Sweeten Your Life with Erythritol

Erythritol May Help
Protect Your Memory

It’s an excellent substitute for sugar, which has been
implicated as a risk factor for Alzheimer’s disease
By Will Block

Be careful crossing streets, ooh-ooh,
Cut out sweets, ooh-ooh,
Lay off meat, ooh-ooh,
You’ll get a pain and ruin your tum-tum!

— From “Button Up Your Overcoat” (1928)
Lyrics by B. G. DeSylva and Lew Brown

ometimes pop culture is ahead of its time. But . . . cut out sweets? Are you kidding? Would life be worth living? (Hmm, could be a new song there; too bad Sinatra is no longer with us.) No, cutting out sweets doesn’t bear thinking on, no matter how healthy the consequences—not even when we listen to Linus Pauling, who, in a 1974 interview with The Saturday Evening Post, said,
My conclusion is that by eating good, unadulterated, natural food, with emphasis on green and yellow or red vegetables, by a proper intake of vitamin C, vitamin E, and other vitamins, by largely eliminating ordinary sugar from the diet, and by some physical exercise every day, the process of deterioration that ultimately leads to death can be postponed an average of twenty years. [Italics ours]

Pauling was by no means the first scientist to condemn our overindulgence in sugar, which exploded during the twentieth century. He was, however, the most astute and authoritative. As always, he chose his words carefully, and he gave us two blessed loopholes with the words “largely” and “ordinary.”

First of all, nothing as wonderful as sugar should be totally eliminated from the diet, even if that were practical, which it’s not. We all need some pure pleasure in our lives. Be reasonable about avoiding sugar, not fanatical.

Second, there are about two dozen commercially available sugar substitutes—some natural, some synthetic. Based on an arbitrary value of 100 for the sweetness of sucrose (table sugar), their values range from 40 to an astounding 800,000. Among the compounds at the lower end of this scale are several that chemists call sugar alcohols, through which we can indulge our collective sweet tooth without guilt—or harm.

Glycemic Control Entails Healthy Food Substitutes

A major factor in protecting and improving our health is glycemic control, the regulation of our intake of digestible carbohydrates (including ordinary sugar) so as to minimize their impact on our blood sugar (glucose) levels. We can do this by choosing our foods on the basis of their glycemic index and by paying attention to the glycemic load they impose on our system.*

*For explanations of these and other aspects of glycemic control, see “Lowering Cholesterol with Beta-Glucan-Rich Barley” (July 2007), “Beta-Glucan-Rich Barley Helps Control Blood Sugar” (August 2007), “Glycemic Control—Best for Weight Loss” (September 2007), and “Glycemic Control May Protect Your Vision” (October 2007).

For some traditional food ingredients, we can also use healthy substitutes in our cooking and baking, such as beta-glucan-rich barley (a health powerhouse), resistant starch (a relatively indigestible type of starch), and the sugar alcohol erythritol. (For the advantages of erythritol as a sugar substitute, see the first sidebar.)

Erythritol—Almost Too Good to Be True

Erythritol is 70% as sweet as sucrose, so to obtain equivalent sweetness in a given food, you’d have to use 43% more of it. That, of course, means 43% more calories—but don’t worry, because erythritol has only 0.2 calorie per gram, or 95% less than sucrose (4 cal/g) and other carbohydrates. For all practical purposes, erythritol is calorie-free. Furthermore, it has a glycemic index of zero, so it has no effect on blood glucose levels (or insulin levels) and is therefore safe for diabetics. And it doesn’t promote tooth decay, so moms don’t have to worry about its effect on their kids’ teeth.

© iStockphoto.com/Sylvia Cook
Erythritol is a natural sugar alcohol—but it’s nothing like grain alcohol and cannot make you drunk. It’s found in small amounts in pears, grapes, melons, mushrooms, and some fermented foods, such as wine, beer, cheese, and soy sauce. Commercially, it’s made by the microbial fermentation of glucose. It’s used as a sweetener in a wide variety of dessert-type foods and beverages—the very items that normally contain lots of sugar. Erythritol is approved by the FDA and has no known toxicity in normal daily use.

Last but not least, erythritol is efficiently absorbed (about 90%) from the small intestine into the bloodstream. All but the very small amount that gets metabolized is then excreted, unchanged, in the urine. In this regard, it differs importantly from most other commonly used sugar alcohols, such as sorbitol, maltitol, and xylitol, which are poorly absorbed. They wind up in the colon, where they undergo microbial fermentation that produces gas and draws in excess water, both of which have socially undesirable consequences. These sweeteners are therefore not suitable for bulk use in cooking or baking.* Erythritol is relatively immune to microbial fermentation, so even the 10% of it that reaches the colon doesn’t cause problems.

*Like erythritol, the sugar alcohol mannitol is well absorbed (80%), and it too is 70% as sweet as sucrose—but it has 8 times the caloric value of erythritol, which makes it less desirable for bulk use in cooking or baking. All the other common sugar alcohols are also much more calorie-rich than erythritol (although still less so than sucrose).

Erythritol is best for making low-calorie dessert dishes, such as cakes, cookies, puddings, ice cream, candy, etc., but it can also be used for general cooking and baking. Because it acts differently than sucrose in some respects, some kitchen experimentation may be required to get used to it, but it’s worth the effort.

Can Sugar Rot Your Brain?

Didn’t your mom always warn you that eating too much sugar would rot your teeth? She was right, of course. Little did she know, though, that too much sugar, especially from guzzling too many sweetened beverages, such as soda pop, might indirectly rot your brain—literally, as in Alzheimer’s disease (AD). Can this be true?

Researchers at the University of Alabama at Birmingham believe it is true, and they have evidence to back it up, from a study done with mice subjected to a long-term diet that included sugar-sweetened water.1 Let’s jump ahead for a moment to their concluding statement, which strikes an unusually assertive tone for a scientific paper, where a certain sober reserve is the norm. With no false modesty, they stated,

Our findings are of tremendous importance, given that the consumption of sugar-sweetened beverages has increased dramatically in the past decades and will most likely remain high in modern societies. Controlling the consumption of sugar-sweetened beverages may be an effective way to curtail the risk of developing AD.

When Sugar Turns to Fat

Wow. Let’s see what led to that remarkable claim. In their paper, the researchers pointed to the compelling evidence that excessive consumption of sweet foods, particularly sugared beverages, is a major factor in the worldwide obesity epidemic, which is hitting American children particularly hard. Even moderate obesity can contribute to the metabolic syndrome and type 2 diabetes, which used to be an adults-only disease but is now increasingly common in our kids.

Numerous studies have also shown a strong association between type 2 diabetes and an increased risk for AD, independently of the risk for vascular dementia, which is caused by cerebrovascular disease. Scientists suspect that insulin resistance and the resultant high insulin levels, which are characteristic of type 2 diabetes, may contribute to the brain damage seen in AD. A high dietary fat intake and excess body weight are known to increase the risk for AD, but no one had investigated the possible link between ordinary sugar and AD.

Sugar Causes Weight Gain and Insulin Resistance

The Alabama researchers filled that gap. They used 2-month-old male “transgenic” mice that had been genetically engineered to develop AD-like symptoms (memory impairment and plaque deposits in the brain) by 6 months of age. All the mice received a standard, well-balanced, low-fat diet of mouse chow (in unlimited amounts so they could regulate their own intake), but the control mice were given plain water, while the test mice were given water sweetened with 10% sucrose (table sugar). Thus the experiment simulated a human diet that includes the excessive consumption of sugared soft drinks (which usually contain about 11% sugar).

This regimen lasted for 6 months—a long time by mouse standards. Overall, the test mice ate less food than the controls, but they drank more water, and they gained 17% more weight—the result of all those empty calories from the sugar, which turned to fat. They showed markedly impaired glucose tolerance, their fasting plasma insulin levels were 3 times higher than those of the controls—a very bad sign—and their total cholesterol levels were 30% higher than those of the controls.

Sugar Even Causes Signs of Alzheimer’s Disease

These results were not surprising, given all that we know regarding the tendency of excess dietary sugar to produce excess fat and the liabilities associated with fat, including insulin resistance and diabetes. What really got the researchers’ attention, though, was that the mice on the high-sugar diet had dramatically impaired memory and spatial learning ability compared with the control mice and with normal, nontransgenic mice.

Furthermore, their brains at autopsy (at the end of the trial, when they were 8 months old) contained 2.9 times as much AD-type plaque as those of the controls. Such plaque consists mainly of a protein called amyloid-beta, which is produced from an amyloid precursor protein called APP.

Humans Might Be More Susceptible than Mice

In other words, the AD-like condition in the test mice was much worse than in the controls, and their excessive sugar intake—independently of their fat intake—was the cause. Their caloric intake (43% of it from the sugar) corresponded, in terms of a 2000-cal/day human diet, to a daily consumption of five 12-oz cans of sugared beverages—an amount consumed by many Americans, especially the younger ones. To make things worse, humans get a lot of additional sugar from their food (especially if they eat much processed food), whereas the mice did not.

Furthermore, because the basal metabolic rate in mice is about 7 times higher than in humans, mice need a much higher caloric intake, in proportion to their weight, than humans do. What this means, the researchers said, is that in humans, a lower level of sugar consumption might produce degenerative effects similar to those seen in the mice. That’s a very unsettling thought, and a powerful incentive to use viable sugar substitutes—especially erythritol.

A Narrow Escape

For reasons too technical to go into, the researchers suggested that the sharp increase in brain plaque seen in the test mice was not due to an increased production of amyloid-beta from APP, but rather to an increased tendency for existing, free amyloid-beta molecules to aggregate and form the harmful deposits. In any case (and assuming that the mouse experiment has relevance to humans), one can only wonder how many human cases of AD could be avoided, even if only narrowly, simply by avoiding excessive sugar consumption.

The potential narrowness of the escape is highlighted by the results of a recent study at the Rush University Medical Center in Chicago indicating that the great majority of older, community-dwelling (noninstitutionalized) Americans may have significant brain pathology—mostly of the Alzheimer’s type, often in combination with other abnormalities—whether they know it or not.2 This became apparent at the autopsies of 141 older adults, only 14% of whom were free of the signs of degenerative brain disease. All the rest showed neuropathological evidence of dementia—even those in whom the disease had not yet become clinically apparent while they were still alive.

What Color Is Your Meat?

Thus, we may all be, in a sense, time bombs waiting for something to push us over the edge from health into disease—and ordinary sugar may be a fuse. All the more reason to get serious about glycemic control, among many other concerns, to help preserve and protect our precious health.

By the way, getting back to those “Button Up Your Overcoat” lyrics and their warning about meat, we’re reminded of what Tommy Smothers said on that subject: “Red meat is not bad for you. Now, blue-green meat, that’s bad for you!”*

*It turns out, alas, that brown is not so good for you either. See the article on page 17 of this issue.

Sugar—A Sweet and Sour Tale

Every sweet has its sour, every evil its good.
— Ralph Waldo Emerson

We may be sour on sugar for medical reasons, but let’s not forget the good side of this nutritional “evil.” Sugar has a long history of making people happy, but an even longer one of helping to heal their wounds—some of which may have been incurred while fighting over . . . sugar. It was a precious commodity, often worth its weight in gold, until European settlers introduced it to South America and the Caribbean Islands and began large-scale production (with slave labor) to supply the global market.

Sugar cane (Saccharum officinarum), a grass native to New Guinea, had previously been cultivated since at least 3000 B.C., first in India and then elsewhere in the ancient world. Around the sixth century A.D., knowledge of sugar cane and how to get sugar from it spread westward to the Middle East, where Arabs embraced it. They helped popularize it further during their conquests of northern Africa and parts of southern Europe in the last centuries of the first millennium.

Sugar remained an expensive medicine, however, and the demand for it was fueled by apothecaries who used it to help mask the foul taste of many other medicines they prescribed. Along with honey, sugar was prized for its ability to stop bleeding and to heal deep wounds, where it promotes new tissue growth by drying the wound bed; it also weakens bacteria by dehydrating them. Battle surgeons used it for this purpose, and even today, some surgeons do the same.1 (Wouldn’t you rather have sugar rubbed in a wound than salt?)

It’s useful, by the way, to know something about the different kinds of sugar (which aren’t all that different, actually). Cane sugar and beet sugar, the two principal white table sugars, are chemically identical (aside from minor impurities)—both consist of sucrose, a molecule consisting of a fructose molecule and a glucose molecule linked by a chemical bond (the fructose/glucose ratio in sucrose is thus 1:1).

Brown sugar too is sucrose, but it’s less refined and contains about 5% molasses. Raw sugars, with exotic names such as demerara, turbinado, and muscovado, are minor variants of brown sugar, i.e., they too are just sucrose with a bit of molasses. Don’t fall for the hype.

Honey consists mainly of fructose and glucose (in a 1.2:1 ratio) as individual molecules, i.e., they’re not linked. (Honey also contains some water, small amounts of other sugars, and traces of aromatic compounds that impart its distinctive flavors.) Thus, honey is not sucrose, but nutritionally speaking, it might as well be, because guess what happens when sucrose hits your small intestine? It’s broken down to individual fructose and glucose molecules (1:1), i.e., it becomes a quasi-honey. Your body doesn’t know or care where the fructose and glucose came from, and their calories are the same in any case.

A 1:1 mixture of fructose and glucose, by the way, is called invert sugar, or just invert; it’s widely used in the making of candy because it tends not to crystallize as readily as sucrose does. Honey is essentially invert sugar. Another form of invert sugar (almost) is high-fructose corn syrup (HFCS), a liquid sweetener that has found wide use in the food and beverage industry because it’s cheaper than sucrose or honey.

HFCS is made by the enzymatic degradation of cornstarch, followed by further fermentation to convert some of the glucose from the resulting product to fructose. The standard commercial form of this syrup contains 42% fructose and 53% glucose (a 0.8:1 ratio). On a weight basis, its sweetness is equivalent to that of sucrose, and, like all the other forms of sugar, it has the same caloric content (4 cal/g). When reading food or beverage labels, watch out for this ingredient, and beware.

Ideally, all the sugars described above should be largely eliminated from your diet—a major step toward glycemic control and better health for your body and your brain.


  1. Swerdlow JL. Nature’s Medicine: Plants That Heal. National Geographic Society, Washington, DC, 2000.


  1. Cao D, Lu H, Lewis TL, Li L. Intake of sucrose-sweetened water induces insulin resistance and exacerbates memory deficits and amyloidosis in a transgenic mouse model of Alzheimer disease. J Biol Chem 2007;282: 36275-82.
  2. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology 2007;69:2197-204.

Will Block is the publisher and editorial director of Life Enhancement magazine.

FREE Subscription

  • You're just getting started! We have published thousands of scientific health articles. Stay updated and maintain your health.

    It's free to your e-mail inbox and you can unsubscribe at any time.
    Loading Indicator