The
sugar alcohol erythritol is a relatively new
food ingredient. It is naturally occurring in plants, however, produced commercially by fermentation. It is also produced endogenously via the pentose phosphate pathway (PPP). Consumers perceive
erythritol as less healthy than
sweeteners extracted from plants, including
sucrose. This review evaluates that perspective by summarizing current literature regarding
erythritol's safety, production, metabolism, and health effects. Dietary
erythritol is 30% less sweet than
sucrose, but contains negligible energy. Because it is almost fully absorbed and excreted in urine, it is better tolerated than other
sugar alcohols. Evidence shows
erythritol has potential as a beneficial replacement for
sugar in healthy and diabetic subjects as it exerts no effects on
glucose or
insulin and induces gut
hormone secretions that modulate satiety to promote
weight loss. Long-term rodent studies show
erythritol consumption lowers
body weight or adiposity. However, observational studies indicate positive association between plasma
erythritol and
obesity and cardiometabolic disease. It is unlikely that dietary
erythritol is mediating these associations, rather they reflect dysregulated PPP due to impaired glycemia or
glucose-rich diet. However, long-term clinical trials investigating the effects of chronic
erythritol consumption on
body weight and risk for
metabolic diseases are needed. Current evidence suggests these studies will document beneficial effects of dietary
erythritol compared to caloric
sugars and allay consumer misperceptions.