Erythritol and other sweeteners – what is worth knowing about them?

Erythritol is a kind of sweetener and although it belongs to the group of polyols, such as xylitol or maltitol, this is an exception, because it is considered as a low-FODMAP product, i.e. with a low tendency to ferment. This alcoholic sugar is easily absorbed at the small intestine stage, which means that most people with IBS should tolerate it well. However, studies show that erythritol may exacerbate existing problems in the absorption of fructose, which may be an additional difficulty for people with this problem.

What is Erythritol?

Erythritol is a four-carbon sugar alcohol, absorbed in the small intestine quite effectively, in contrast to other alcoholic sugars already included in the high FODMAP group, such as sorbitol, maltitol, mannitol, xylitol. Studies show that only about 1/10 of the adopted erythritol dose goes further, up to the large intestine, and the bacteria at this stage of the digestive tract don’t cause rapid degradation of erythritol. Theoretically, erythritol shouldn’t intensify IBS symptoms, hence it is assumed that this product belongs to the FODMAP low group and can be used by people on the FODMAP dietary protocol.

However, the supplementation of erythritol can be a problem when fructose is intolerant. In the case of existing fructose intolerance, the presence of erythritol in the supply of fructose causes its absorption in the small intestine to decrease. The unbounded fructose enters the large intestine where it begins to violently undergo fermentation processes, causing symptoms identical with IBS. This means that erythritol itself, although included in the low FODMAP group, in combination with fructose, which is high in FODMAP, may enhance the effect of fermentation and thus digestive ailments.

Where we can find Erythritol?

Erythritol is naturally found in very small amounts (in the order of tenths of gram per serving) in certain fruits, fungi, and products resulting from yeast fermentation, such as wine or soy sauce. Thus, from natural sources one doesn’t need to fear its supply, which could negatively affect the absorption of fructose.

Erythritol is also obtained by fermentation of glucose from wheat or maize starch using non-pathogenic yeast. Such erythritol can be purchased on shop shelves in its pure form. In commercial products, it can be found in gums, jams, confectionery and zero-syrups (erythritol has an average of 0.24 kcal per 1g, hence low in calories).

Erythritol and blood sugar level

As humans don’t have enzymes that cause the breakdown of erythritol, this is mostly excreted in the urine, previously absorbed into the bloodstream. When healthy people were given a portion of erythritol, this didn’t affect the level of sugar, insulin, as well as lipid values, such as triglycerides or cholesterol. With this title, erythritol may be a good solution for people struggling with obesity, insulin resistance or diabetes.

Erythritol – summary

Erythritol is an excellent sugar substitute. It has no effect on the glycemic economy, its supply is not accompanied by an increase in the calorie content of the diet, hence it can be a great addition during the period of nutritional restriction in order to diversify food. However, it is worth noting its limitation in the case of fructose intolerance manifested by symptoms like IBS, such as flatulence, gas collection. In such cases, connections with products rich in fructose, such as apples or honey, should be avoided.

But is it worth using sweeteners, instead of common white sugar?

In recent years, there is an increase in both market availability and the widespread use of food products containing calorie-free or low-calorie sweeteners, which are an alternative to traditional white table sugar, guaranteeing equally sweet taste of meals and beverages consumed during the day, but without unnecessary exposure to additional energy consumption.

Consumption of sweeteners and health

Certainly, a large number of scientific publications in this matter indicates that there is a lack of conclusive evidence for both beneficial and harmful effects of calorie-free sweetener consumption on appetite, short-term food consumption, cancer risk, type 2 diabetes, chronic kidney disease, caries, weight gain and the risk of obesity, headaches, depression, cognitive functions, neurological and behavioral disorders, risk of premature labor, cardiovascular risk, therefore further well-designed studies are needed.

The published two years ago systematic work Review and meta-analysis, it was observed that the evidence from 7 randomized controlled trials involving more than 1000 people clearly didn’t confirm the expected benefits from the consumption of non-nutritive sweeteners for managing body weight, while data from 30 observational studies, lasting on average ten years and involving nearly 406,000 people have shown that routine use of artificial sweeteners may be associated with an increased BMI index and an increased cardiometabolic risk.

In another meta-analysis of 15 randomized controlled trials, the aim of which was to assess the effect of low-calorie sweeteners on the composition and body weight of participants, all parameters examined, including body weight (-0.80 kg), body mass index BMI (- 0.24 kg)/m2), fat mass (- 1.10 kg) and waist circumference (-0.83 cm) as a result of replacing sugar with less calorific or completely calorie-free sweeteners.

International scientific experts in the field of food, dietetics, endocrinology, physical activity, pediatrics, nursing, toxicology and public health who met in Lisbon in early July 2017 to reach a consensus on the use of low-calorie and completely calorie-free sweeteners as a substitute for sugar and other caloric sweeteners concluded that the use of artificial sweeteners instead of sugar may bring potential benefits, including, among others: weight reduction, moderate improvement in glycemic control in diabetic patients, reduced risk of tooth decay and improvement of oral health.

Artificial sweeteners in the diet of children and adolescents

In a systematic review of the impact of early exposure of pregnant women, infants and children up to 12 years of age on non-nutritive sweeteners and long-term metabolic health in the study published three years ago, the impact of consumption of sweeteners on metabolic health of children was uncertain and contradictory the data suggest their potentially unfavorable impact on the increase in BMI and increase in adipose tissue.

In turn, experts from the European Society of Gastroenterology, Hepatology and Child Nutrition (ESPGHAN) published a position at the end of 2017, underlining that replacing sugar with artificial sweeteners can reduce energy consumption in the short term, but their effectiveness and safety as a long-term strategy for weight management requires further evaluation, because there is no such research at the moment with children, therefore the researchers suggested that the best solution is to avoid children’s non-food sweeteners and focus on reducing total sweetener intake (caloric and non-caloric), which seems to be a better concept in the fight against overweight and obesity, than the use of artificial sweeteners.