What is Plant-Based Erythritol?
Erythritol is a sugar alcohol found naturally in small amounts in some fruits and fermented foods. While its source can be plant-based glucose, the commercially used erythritol in many products is produced through large-scale fermentation, resulting in much higher concentrations than found in nature.
Traditional Understanding and Benefits
Historically, erythritol has been valued for its benefits, particularly for those managing blood sugar. It has a zero glycemic index, is low in calories, and does not contribute to tooth decay. It is also generally well-tolerated digestively compared to other sugar alcohols.
The 2023 Cardiovascular Study: A Shift in Perspective
A significant 2023 study published in Nature Medicine linked high blood erythritol levels to an increased risk of heart attack and stroke. This was based on analyzing data from thousands of individuals and laboratory tests showing erythritol enhanced blood clot formation. A small study also demonstrated that consuming a drink with 30 grams of erythritol caused a substantial, prolonged spike in blood levels.
Potential Cardiovascular Risks Explained
The concern centers on erythritol's potential to increase platelet activation and clotting, which can lead to serious cardiac events. This is particularly relevant for those already at higher risk for heart disease, such as individuals with diabetes or obesity.
The Debate: Correlation vs. Causation
While the 2023 study showed an association, it did not definitively prove causation. Industry groups have noted these findings contradict previous research. The FDA has acknowledged the study but called for more research, especially considering the study population's pre-existing risks. A subsequent 2024 study also suggested increased clotting potential after consumption.
Comparison Table: Erythritol vs. Other Sweeteners
| Feature | Erythritol | Stevia | Monk Fruit | Sucrose (Sugar) |
|---|---|---|---|---|
| Origin | Naturally in fruits, commercially from cornstarch fermentation | Plant extract from Stevia rebaudiana leaves | Plant extract from monk fruit | Plant (e.g., sugarcane, beets) |
| Calories | Nearly zero | Zero | Zero | 4 kcal/gram |
| Glycemic Index | 0 | 0 | 0 | ~65 |
| Sweetness | ~70% of sugar | ~200-400x sweeter than sugar | ~100-250x sweeter than sugar | 100% |
| Key Concerns | Recent link to cardiovascular risks | Some reports of digestive distress and regulation concerns | Primarily limited human studies | Well-documented risks of obesity, diabetes, and heart disease |
| Aftertaste | Mild cooling effect | Often described as licorice-like or bitter | None | None |
Potential for Gastrointestinal Side Effects
Though better tolerated than some sugar alcohols, consuming large amounts of erythritol can still lead to digestive issues like bloating, cramping, and diarrhea in some individuals.
What is the FDA's Stance?
The FDA granted erythritol "Generally Recognized as Safe" (GRAS) status in 1997. This allows its use in foods without extensive safety studies or specific labeling on nutrition panels. However, this classification predates the recent cardiovascular concerns, leading some experts to call for updated regulations.
Conclusion: A Balanced View
While erythritol offers benefits as a low-calorie, non-glycemic sweetener, recent findings linking high consumption to increased cardiovascular risk, particularly from processed foods, warrant caution. The key distinction is between the small amounts found naturally and the high concentrations in manufactured products. For healthy individuals, moderate use may be acceptable. However, those with existing heart conditions, obesity, or diabetes should be particularly mindful, consider limiting processed foods high in erythritol, and consult their doctor. Focusing on whole, plant-based foods for sweetness remains the most recommended approach.
To review the original findings on erythritol and cardiovascular event risk, see the full study published in Nature Medicine here: The artificial sweetener erythritol and cardiovascular event risk.
