We all know that a diet high in sugar (no matter the source) does not support your health. This fact, along with an increased desire to better control blood sugar, weight, and overall health, has increased the use and popularity of sugar substitutes.
When it comes to sugar substitutes, allulose and erythritol are popular choices for those looking to reduce sugar intake without sacrificing sweetness. Both sweeteners offer a low-calorie alternative to sugar, with unique characteristics that make them appealing for different uses in cooking and baking or adding to your morning coffee.
However, recent discussions have raised concerns about the safety of erythritol, particularly regarding the latest claim linking erythritol to blood clotting, stroke and heart attacks. Wow!
In this comparison, we’ll explore the key differences between allulose and erythritol, and address whether consuming erythritol is truly safe.
Comparing Sugar Substitutes
First, let’s break down the difference between different sugar substitutes as they are not all created equal.
“Natural” Sugar Substitutes
Natural sugar substitutes naturally occur in plants and can also be synthetically made. The following are a few examples:
- Monkfruit: A small Asian melon that has been used in Chinese medicine and by Buddhist monks for centuries. Monk fruit extract is made by crushing the fruit and drying the juice into a powder which has no calories, carbs, or sugar.
- Stevia: A non-nutritive, zero-calorie sweetener that comes from the leaves of the Stevia rebaudiana plant. Stevia has also been used for hundreds of years. The leaves contain a glycoside called steviol glycoside that makes stevia 200–400 times sweeter than table sugar so very small amounts are needed.
- Allulose: A newer low calorie discovery, allulose is found in small amounts in certain fruits and other food sources, but store-bought allulose is usually synthetically made from corn or other inexpensive sources of fructose. We’ll dive more into this later!
Sugar Alcohols
Sugar alcohols, also known as polyols, can also be natural or synthetically made. They can be found in some fruits and vegetables, and the body also produces some sugar alcohols, like erythritol.
However, most sugar alcohols are made commercially through chemical modification of sugars, which is similar to the natural fermentation process. The final products are chemically identical to naturally occurring sugar alcohols. These sugar alcohols are often used in sugar-free gum, candies, and other snack foods.
Sugar alcohols contain fewer calories than regular sugar because they are not completely metabolized by the body. Some examples of sugar alcohols include erythritol, isomalt, lactitol, maltitol, sorbitol, and xylitol. More on erythritol later!
You should know that sugar alcohols or polyols are the “P” in high FODMAP foods. That is, they are fermentable carbohydrates that can cause GI issues for some people, especially if consumed in excess.
Artificial Sweeteners
There is nothing natural about artificial sweeteners. These are chemically synthesized sweeteners, also called nonnutritive sweeteners, low calorie sweeteners, or intense sweeteners, which provide zero calories.
They are also 200 to 20,000 times sweeter than regular sugar so very little is needed. Examples include: aspartame, saccharine, sucralose, neotame, and acesulfame-K.
Artificial sweeteners have also been found to cause GI symptoms (diarrhea, gas, bloating) in sensitive individuals and have been found to significantly alter the gut microbiome1.
What is Allulose?
Allulose is a not so common sugar found naturally in small amounts in foods like figs, raisins, jackfruit, and maple syrup. It is a simple sugar with a chemical structure similar to fructose but is not metabolized like regular sugars.
It is approximately 70% as sweet as table sugar (sucrose), offering a milder sweetness and contains very few calories (about 0.2 kcal per gram) since it is mostly excreted unchanged in the urine and minimally metabolized.
Benefits of Allulose
There aren’t a lot of large randomized controlled trials that confirm the beneficial effects of allulose but there are studies showing some promising potential benefits.
Allulose has a negligible impact on blood sugar and insulin levels, making it a good option for people with diabetes. It has also been found to improve post meal blood sugars in healthy people2.
Some recent research suggests that allulose could provide anti-inflammatory benefits, relieving oxidative stress3. In addition, allulose (depending on the dose) may play a role in significantly decreasing body fat percentage and body fat mass4.
Allulose is generally well-tolerated compared to other sweeteners, but if consumed in very large amounts (0.5g/kg body weight) it may cause diarrhea, bloating or gas in some people5.
How To Use Allulose
What’s great about allulose is that it closely mimics the taste and texture of sugar without a cooling effect or aftertaste. It also behaves similarly to sugar in baking, browning and caramelizing like sugar, making it a good substitute in recipes.
Although allulose is not as sweet as sugar, you can usually get away with using a 1:1 replacement in your recipes.
Of course, you can also find allulose used in a variety of processed foods from baked goods, beverages, cereals, desserts, salad dressing and snack foods.
Downsides to Allulose
A downside to allulose is not everyone can buy it. It is approved by the U.S. Food and Drug Administration (FDA) and is considered “generally recognized as safe” (GRAS).
It is also approved in other countries, including Japan, Mexico, Singapore, and South Korea. However, it is not yet approved in Canada or the European Union as it is still considered somewhat of a novel food.
Another drawback, besides being more difficult to find, is that it tends to be more expensive compared to erythritol.
What is Erythritol?
As mentioned earlier, erythritol is a sugar alcohol. Sugar alcohols were discovered years ago but didn’t start being commercially produced until the 80s. Contrary to the name they are neither a sugar nor an alcohol.
Erythritol is found naturally in very small amounts in fruits like grapes, peaches, pears and melon. It’s also found in mushrooms and fermented foods like beer, soy sauce and wine.
Your red blood cells actually make small amounts of erythritol and it can also be found in other bodily fluids like your blood plasma and in your urine6. Erythritol can also be commercially produced through fermentation.
Erythritol is unique from other sugar alcohols because it contains zero calories and does not impact blood glucose or insulin secretion. It also tends to be more well tolerated than other sugar alcohols because it is more rapidly and completely absorbed in the small intestine before being excreted in your urine.
Other sugar alcohols are either not absorbed at all or only partially absorbed in the small intestine. The remaining unabsorbed sugar alcohols pass through to the large intestine, where gut bacteria ferment them. This is what can cause a lot of the GI side effects (gas, bloating, diarrhea) associated with sugar alcohols.
Erythritol is about 60-80% as sweet as regular sugar and is often mixed with other sweeteners like monkfruit and stevia. It has been approved for use in more than 60 countries and has had a good safety profile….until recent claims.
Benefits of Erythritol
Yes, there’s been benefits associated with erythritol! Let’s take a look at a couple.
Dental Health
There is strong scientific evidence demonstrating the beneficial effects of erythritol on oral health with long-term controlled clinical trials on both children and adults. It’s been demonstrated to inhibit bacterial growth and plaque, lowering the number of dental cavities7.
Blood Sugar, Insulin, Hunger Hormones
Human studies in both lean people and people with obesity, with and without diabetes have shown that erythritol doses of 20–75 gm do not affect blood sugar or insulin levels6.
Another interesting observation was that subjects given 75g of erythritol led to a significant increase in the release of satiety hormones GLP-1, cholecystokinin (CCK) which delay stomach emptying and help curb your appetite8. It also appeared to decrease ghrelin which is the hunger hormone9.
Vascular Function in Type 2 Diabetics
24 people with type 2 diabetes were given 36g of erythritol daily (12g 3x/day) for four weeks. Vascular function was assessed before and after acute dose (2 hours) and then at the end of the 4 weeks.
Results suggested that erythritol improves endothelial function and reduces central aortic stiffness (improving elasticity of your blood vessels)10. While only a pilot study (and lacking a control group), it still offers interesting insight.
How To Use Erythritol
Erythritol is a versatile sugar substitute and is often blended with other sweeteners like stevia (Truvia) or monkfruit and can be found in a variety of packaged foods such as energy bars, frozen desserts, sauces, salad dressing, yogurt, and sugar-free gum. .
Unlike allulose, it doesn’t caramelize or brown like sugar so may not be the best option for baking. Additionally, because it can have a cooling aftertaste, it’s often best used in recipes where this effect complements the flavors.
You’ll commonly find erythritol used to sweeten beverages like coffee, tea, soda, vitamin water, energy drinks or lemonades. It dissolves easily in liquids, making it a convenient choice for drinks.
Concerns About Erythritol
It all started with a 2023 study that showed an association between erythritol and cardiovascular events (heart attack, stroke). The media predictably went crazy over this. However, this study was flawed and even the authors admitted it did not prove causation. For a review on this study go HERE.
Now in August 2024, the same authors published another study on erythritol, this time an intervention study. They took 20 healthy subjects and had them fast overnight, assessed blood/platelet function at baseline and then gave 10 subjects 30g of sugar and the other 10 were given 30g of erythritol.
Their blood levels/platelets were remeasured 30 minutes after consumption and put in a petri dish. They then added a bunch of antagonists to the petri dish and this is what they found:
- A 1,000-fold increase in erythritol levels for the erythritol group, not the sugar group.
- A significant increase in platelet aggregation (process where blood platelets stick together to form a clot) in the erythritol group.
- Erythritol increased dense granule markers of serotonin and the a-granule marker CXCL4 (released when platelets are activated).
So, What Does All This Mean?
I have to admit, when I first heard some of the details about this study I was ready to throw my monkfruit sweetener in the trash. But, then I dug a little deeper because it didn’t make sense to me.
Blood Levels of Erythritol
Well, first it’s not that surprising that blood levels of erythritol rose in the erythritol group vs the sugar group. Is it alarming that it rose so high? I don’t know.
Our bodies naturally produce erythritol and even though it’s usually in small amounts you would think our body is smart enough to get rid of what we don’t need. As mentioned earlier, erythritol is rapidly absorbed in the small intestine before being predominately excreted unchanged in the urine.
Blood levels were measured only 30 minutes after consumption. What did levels look like 2 hours or even 24 hours after? That would be interesting.
There have been studies reporting an association of circulating erythritol with cardiometabolic disease. But, interestingly, two of the largest studies looking at this used blood samples that were taken before erythritol was even approved in our food supply. So, dietary erythritol did not affect this association.
Erythritol is produced in healthy human red blood cells via a pathway called the Pentose Phosphate Pathway (PPP). It has been theorized that plasma erythritol can be a benign marker of PPP dysregulation resulting from high glucose or fructose diets or conditions that increase blood sugar6. However, studies need to be done to confirm this.
Platelet Aggregation and Erythritol
The latest study showed that more erythritol in the blood meant more platelet aggregation which means a higher chance of our blood clotting. Or does it?
They didn’t actually measure aggregation and clotting in the 20 humans in this study. They took their blood, put it in a petri dish, gave it an antagonist cocktail and watched what happened. But that does not show how our human body actually responds!
Another thing I find interesting is the conflict of interest statement reported for Dr. Hazen, one of the main authors behind both of the studies. Directly quoted from the 2023 study:
“Dr. Hazen reports being named as co-inventor on pending and issued patents held by the Cleveland Clinic relating to cardiovascular diagnostics and therapeutics, being a paid consultant formerly for Procter & Gamble and currently with Zehna Therapeutics. He also reports having received research funds from Procter & Gamble, Zehna Therapeutics and Roche Diagnostics, and being eligible to receive royalty payments for inventions or discoveries related to cardiovascular diagnostics or therapeutics from Cleveland HeartLab, a wholly owned subsidiary of Quest Diagnostics, Procter & Gamble and Zehna therapeutics.”
Bottomline
Personally, I am not overly concerned about the findings of this study because ultimately it means nothing about what really happens in the human body. Was erythritol unfairly targeted? Obviously, we need more long-term studies looking at this in actual humans.
I can understand, however, why some might want to avoid erythritol all-together to be on the safe side. Is the solution to include more “natural” sugar in our diet? I think there is clear evidence that this is not the healthy solution.
Avoiding over-consumption of both sugar and sugar substitutes by avoiding or limiting processed foods is always ideal. Avoiding artificial sweeteners all-together is recommended. But, I think there’s a place for stevia, monkfruit, allulose, and sugar alcohols to provide some sweetness in our diet while helping to decrease our overall sugar intake.
I love my morning coffee but it tastes so much better with a little monkfruit added. Most monkfruit is blended with erythritol but Lakanto* also makes a monkfruit blended with allulose instead (*as an Amazon Associate, I earn from qualifying purchases). Options!
Allulose Vs Erythritol: Final Thoughts
Both allulose and erythritol offer a good low-calorie alternative to sugar, each with its unique benefits and downsides.
Allulose, the new kid on the block, has some potential promising benefits. It closely mimics the taste and texture of sugar, making it ideal for baking and cooking, while erythritol is widely available and versatile, though it may cause digestive discomfort in some individuals.
Both sweeteners have minimal impact on blood sugar levels, making them suitable for those managing diabetes or following a low-sugar diet. Avoiding over-consumption of any sugar substitute I think is key. More long-term research is needed to properly address the safety concerns over erythritol.
Each can serve as effective tools in reducing sugar intake while still enjoying some sweetness. Ultimately, the choice between allulose and erythritol comes down to personal preference, tolerance, and what feels like the best choice for your overall health.
For other blog articles on different plant-based topics go here: Veg Out With Maria or join the newsletter to keep up-to-date on the latest!
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Maria Tointon, RDN, LDN, CSR is a Registered and Licensed Dietitian Nutritionist with over 20 years of experience and a passion for helping others achieve their health goals through plant-based nutrition. Follow on Instagram @vegoutwithmaria.
Thanks for this article Maria! I really enjoyed it. I was having all these doubts about erythritol and allulose and was lost in the tons of conflicting info regarding them. I think you made a lot of blaance with what you wrote as fo how much to consume which is really the key.
If you ever find any new studies, please let me know how to be notified.
Thanks
You are so welcome, Roger :). I’m happy to hear you enjoyed the article. I was tired of seeing posts that just sided with the sensational headlines without digging further. I will update the blog post if I hear any new study findings. Cheers!