Erythritol, Stevia: The New Natural Sweeteners

Dr. Christopher McGowan
September 4, 2020

Let’s say you are standing in the soda aisle at your local grocery store. Everywhere you look, there are “sugar-free” options for nearly every one of your favorite drinks. Some of them even claim to have zero calories from sweeteners. If you are counting calories, but still crave a carbonated beverage, this may seem like a wish granted. If you are a skeptical sort of person, though, promises of sugar substitutes may seem too good to be true. Is the low-calorie promise some tricky labeling, or is there some culinary wizardry going on to trick your taste buds while helping you trim your waistline?

It turns out there are many different ways to satisfy your sweet tooth without adding the calories found in regular sugar. This is possible thanks to the introduction of a variety of alternative sweeteners into the market over the last several decades. You may find that your favorite treats can be made free of extra calories, but as they say, there is no free lunch. Even the promises of low or zero-calorie sweeteners should be taken with a grain of salt.

What are the Different Types of Artificial Sweeteners?

If all you are looking for is a sweet taste, there are a wide range of foods and additives you can turn to besides table sugar. This includes, among others:

  • maple syrup
  • allulose
  • agave syrup
  • monk fruit sweetener

For decades, Americans have been leading the global hunt to find ways to get the sweet flavor we love in everything from baked goods to chewing gum without using table sugar. One of the first of these was saccharin. Discovered in the late 1800s, this sweetener was effective but left a bitter aftertaste that left people looking for better alternatives. 

The search for better sugar substitutes has led to the development of many different artificial sweeteners whose names you probably already know. Aspartame, sucralose, and others have been around for decades. In recent years, newer natural sweeteners have been developed and are slowly being added to the mix as well. This latter category contains two interesting options, erythritol, and stevia, each with their own potential downsides and benefits. 

Erythritol (marketed as Truvia) is a somewhat unique member of a family of compounds known as polyols or sugar alcohols. These naturally occurring chemical compounds are found in many different fruits such as watermelon, pears, and grapes. Though we have been consuming erythritol for millennia, modern food production methods have made it possible to process this polyol into a form that resembles table sugar. 

Stevia is a different beast altogether. For one thing, unlike products like NutraSweet and Splenda, this sugar alternative is exactly what it says on the packaging rather than a brand name for a chemical sugar substitute. Processed from an extract of the stevia rebaudiana plant, stevia has been used by people in eastern South America for centuries.

A Closer Look at Stevia

Stevia rebaudiana is a plant native to South America that has been used by indigenous communities in Paraguay and Brazil for more than 500 years. Most native South Americans who ate stevia simply chewed the leaves to get the sweet taste from the plant. Today, stevia leaves are picked, dried, and steeped in hot water to produce an extract, which is then put through a filtration process and centrifuged to create a concentrated, pure stevia extract. This production process is usually free of other chemicals, which puts stevia in a category of other plant-based sweeteners like monk fruit where the final product is nearly 100% natural plant extract.

Stevia extract has gained attention beyond its South American roots because of some remarkable properties. Raw liquid stevia can be more than 300 times sweeter than table sugar, though it is usually processed into a granulated form that resembles table sugar. Stevia’s claim to fame is that it is not broken down by the body during digestion. As a result, stevia is considered a zero-calorie sweetener, which makes it a good candidate for people interested in weight loss but who still want to have a little something sweet from time to time without worrying as much about the calorie count. 

Stevia’s zero-calorie bragging rights have made it popular for people in the low-carb set. Individuals on ketogenic diets are trying to avoid all excess carbs, so sugar replacements without carbs are very important if you are going to keep to your keto diet. 

Low-carb diets aren’t the only places where stevia can provide health benefits. Stevia products have a very low glycemic index, which is a measure of how much a substance affects your blood sugar levels when you ingest it. This means that for many people, such as those suffering from type 2 diabetes, who need to pay particular attention to their blood sugar, stevia can be very helpful in helping to regulate blood glucose levels. 

A Closer Look at Erythritol

Among low-carb sweeteners, erythritol is a polyol that has emerged as a promising option for people looking to avoid a lot of the strange aftertastes of artificial sweeteners or the potential digestive problems common with some natural sweeteners. Though not sugars in the strictest sense, polyols are referred to as sugar alcohols. Erythritol is a member of the polyol family of chemicals that contains several other related compounds such as:

  • maltitol
  • mannitol
  • xylitol
  • sorbitol 

Like monk fruit extract or stevia, erythritol has been in human diets for a long, long time, though it is hiding a little further under the radar. Rather than being consumed as a sweetener in its own right like stevia leaves, erythritol is part of the sweet taste of many different kinds of fruit.

Sugar alcohols may be naturally occurring, but to get them to your table they are produced in industrial facilities. This process involves fermenting down fructose found in corn or other plant materials such as birch. The eventual product of this fermentation is combined with small amounts of other compounds to create products you can buy in the grocery store or on Amazon. 

Erythritol is found most often in a product called Truvia. This product has been designed to have a texture you expect from table sugar but does not have the same amount of sweetness as a similar amount of sugar. Other products such as Swerve are made primarily of erythritol but also contain plant fibers called oligosaccharides. These are often included to help mimic the amount of sweetness in sugar more closely.

Problems with Sugar Alcohols

Substituting artificial sweeteners for sugar may seem like a straightforward win when it comes to counting calories, but this is not the whole story. Food and drink producers, and even calorie-conscious home chefs, cannot use these sugar substitutes if they leave a bitter aftertaste or don’t behave like regular sugar in some recipes. 

One example of these differences is that erythritol does not caramelize like regular sugar. So, for those folks looking to top a sugar-free version of a creme brûlée, that delectable crust may not turn out quite like you hoped if you swapped the decadent sugar for an alternative sweetener. For other recipes where texture is important, confectioner’s versions of erythritol are available to help mimic the texture you could get with table sugar. 

The problems with sugar alcohol run deeper than just getting the texture of a dish right. Despite being chemically similar to one another, sugar alcohols differ in how they are digested. Some, like sorbitol and xylitol, make it through your small intestine and can be fermented in your large intestine. This fermentation produces gas that can lead to bloating and abdominal discomfort. 

Some sugar alcohols have also been linked to an unpleasant health condition known as osmotic diarrhea. This effect occurs when your intestines draw water out of other tissues to help digest certain foods. This can happen with some artificial sweeteners and even some natural sweeteners. This extra water in your digestive tract not only contributes to potentially dangerous dehydration but also can cause a laxative effect that may leave you running for the restroom more often than you would like. 

Erythritol is somewhat unique among sugar alcohols in that it avoids some of the more obnoxious side effects mentioned above. Since it is almost completely digested in the small intestine, there is no chance for fermentation further down in the large intestine. Additionally, it does not produce the osmotic effect common to other polyols.

How Safe are Keto Sweeteners?

The Food and Drug Administration (FDA) has determined that all the sweeteners mentioned in this article are generally regarded as safe for human consumption. This means there are no known adverse health effects from consuming a normal amount of these products. 

This does not mean, however, that there are no potential downsides. Erythritol, for example, has only received FDA approval in the last couple of decades. While this may seem like a long time to be on the market, in the world of scientific studies, this is a relatively short time to be studying the effects of long-term consumption of a particular additive. 

As recently as 2017, a study on the effects of erythritol levels in the blood and overall body weight showed a correlation between elevated levels of blood erythritol and weight gain in young adults. More study is needed to understand the exact connection here, but it could suggest trying to supercharge your weight loss goals by swapping out sugar for erythritol may not work out.

Weight Loss and Artificial Sweeteners

When you are looking to drop pounds, the little details matter. Small decisions can add up to big gains over time. There are some situations where a big decision is needed to see progress. For some people, the definitive step of weight loss procedures or a bariatric revision can seem like the best option. 

Everyone should be conscious of their intake of sugars or artificial sweeteners, but it becomes very important to watch what you eat if you have been through a weight loss procedure. In many cases, the alterations to the available size of your stomach will prevent you from eating as many calories as you would have previously. This means you need to make every calorie count. 

It also means you need to be careful of certain sweeteners. Some artificial sweeteners can cause osmotic diarrhea by drawing water into the intestine to aid in digestion. This is particularly a problem with some polyol-based sweeteners. This diarrhea can cause potentially dangerous dehydration that can be hard to fight if you can only drink a limited amount of water at a time to replenish the liquid you are losing into your stool. If you are trying to hydrate by drinking soda or other sweetened beverages that contain yet more artificial sweeteners, you may be only furthering the problem. 

At True You Weight Loss we can help you understand the risks and potential advantages of replacing sugar in your diet. As the nation’s first and only physician-founded practice exclusively focused on non-surgical, state-of-the-art weight loss procedures, we are the perfect resource to help you understand the benefits and challenges of weight loss procedures, as well as help you live well with the restrictions a past gastric bypass may have placed on your diet. 

If you are considering a weight loss procedure, or want help living with the effects of a past weight loss surgery, request a consultation today. We are here to help you find the freedom to fully experience life again.

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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