Is Erythritol Dangerous for Your Health?

Erythritol is a sugar substitute found in many low calorie or low sugar processed foods (or possibly even being stirred into your coffee)? And if you’re using another sugar substitute, look carefully. Erythritol just might be one of the ingredients in it, often combined with stevia or monk fruit, for example.

Recently it’s been in the news because of a collection of studies linking it to heart attacks and strokes due to an effect it may have on blood clotting.

I’m not going to get into scientific details here, but I've been listening/reading from several sources on this, and the various people whose opinions I respect have drawn varied conclusions. Here's my take for now...

1. In the long term, sugar and all sugar substitutes are worth avoiding or minimizing for a number of reasons. And this is PART of what I help people with in my nutritional coaching. Sweet taste triggers an appetite for more. People using sugar and/or substitutes have greater tendency to overeat period, possibly because of that appetite trigger. Sugar substitutes can also raise insulin levels (the sweet taste tells the body that sugar is on the way, even if it isn't), and higher insulin levels is a health concern all its own for many reasons (heart, brain, diabetes, etc.)

Minimizing sugar in particular has many important health benefits, not the least of which is a healthier liver, critical for daily detoxing, hormonal balance and many, many other functions our livers do for us!

Minimizing sugar of all kinds will also help you regulate blood sugar, appetite and weight, all of which will help your energy, heart health, brain health and more.

2. Most sugar substitutes have very little if any research on their safety, especially long term. (NONE that I know of have been proven safe. Even stevia has some questions about its impact on the gut microbiome.)

3. It seems clear these recent studies on erythritol do raise important concerns, yet are also not conclusive when looked at closely, in spite of how news media presents them. (Potentially concerning, but not conclusive.) Always remember the primary goal of news sources, to get people to click! News sources often do an extremely poor job of accurately reporting on 'nutrition science' (whether it is well done science or not).

4. Sugar intake can be a very serious health problem, even to the point of addiction, and sometimes sugar substitutes are the better choice. Especially if they can be used as a temporary bridge to wean someone off the need for so much 'sweet'. Erythritol may or may not be an ok choice of sugar substitute.

5. My personal preferences include using real sugar or honey when I do have something sweet, as long as I can keep it to a minimum and not have it trigger overdoing it. I also so far like monk fruit, and have heard very promising things about allulose. Yet both of these have also not been 'proven' safe, and might never be!

6. Again, helping people return to intuitively healthy eating with real, whole foods is an important part of my work. And though it may be 'simple', it is not easy or straightforward given the food environments that surround us, as well as the many misconceptions about what 'healthy' eating looks like.

Some take-aways for now:

If you have any concerns for your cardiovascular health, including inflammation, poor cholesterol profile, blood sugar issues or insulin resistance, you should probably minimize erythritol for now until more research is done. That means either eliminate it completely, or at least don’t have it everyday and try to keep intake under 5-10 grams when you do have it.

Don’t assume that any sugar substitute is fine for health long term, no matter what the label says. Use them strategically as needed to help you reduce sugar intake, and long term avoid daily use. Save them for special occasions, and then enjoy!

Know that some sugar in your diet may or may not be fine. It really depends on your metabolic health, your liver health, how and when you consume it, and on your tendency to lose control when you have it (level of addiction).