Erythritol: Benefits, Risks & How to Use This Sugar Substitute

Erythritol is a low-calorie sweetener from the sugar alcohol family, used in many foods and drinks as a sugar substitute. It tastes about 70% as sweet as sugar but provides nearly zero calories.

Most erythritol is absorbed in the small intestine and excreted unchanged in the urine, so it does not raise blood sugar or insulin levels. It also causes fewer digestive issues compared to other sugar alcohols.

Recent studies have linked high erythritol levels to a possible increase in heart-related risks, such as blood clots. Even so, health agencies like the EFSA and FDA continue to consider it safe in moderate amounts.

Possible benefits

Erythritol may offer several health-related benefits, particularly as a sugar substitute in specific diets and medical conditions.

1. Helps control blood sugar

Erythritol has a glycemic index of zero and does not raise blood glucose or insulin levels. This makes it a suitable sweetener for people with diabetes or insulin resistance.

2. Provides antioxidant effects

Animal and lab studies suggest erythritol may act as an antioxidant by reducing oxidative stress in diabetic rats. It may also help improve glucose tolerance and reduce inflammation in the intestines.

3. Supports dental health

Erythritol may protect against tooth decay by reducing plaque buildup and delaying the development of cavities. In a 3-year clinical study, it performed better than both xylitol and sorbitol in supporting oral health.

4. Suitable for cooking and baking

Erythritol is heat-stable and retains its sweetness when exposed to high temperatures. This makes it a practical sugar substitute in baked goods, sauces, and other cooked recipes.

5. Has good digestive tolerance

Unlike other sugar alcohols, erythritol is mostly absorbed in the small intestine and excreted in the urine without being fermented by gut bacteria. This greatly reduces the risk of gas, bloating, or diarrhea, especially when consumed in moderate amounts.

How to consume

Erythritol is available in granulated and powdered forms and can be used to sweeten drinks, baked goods, sauces, and desserts. It is often combined with other natural sweeteners like stevia or monk fruit to improve taste and texture.

Diets it can be included in:

• Ketogenic diets: Erythritol contains almost no digestible carbohydrates and has a glycemic index close to zero, making it compatible with low-carb and ketogenic diets.
• Low-FODMAP diets: Erythritol is absorbed in the small intestine and is not fermented in the colon, making it less likely to trigger symptoms in people with irritable bowel syndrome (IBS), although temporary restriction may be recommended during elimination phases.
• Diabetic diets: Because it does not affect blood sugar or insulin levels, erythritol is considered safe for people with diabetes.

These features make erythritol a versatile option for a variety of health-focused and therapeutic diets.

Is erythritol bad for you?

While erythritol has long been considered safe, recent studies have raised concerns about its impact on cardiovascular health. Research published in 2023 and 2024 found that people with higher blood levels of erythritol had a greater risk of major adverse cardiovascular events, such as heart attacks and strokes.

Laboratory and human studies suggest that erythritol may increase platelet activity, which can promote blood clot formation. One small trial found that drinking 30 grams of erythritol led to elevated platelet aggregation for over 48 hours.

Some experts believe that high circulating levels of erythritol may be more of a marker of metabolic dysfunction than a direct cause of cardiovascular problems. However, due to these findings, people with a history of heart disease or blood clots may be advised to limit high intake until more research is available.

Side effects and contraindications

When consumed in moderate amounts, erythritol is generally well tolerated. Most of it is absorbed before reaching the large intestine, which limits the gastrointestinal discomfort commonly caused by other sugar alcohols like sorbitol and mannitol.

However, consuming large amounts may cause nausea, bloating, or diarrhea, especially in sensitive individuals. Regulatory agencies like EFSA have set an acceptable daily intake (ADI) of 0.5 grams per kilogram of body weight to minimize the risk of laxative effects.

People with IBS or digestive sensitivities are usually advised to introduce erythritol gradually and monitor for symptoms. While it is less fermentable than other polyols, responses can vary from person to person.

Erythritol vs. other sweeteners

The table below compares erythritol with other commonly used sweeteners based on key health and nutritional factors.

While each sweetener has its own advantages and drawbacks, erythritol stands out for its low calorie content, minimal blood sugar impact, and good digestive tolerance.