Erythritol, one of the most popular "natural" zero-calorie sweeteners, has been a hot topic in the news these past two weeks.
It is a natural sugar alcohol, just like Xylitol, with nearly zero carbs and zero calories per gram.
Erythritol has no effect on glucose or insulin levels, making it a popular sugar substitute in Keto products and for people with diabetes.
Although past research has linked erythritol to several health benefits, sugar alcohols, like erythritol, are not completely absorbed by the body and are fermented by bacteria in our large intestines. This is why they can cause gastrointestinal problems like gas, bloating, cramping, and diarrhea and why I stopped eating it years ago.
I prefer other natural sweeteners that serve as sugar substitutes — such as pure monk fruit or raw honey that I recommend in my cookbooks.
The recent study that's making headline news and that's become a widespread debate on social media just came out and was published by Nature Medicine correlates erythritol in your blood to higher incidents of heart attacks and strokes.
That sure sounds scary, but a few points are critical when deciding if you will stop eating erythritol.
To understand this study further, I dove into analyzing the study and seeking out the opinions from several of my favorite Doctors whom I follow and trust. Here is a great discussion of the study's findings from Dr. David Perlmutter and Dr. Austin Perlmutter.
Here are some key points I want to make:
1. Correlation does NOT mean causation.
2. This study was based on "endogenous erythritol" and DID NOT measure "dietary erythritol ." Side Note: Our bodies manufacture endogenous erythritol. Erythritol is a sugar alcohol naturally found in fruits and vegetables. We can also make it in our bodies from glucose through the pentose phosphate pathway (PPP).
3. Researchers looked at 4,000 people from the United States and Europe and tracked them for several years. The key thing to recognize when interpreting this study is that the vast majority of people were already in poor health. The participants were mostly over the age of 60 and already had or were at high risk for cardiovascular diseases because of conditions like diabetes and hypertension.
In addition, the researchers did not control the group, which means it's unknown if they had higher erythritol levels due to poor baseline health instead of due to diet. Not to mention the size of the interventional group was only eight people.
Although the study found an association between erythritol and elevated cardiovascular risk, it did NOT prove that the compound caused strokes and heart attacks.
As I discussed in my course, there's been debates on "healthier" sugars and sugar alternatives for years, like erythritol, found in several sweetener brands, including Lily's Chocolates and Lakanto products.
So what's the final verdict on erythritol?
Based on my opinion of the study, hearing other Doctor's viewpoints, and the recent article published by the New York Times that did a great job presenting the facts and not sensationalizing the study, I feel the findings are too preliminary to completely wipe out this sweetener as an option for some people looking for an alternative to ultra-processed sugars like High Fructose Corn Syrup (HFCS) and artificial sweeteners like Sucralose.
I would however proceed cautiously, listen to your body, and always apply the WHO (World Health Organization) guidelines, not to exceed 25 grams of added sugars a day and to make those added sugars come from a "healthier" unrefined source like dates or honey, Monk Fruit or Stevia.
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