, and dried fruits. However, if a sweetener helps you lower your calorie intake and avoid consuming high-sugar, high-calorie baked goods or drinks, then I do think you need to consider the trade-offs. For example, if you are overweight or have diabetes, it might be better to use such sweeteners as a tool to lower your daily calorie consumption. However, you still need to be conscious of how much you consume each day, and I think more studies are needed to confirm whether erythritol really can increase the risk of cardiovascular events.
Of course, like with so many things, everyone has a different bodily structure, so make sure to be aware of how you feel after consumption. Your body will often tell you if something you consume is not good for it. Remember to always check the ingredients list, as many products that contain erythritol do not only contain erythritol, and there may be other ingredients that you need to keep an eye on.
References:
• National Library of Medicine. “Erythritol: An In-Depth Discussion of Its Potential to Be a Beneficial Dietary Component”. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9824470/
• Food Insight. “What is Erythritol?”. https://foodinsight.org/what-is-erythritol/
• Nature. “Non-nutritional sweeteners and cardiovascular risk”. https://www.nature.com/articles/s41591-023-02245-3
• Nature. “Artificial sweetener linked to higher CVD risk”. https://www.nature.com/articles/s41569-023-00855-5
• Nature. “The artificial sweetener erythritol and cardiovascular event risk”. https://www.nature.com/articles/s41591-023-02223-9
• PubMed. “Health potential of polyols as sugar replacers, with emphasis on low glycaemic properties”. https://pubmed.ncbi.nlm.nih.gov/19087388/
• PubMed. “Gut hormone secretion, gastric emptying, and glycemic responses to erythritol and xylitol in lean and obese subjects”. https://pubmed.ncbi.nlm.nih.gov/27117004/
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Ayda Ersoy is a nutritionist (Dip.C.N., Dip.S.N.); master trainer (CPT ACE, NCSF, CanfitPro); registered yoga teacher; founder, Health Angel Nutrition, Fitness and Wellness; and founder, SMS (Stability, Mobility Strength) Intuitive Training System.
