Erythritol (E968)

What is Erythritol?

Erythritol is a sugar alcohol (polyol) — a sugar-like molecule that the body handles differently from sugar. Commercially it is made by fermenting glucose with the yeast-like fungus Moniliella pollinis, then crystallizing the result. It also occurs naturally in small amounts in pears, melons, grapes and fermented foods such as soy sauce and wine.

It is about 70% as sweet as table sugar, with a clean taste and a distinct cooling sensation on the tongue. Unlike most polyols, most of what you eat is absorbed in the small intestine and then passed out in urine largely unchanged, rather than being fermented by gut bacteria — which is why it causes less bloating than sorbitol or maltitol.

Two things matter for reading the research that follows. First, erythritol raises neither blood glucose nor insulin. Second, the body also produces erythritol itself, from glucose through the pentose-phosphate pathway, and that internal production increases under oxidative stress.

On a label it appears as erythritol, often blended with stevia or monk fruit, or as E968.

Why is Erythritol used in food?

Erythritol is the bulking agent that makes "sugar-free" products look and behave like the originals. Stevia and monk fruit are hundreds of times sweeter than sugar, so a recipe needs only a pinch — leaving nothing to fill the volume sugar used to occupy. Erythritol provides that bulk with almost no calories.

You'll find it in keto and low-carb baked goods, sugar-free chocolate and candy, tabletop sweetener blends, protein bars, "zero sugar" drinks and ice cream, and chewing gum, where it also resists tooth decay because oral bacteria cannot ferment it.

Is Erythritol safe? What the research says

What regulators say. In the US, erythritol is used under GRAS status; FDA reviewed an industry notice in 2019 and said it had no questions about the conclusion that erythritol is safe for its intended uses. In 2023 EFSA re-evaluated it and set an acceptable daily intake of 0.5 g per kg of body weight per day — about 35 g for a 70 kg adult — which the panel said is protective both against the immediate laxative effect and against potential long-term effects.

Digestive effects. The 0.5 g/kg figure comes from human studies of diarrhea. EFSA also found that at the 95th percentile of intake, some consumers are at or above the ADI — mostly people eating a lot of sugar-free products. In the EU, foods with more than 10% added polyols must warn that excessive consumption may have a laxative effect, and EFSA concluded the evidence does not support exempting erythritol from that rule.

The cardiovascular question. In 2023, a Nature Medicine study reported that people with higher blood erythritol had a higher three-year risk of heart attack and stroke, across three patient groups totaling about 4,100 people (hazard ratios of roughly 1.8 and 2.2 in the validation groups). The same paper showed erythritol made platelets more likely to clot in laboratory tests and in animals, and found that 8 healthy volunteers who drank erythritol had elevated blood levels for more than two days. A follow-up study in 2024 gave 30 g of erythritol or glucose to two groups of 10 healthy volunteers: erythritol raised plasma levels more than a thousandfold and increased platelet reactivity within 30 minutes; glucose did not.

How to read that. These are the honest limits of what has been shown:

• The patient studies were observational. They measured erythritol in blood, not erythritol eaten, and people with metabolic disease make more erythritol internally. FDA's own 2023 review of the paper noted that such studies are incapable of establishing causation, that diet was not accounted for, and that the participants were already at high cardiac risk.
• The platelet work is mechanistic — laboratory and animal experiments plus short human studies with 8–20 people, measuring a marker of clotting rather than actual heart attacks.
• No study has yet shown that people who eat erythritol go on to have more cardiovascular events than people who don't.

FDA's position after reviewing the 2023 paper was that erythritol "has consistently been shown to be safe" over three decades of testing, and that carefully controlled studies are needed to work out whether blood erythritol is a marker of metabolic disease or a contributor to it. EFSA's 2023 re-evaluation, which came after the Nature Medicine paper, kept erythritol authorized.

Bottom line: erythritol remains approved on both sides of the Atlantic, and the case against it is unresolved rather than proven. If you use sugar-free products occasionally, there is nothing here that demands action. If erythritol is a daily staple in large amounts, the open question is worth knowing about, and varying your sweeteners is a low-cost hedge.

Erythritol regulation: US vs EU

Erythritol is permitted in the US and the EU, and the research since 2023 has not changed either status.

In the US it is used under GRAS status rather than a formal food additive regulation: manufacturers concluded it is safe, and FDA responded in 2019 that it had no questions. FDA reviewed the 2023 Nature Medicine paper in an internal memo dated June 15, 2023 and did not take regulatory action, calling for better-designed studies instead.

In the EU it is authorized as E968. EFSA re-evaluated it in 2023 and set an ADI of 0.5 g per kg of body weight per day. Foods containing more than 10% added polyols must carry the warning that excessive consumption may produce laxative effects; EFSA declined to exempt erythritol from it. Check the latest status: this is an active research area and either agency could revisit it.

Who should limit or avoid Erythritol?

• People with established cardiovascular disease or high risk. The open question applies most to you, and you are also the group in which erythritol was measured. It is reasonable to discuss heavy daily use with your doctor rather than to assume either way.
• Heavy users of sugar-free products. EFSA found that the highest consumers already reach or exceed the daily limit. If keto bars, sugar-free chocolate and zero-sugar drinks are daily items, rotating sweeteners keeps intake down.
• People with IBS or a sensitive gut. Erythritol is gentler than other polyols, but large single doses still cause nausea and diarrhea in some people.
• People with diabetes. Erythritol does not raise blood glucose or insulin, which is its main practical advantage over sugar.
• Dog owners. Erythritol is not the dangerous one — that is xylitol, which is toxic to dogs. Blends can contain both, so check the label.