Erythritol: Healthy or Harmful for Weight Loss?

Dr. Christopher McGowan
August 28, 2020

For the last few decades, it seems like our hopes for, and the reality of, American waistlines have been heading in opposite directions. As society puts on the pressure to get thinner and thinner, the problem of obesity in America has turned into an epidemic. People have been looking for answers to why so many Americans are struggling with weight gain, and it seems everyone is ready to point the finger in a different direction. 

One surprising candidate that has come under scrutiny for contributing to this growing problem is the artificial sweeteners in the food we eat. Though cutting sugar and replacing it with lower-calorie sweeteners would seem to help if you are trying to cut calories and lose weight, there is debate about the health benefits of sugar substitutes. Some research has even suggested these low-calorie or zero-calorie alternative sweeteners may have the unintended side effect of causing an increase in body weight. 

One of the most recent sugar substitutes to come out on the wrong side of a medical study about weight loss is erythritol. This naturally occurring sugar alcohol has only recently been approved by the Food and Drug Administration (FDA). Though erythritol has proved to be a promising and welcome alternative to some other sweeteners, there is now some evidence that large amounts of erythritol in your blood may correlate to weight gain.

What Are Artificial Sweeteners?

Simply put, artificial sweeteners are additives in food and beverages that provide the sweet taste we crave without the caloric load of regular sugar. Many artificial sweeteners like saccharin, aspartame (NutraSweet), sucralose (Splenda), and others have been with us for several decades now, but they are not without their drawbacks. Some, like saccharin, left a strange aftertaste. Others were found to have a range of negative side effects on the regulation of insulin levels, and some sweeteners have even been identified as potential causes of cancer by some researchers. 

Over time, people have come to question whether these sugar substitutes were really any healthier for us than just eating sugar. In response, people began to look for natural sweeteners that could still give the same sweet taste of table sugar without some of the undesirable side effects. 

The search for new sweeteners led to the development of sugar alternatives like stevia, a plant extract, and to work on a class of chemicals called polyols or sugar alcohols. Sugar alcohols, despite being neither sugar nor alcohol in the strictest sense, are a group of naturally occurring compounds called polyols found in food like pears, watermelons, and grapes. These natural sweeteners can also be produced through industrial processes from the fructose in plants such as corn. There are several kinds of sugar alcohol that have been approved for use by the FDA including:

  • xylitol
  • sorbitol
  • mannitol
  • maltitol
  • erythritol

These polyols have proven to be a mixed bag when it comes to how healthy they are in relation to regular sugar or other artificial sweeteners. There are some side effects to consuming polyol-based sweeteners. Though they are not all the same, bloating, abdominal pain, diarrhea, and even dehydration have all been documented in people who consume these sugar substitutes.

Do Sugar Alcohols Have Side Effects?

It is true that foods made with sugar alcohols are lower in calories than comparable foods made with table sugar. Sugar alcohols are ingestible carbs, though, and carbs have taken a beating in nutrition and dietary circles for the last several years.

Erythritol is generally regarded as safe for nearly everyone, partly because it is not readily metabolized into glucose by your body. Part of this comes down to how erythritol is absorbed into your body. Around 90% of the erythritol you eat is absorbed by your small intestine, passes through your blood chemically intact, and is removed from your body in your urine. Most sugar alcohols like sorbitol and mannitol pass further down the digestive tract and are fermented in the gut. When other sweeteners are fermented, they produce potentially embarrassing or uncomfortable amounts of gas, bloating, and abdominal discomfort.

More worryingly, some polyol sweeteners produce a condition known as osmotic diarrhea if taken in sufficient quantities. As your body tries to digest these sweeteners, water is drawn into your intestine to aid in the digestion. This causes the twin problems of taking moisture from surrounding tissue where you need it and putting it in your colon where you don’t. If enough water enters your colon, you can experience a laxative effect resulting in the loosening of your stool as well as dehydration due to the water loss from surrounding tissues.

Health Benefits of Erythritol

Among the sugar alcohols, erythritol is something of an anomaly. Erythritol does not draw water into the colon as it is digested, which eliminates one of the major digestive concerns about other sugar alcohols. Studies have shown it would take more than 50 grams of erythritol a day to make your gut a little grumbly, and that is more than four times the recommended daily dose of erythritol.

What is more, because it has a low glycemic index and is not easily converted into glucose by the body, erythritol helps to regulate insulin levels. If you have been diagnosed with type 2 diabetes, keeping a constant watch on your blood sugar levels means you need to consider what you eat more carefully than you might otherwise. A wide range of health issues are linked to hyperglycemia (high blood sugar) including headliners like cancer, heart disease, obesity, and even Alzheimer’s. Some research has suggested there could be further health benefits for people with diabetes. By avoiding the blood sugar spikes sugar can cause in people with type 2 diabetes, erythritol helps protect your blood vessels from the damaging effects of hyperglycemia. 

Another area where erythritol seems to clearly come out on top is oral health. It is no secret that regular sugar is bad for your teeth. The sucrose in sugar reacts with bacteria in your mouth to form an acidic solution that wears away tooth enamel. The chemical structure of erythritol does not interact with the bacteria in your mouth in the same way as sugar does, and studies have proven switching to erythritol versus sugar or even sorbitol leads to less tooth decay. 

It should be noted that erythritol is not a free pass from the dentist. You are still better off eating a low-sugar diet if you are concerned about dental health. However, there is some comfort in knowing you can use erythritol-based products like Truvia if you are particularly anxious about sweeteners affecting your teeth.

Finally, erythritol has one more benefit hiding up its sleeve. Though it is technically a carb like other sugar alcohols, it is not processed in the same way as other polyols. This means that for people who are looking to eliminate carbs from their diets, erythritol can be a real game-changer. If you are maintaining a strict low-carb regimen such as a ketogenic (or keto) diet, you should avoid sugar alcohols as they prevent you from entering ketosis. Erythritol, on the other hand, is not metabolized in the same way, meaning it isn’t working against you.

Dangers of Erythritol

So, erythritol has nearly zero calories, won’t give you the runs, helps you manage your blood sugar levels, and doesn’t prevent you from entering ketosis if you are trying to go fully low-carb. This might make erythritol sound like a dietary silver bullet. 

If erythritol sounds like a perfect alternative for those looking to live a sugar-free life and still enjoy some sweets, that is because you have only heard half the story. Studies have been published in the last few years that have shown there are potential negative effects of erythritol, including possible weight gain. 

A 2017 study specifically linked higher amounts of blood erythritol in young adults with weight gain when measured over several months. Understanding the exact mechanism of how erythritol might be contributing to weight gain still requires more research, but this study shows us that simply swapping out the sugar for another compound may not be a dietary-free pass. 

In the end, keeping to a low-sugar diet will always be a better plan for weight loss than simply switching to regular sugar to sweeten what you eat and drink. If you are looking to lose weight, the healthiest way will be through modifying your diet and lifestyle to bring about the results you want over time.  

At True You Weight Loss, we know how challenging it can be to understand how to lose weight and find a place where you can feel comfortable in your own body. It is easy to get lost in the dizzying array of promises and warnings about diets, exercise programs, and even weight loss surgeries and procedures. That is why we are committed to helping you find a solution that works and allows you to find freedom from worrying about your weight so you can get back to living your life. Request a consultation if you want to learn more about the services and expertise we offer. 

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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