Healthy Sweetness: What is Erythritol? HEALTH & TASTE FACTS

Erythritol is a four-carbon molecule that is naturally present in various foods (vegetables, fruits, fermented foods) and is even produced naturally in the human body as part of the anti-inflammatory pentose phosphate pathway. Some of its natural sources include pears, watermelon, peaches, melons, mushrooms, wine, tamari, and even cheeses. Commercially, it is made through natural fermentation of glucose.

WHY is Erythritol DIFFERENT from other Sugar Alcohols?

Unlike other sugar alcohols, erythritol has a uniquely tiny molecular size, so it does not cause bloating/laxative effects in normal food/drink quantities. Multiple human trials demonstrate that (c. 90%) erythritol is absorbed in the small intestine and excreted unchanged via urine (i, ii). The absorbed erythritol is not metabolized and simply washes through and out. The smaller proportion that is not absorbed in the small intestine may be fermented in the larger intestine, as many non-caloric fibers are. To put it simply, it has no significant metabolic effect (and is non-caloric, not used for energy), as most of it is excreted unchanged and the small amount that reaches the large intestine is consumed by commensal bacteria as any food fiber (ii). While other sugar alcohols (e.g., maltitol, xylitol, sorbitol) in quantities found in food/beverage products cause diarrhea and bloating, because of its low molecular weight, this is NOT the case for erythritol.

Erythritol Increases Satiety

Erythritol improves satiety by suppressing ghrelin (hunger hormone) (iii) and increasing satiety-inducing GLP-1 and CCK (i). One of the key concerns of a high-sugar diet is that it leads to higher calorie intake due to feeling hungrier and less satiated. Foods that help to improve satiety are highly effective in improving weight loss and maintenance.

Erythritol is Anti-Inflammatory

Our body produces erythritol endogenously as part of the anti-inflammatory Pentose Phosphate Pathway. Its anti-inflammatory effects and mechanisms of action have been investigated (iv). Researchers studied mice that were on high-fat diets and had metabolic disorders. Those mice who were given water with 5% erythritol for 20 weeks had a) significantly lower body weight, b) higher energy expenditure, and c) improved glucose tolerance.

They also had less liver fat, smaller adipocytes, and significantly better inflammatory measures in the small intestine and higher beneficial short-chain fatty acids. Behind this, they observed erythritol lower blood lipids and lower hepatic enzymes vs. the control group: triglycerides (p=0.035), LDL cholesterol (p=0.006), nonesterified fatty acid (p=0.007), aspartate transaminase (p =0.20), alanine aminotransferase (p=0.012). Given how liver fat accumulation and fibrosis result from high fructose diets as well, it is interesting that this ingredient from the healthy sweetness toolkit ameliorates this. 

Liver Fibrosis score | Oil Red O staining (shows liver fat accumulation) | Adipocyte cell size

Kawano, R. et al. (2021)

Lower M1 pro-inflammatory macrophages and higher M2 anti-inflammatory macrophages were found in the erythritol group in both the epididymal white adipose tissue and the small intestine (p<0.0001 for all, excl. M1 in small intestine p<0.030). They also observed lower gene expression of inflammatory cytokines such as IL-5, IL-6, IL-13, and TNF-alpha.

Erythritol Benefits Oral and Dental health

Consuming erythritol-sweetened candies vs. xylitol and sorbitol ones, significantly reduces pathogenic plaque mutans streptococci while maintaining commensal Lactobacillus levels (iii).

What about TASTE? Using Erythritol alone to sweeten creates a cooling sensation, but a small amount, in a good recipe avoids this

To create a well-rounded, delicious, sweet taste, erythritol can be a great non-caloric ingredient of your sweetness, when used moderately. Through our lab-research, we see how specific ingredients work synergistically to create a healthy, natural taste response. With its zero calories, no osmotic pressure, anti-inflammatory health effects, erythritol is an excellent component in a healthy sweet mix. When used alone to sweeten, your sweet food/drink will not taste great.

HEALTHY CONCLUSION: WHEN YOU THINK B CAUSES A, BUT IN REALITY, MOST LIKELY A CAUSES   B

Based on comprehensively evaluating published research on sweet ingredients, erythritol is health-supporting. Two studies implied that it is not. Here you can read a scientific evaluation of the one that created unwarranted headlines. 

In Brief: The Witkowski et al. paper took data from a historical blood bank of people with cardiometabolic disease and measured erythritol levels from this bank, noticing the ones with higher blood pressure and cardiometabolic disease had higher levels. To find out when the data was from, one had to request access to data that was not in the paper itself. The samples were from a time when erythritol was not available in food/drink products. Thus, what they measured was produced in the body endogenously. As explained above, erythritol is produced naturally as part of the anti-inflammatory pentose phosphate pathway, potentially in this case to try to ameliorate the inflammatory diseased state. This study was a classic example of reverse causation, which the authors acknowledged one year later, after the misinformation had already spread, misinformation that pushed people back again to sugar, which is the major driver of cardiometabolic dysfunction. As an analogy: this paper said firemen cause fires because we see firemen near fires.

References

(i) Wölnerhanssen, B. et al. (2016), ‘Gut hormone secretion, gastric emptying, and glycemic responses to erythritol and xylitol in lean and obese subjects’, Am J Physiol Endocrinol Metab 310: E1053–E1061

(ii) Munro, I.C. et al. (1998), ‘Erythritol: an interpretive summary of biochemical, metabolic, toxicological and clinical data’, Food and Chemical Toxicology, 36(12), pp. 1139-1174

(iii) Sorrentino, ZA et al (2020), ‘An Erythritol-Sweetened Beverage Induces Satiety and Suppresses Ghrelin Compared to Aspartame in Healthy Non-Obese Subjects: A Pilot Study. Cureus. 2020 Nov 10;12(11) 

(iv) Kawano, R. et al. (2021), ‘Erythritol Ameliorates Small Intestinal Inflammation Induced by High-Fat Diets and Improves Glucose Tolerance’, International Journal of Molecular Sciences, 22(11), 5558.

(v) Runnel, R. et al. (2013), ‘Effect of three-year consumption of erythritol, xylitol and sorbitol candies on various plaque and salivary caries-related variables’, Journal of Dentistry, 41, pp. 1236-1244.