Erythritol vs Stevia vs Xylitol

Erythritol vs Stevia vs Xylitol
June 13, 2015 6:44 PM

You might have heard the names erythritol, stevia and xylitol. You might already have some information about these. But how about getting a detailed description of each of these and comparing these three. That’s what this article is for. You need to read this article as it will give you a detailed description of erythritol, stevia and xylitol.


What is it?

Let us first look at erythritol. It is actually a kind of sugar alcohol that has been accepted as an additive in the whole world and particularly in the USA. The first person to discover erythritol was a British chemist named John Stenhouse. He discovered it in 1848. It is naturally found in different fermented foods and fruits. It is actually made by the fermentation caused by a yeast known as Moniliella pollinis. It is about 70% as sweet as sucrose. But it doesn’t affects the blood sugar levels and it isn’t the cause of tooth decay. It also doesn’t have calories and is absorbed by the body and excreted in the form of urine. It is also less likely that gastric side effects will be caused by this sugar alcohol. The reason for this is that it has a unique path in digestion. The caloric value of erythritol is 0.2 kilocalories per gram according to the U.S. Food and Drug Administration labeling requirements. The nutritional value can change according to the country. The labeling in countries such as Japan and the United States is zero calories, whereas the labeling in European Union regulations is 0.24 kcal/g.

The major part of erythritol goes into the body through the blood, after being absorbed via the small intestine. The major difference between eryhtritol and other sweeteners is that it doesn’t have any laxative effects, which are common in other sugar alcohols. The main reason behind this is that more than 90% of erythritol is absorbed before entering the large intestine. Broborygmi and nausea are, however caused in case of high doses of erythritol.

Let us now look how erythritol is produced in the industry. The fermentation process is generally used for the manufacturing of erythritol. The material which is used in the start is either corn or maize. The first part of the fermentation process is converting corn or maize into erythritol. Maize and corn are used by the manufacturers for producing erythritol. Starch is obtained from maize in the first process. Starch is actually a long chained bonding of glucose molecules with each other. You can say that the most common sugar in nature is glucose. It is present in table sugar sucrose. The long chains of starch are broken into relatively smaller glucose molecules through the hydrolysis process. Glucose has now been formed into erythritol through the process of fermentation.

Fermentation takes place after this process. Fermentation is a well-known and popular process and is commonly used in the production of beers, wines and alcohol beverages. More sugars are converted into alcohol during the fermentation of one or two sugars. This process can either take place through bacterial stains or yeast. The fungus named Monilielli is used for fermentation in erythritol manufacture.

Health benefits of erythritol

Let us now look at the health benefits of the use of erythritol. Erythritol has a wide range of benefits. Some of these benefits have been mentioned below:

1. No Calories

Obesity is a worldwide problem and is prominent especially in the US. People are, therefore, looking for different sugar substitutes having zero calories. There are various health benefits of sugar in the body. It creates a sweet taste in the mouth and makes the taste livelier by interacting with other ingredients. Sugar also gives texture to the food. Erythritol is mostly used by people because it contains zero calories. It is naturally found in fermented foods and fruits. There are many advantages of erythritol over other sugars. One of the most important one is that it has zero calories in it. It is also non-insulinemic and non-glycemic. It is also non-carcinogenic and has low hygroscopicity. It can also interact with other sweeteners, like sucralose, rebiana and aspartame.

The reason that erythritol has zero caloric content in it is that the process of absorption and elimination is unique is erythritol and no metabolism is required for this process. Erythritol is therefore, known as a zero calorie bulk sweetener and it reduces the calories of the body.

2. Tolerance in digestion

A major benefit of erythritol is that it has high digestive tolerance in it. It is absorbed directly in the small intestine. Different studies have shown that it isn’t fermented in the human body. So, foods that have large amounts of erythritol in them don’t cause any gaseous and laxative side effects. Recently a study was done which showed that the consumption of 1 kg per body weight of erythritol can easily be tolerated by adults in comparison to the foods which contain sucrose in them. Another study was conducted in 2007 in the University of Salford (1). The main purpose of the study was to find out and compare the gastrointestinal responses of the young adults after consuming about 45g sucrose and 50g erythritol. The population of the study were adults between ages 18 and 24. The respondents of the study took erythritol in their homes. The study showed that there was increased bloating, nausea and colic due to the consumption of erythritol. The researchers said in the conclusion of the study that erythritol causes harmful effects when consumed in large quantities. But it is easily tolerated by the body when consumed in low quantities. The researchers said that about 20 to 35g of erythritol is easily tolerated by the body.

3. Safe for diabetic patients

It has been seen that erythritol has no effect on the insulin levels or the blood serum. Different clinical studies have shown that the use of erythritol is safe for diabetic patients. Different studies have also suggested that erythritol can be used in place of sucrose. People who have diabetes can therefore safely use it without having to worry about their blood sugar.

4. No tooth decay caused

All the polyols are resistant to tooth decay and erythritol is no exception. The reason why it doesn’t cause any cavities is that it does not undergo any metabolism in body. Cavities are formed when sugars are broken down and then bacteria act on those broken pieces of sugar to form acids that harm the tooth enamel. The American Dental Association has claimed that erythritol is quite beneficial against tooth decay and several companies has started using erythritol in their dental health care programs. The FDA has accepted the use of a “doesn’t cause tooth decay” health claim on food containing erythritols and other similar polyols. A study was also done in 2014 to find the effect of erythritol on tooth decay (2). It was a long term study of three years and the population of the study was 485 students. The study showed that erythritol is more beneficial against dental carries as compared to xylithol.

5. Sugar level isn’t increased by erythritol

The enzymes needed to break down erythritol aren’t present in the human body. Erythritol gets dissolved into the blood and passes through urination as it is. A study was conducted in 1994 to see the effect of erythritol on the insulin levels (3). The study showed that there was no effect on the blood sugar levels of healthy individuals when they were given erythritol. The study also showed that erythritol doesn’t affect the cholesterol and triglycerides levels in the body. Erythritol is an excellent source for people having diabetes issues and those who are overweight. People who have different issues related to metabolic syndrome can also benefit themselves from erythritol.

Side effects of erythritol

One shouldn’t be blinded only by the benefits of erythritol. Erythritol has a number of side effects too. Some major side effects produced by the use of erythritol are mentioned below:

1. Effects on gastrointestinal system

Erythritol can produce some harmful effects when consumed in large quantities that include diarrhea, thirst, nausea and cramps. An opinion was published in 2003 in the Scientific Committee on Food of the European Commission’s Health and Consumer Protection Directorate-General which stated that men are more prone to the harmful effects of erythritol as compared to women.

2. Potential to cause cancer

Some people have the view that cancer can be caused by artificial sweeteners. But there is still no clear evidence as to whether cancer in humans can be caused by any artificial sweetener or not. A 2003 opinion published by the Scientific Committee on Food states that there isn’t clear evidence whether erythritol can cause cancer or not. But this point can’t be taken out of consideration.

3. Raises blood sugar levels

It’s a common belief that sugar alcohols don’t effect the blood sugar because they are totally sugar-free. But it is wrong. Sugar alcohols do cause a slight raise in the blood sugar levels which are however, less than normal sugar. Some experts think that erythritol containing foods are normally consumed by people in larger amounts because they are less sweet than sugar.

4. Causing hunger

The brain is usually at work after a person eats food. The brain gives signal to the body that you have eaten food and then hormones are released by the body which decrease appetite. A person doesn’t experience satisfaction after the intake of sugar alcohols. A person, therefore, still feels hungry after consuming the sugar alcohols.


What is it?

Stevia is actually a sugar substitute which is obtained from the species of plants known as Stevia rebaudiana. Stevia glycosides are the main constituents of stevia and are about 150 times sweeter than sugar. They have a stable pH and are also heat-stable. They don’t effect the blood glucose levels due to which they are beneficial for people on carbohydrate-controlled diets. A person retains the taste of stevia for a longer duration as compared to sugar. Some of the compounds of stevia also have a licorise-like aftertaste.

Stevia is legalized in some countries; whereas it isn’t legal in some other countries. You can consider Japan as one example where stevia has been continuously used for more than a decade. Stevia has been banned in some other countries due to political controversies and the health concerns. Stevia was banned in the United States in the 1990s. The European Union, however, legalized stevia in 2011.


Now let us look at some history of stevia. The Guarani peoples of South America have used the plant Stevia rebaudiana for over 1,500 years. The leaves of stevia have been used in Brazil and Paraguay in medicines and teas. The name ‘stevia’ was basically derived from the name of a Professor of Botany in the University of Valencia named Petrus Jacobus Stevus. The stevia plant was first described by a Swiss botanist Moises Santiago Bertoni. But only limited research was done on it at that time. More research was done on stevia in 1931, when two French chemists obtained the glycosides responsible for the sweetness of stevia. The structure of steviol was formally published in 1955.

Commercial use of stevia

Different sweeteners, such as saccharin and cyclamate, were removed during the making of Coca-Cola in the 1970s. The usage of stevia in Japan actually started when an aqueous extract of the leaves was formed into sweeteners. The first commercial preparation of stevia was made in 1971 by a Japanese firm named Morita Kagaku Kogyo Co., Ltd. Stevia is used in Japan in place of sugar in soft drinks and food products. It is also used as a table sugar. The country where the most stevia is currently consumed is Japan.

Stevia gained fame in the US in the 1980s as a non-caloric sweetener in the U.S. natural foods and health industries. The FDA was asked to test the herb by the makers of NutraSweet. Stevia again gained popularity in the US when the Coca-Cola Company explained their plan to use stevia for sweetening their product in America. Coca-Cola Company had also planned to use their stevia containing product in 12 other countries. The FDA approved the use of Truvia in 2008, which is a stevia-sweetener and the Coca-Cola Company started using this sweetener in their company. The Coca-Cola launched their stevia containing sweetener in 2013 throughout the world.

Health benefits of stevia

There are a number of health benefits of stevia. Some of these benefits are shown below

1. Controlling insulin and sugar levels

The extracts of the plant of stevia have been used for quite some time now for the treatment of diabetes. There is also scientific evidence which supports that stevia is beneficial for controlling the blood sugar levels and the insulin levels. One of the most important steps which a person can take to reduce the risks of heart diseases and cancer is to avoid the blood sugar levels to be raised after meals. A study was recently done to find the effect of stevia on glucose levels in diabetic patients (4). The results of the study showed that stevia reduces the blood sugar level in the diabetic patients by 18%. Taking stevia before meals can cause the blood sugar level and insulin levels to become low in comparison to other sugars. Stevia leads to lower insulin levels when it is compared to aspartame. One of the main research findings of one study was that the consumption of stevia can make a person satisfied for longer periods of time and he doesn’t eat more food throughout the day. This is one factor which suggests that consumption of stevia stabilizes a person’s blood sugar and insulin levels.

Insulin resistance is the root cause of many cases of increasing insulin and glucose levels. A study was done in which the rats were given a high fructose diet for four straight weeks (5). The study showed that insulin resistance development is delayed by the consumption of stevia and the blood sugar levels are lowered.

2. Lowering blood pressure

Another major benefit of the consumption of stevia is that it can lower the blood pressure in the body. A double blinded study was recently done in which stevioside, which is a derivate of stevia, was used. The results of the study showed that people who too about 250 gm of stevia for three or more times a day experienced a decrease in their systolic and diastolic levels (6). This study was postponed and then again resumed for a longer time. The results showed that stevia helps in lowering the blood pressure in the body. The thing which is interesting is that the participants didn’t report any side effects of the doses. Another major finding of the study was that the life expectancy of the stevia group was higher than the placebo group. The effect of taking stevia was just like taking a blood pressure lowering medication. Another important point to consider in the study was that the blood pressure levels were lowered only of the people having elevated blood pressure; no effect of stevia consumption was seen on people having normal blood pressure. So, you can think of stevia as an alternative to the traditional method of lowering blood pressure.

3. Hair health and dandruff

It is believed that the consumption of stevia is beneficial for dandruff; dry and dull skin. Different people have reported having stronger and dandruff free hair after the regular use of stevia. Mix 3-4 drop of stevia drops into your shampoo if you want to give a new look to your hair. The color and strength of hair can also be maintained by using stevia as a conditioner and washing it after five minutes or so.

4. Gingivitis

Gingivitis basically means inflammation of the gums. Different studies have shown that the consumption of stevia is beneficial against gingivitis and tooth cavities. The development of infectious organisms in the teeth and gums can be stopped due to the consumption of stevia. People who have used stevia as a mouth wash have reported that it is beneficial against gingivitis and other sore tooth infections. You can simply use stevia as your mouth wash and brush your teeth after that. Making stevia mouthwash is quite easy. You have to simply put stevia in a cup of hot water and put tea leaves in it. Wash your mouth with it for three to four times daily. You can also mix 2-3 drops of stevia in regular toothpaste to make stevia toothpaste.

5. Beneficial against indigestion and heartburn

Stevia tea has been used in Brazil and Bolivia for soothing the stomach and to treat indigestion. You can also drink stevia tea after meals; this will aid in digestion and help against stomach pain.

Side effects of stevia

Now let us look at some side effects of stevia. Some side effects of stevia are shown below:

1. Causing allergic reactions

Stevia can cause severe allergic reactions like anaphylaxis in some cases. The New Health Guide website suggests that people who are already allergic to ragweeds and chrysanthemums should avoid the use of stevia. Some of the allergic symptoms you might experience after consuming stevia are general weakness, dizziness and difficulty swallowing food.

2. Causing harm in the digestive system

Stevia is often used as sugar substitute for losing weight because it is low in calories. Nausea and satiety feelings are caused due to the consumption of stevia. Steviosides are present in stevia, which can cause many digestive problems including decreased hunger and bloating. You should immediately contact a doctor if you experience any of these symptoms.

3. Interaction with other drugs

Stevia can cause adverse reactions with some medicines. Taking stevia and lithium at the same time is often not recommended by experts because stevia can, sometimes, abnormally elevate the levels of lithium in the body. Stevia should also be avoided if you are on a diabetic medication. Several studies have pointed out that the consumption of stevia along with other diabetes medications can cause hypoglycemia in which the blood sugar levels fall abnormally low. Stevia shouldn’t also be taken if you are taking blood pressure medication because the combination of the two can also lower the blood pressure levels. So, you should consult your doctor if you are medications along with it.


What is it?

Xylitol is actually a sugar alcohol which is used as a sweetener most of the times. This word has been derived from the Greek word for sugar alcohols. It is either classified as a sugar alcohol or polyalcohol. The formula of xylitol is CH2OH(CHOH)3CH2OH. It is an isomer of pentane-1, 2, 3, 4, 5-pentol. In sweetness, xylitol is just like sucrose but has 33% lesser calories. Xylitol is quite helpful for the dental health because it results in the reduction of caries which is helpful for remineralization. Many studies have been done regarding xylitol. These studies indicate that xylitol has the ability to form minieralization in the deep layers of enamel. Some studies have also suggested that xylitol reduces the middle ear infection in children (7).

Low concentrations of xylitol are found in many vegetable and fruits. Xylitol can also be obtained from different fibrous materials which include sugar cane bagasse and corn husk. Some other sources of xylitol include berries, mushrooms and oats. Xylan, which is a hemicellulose, is required for the industrial production of xylitol. It can be obtained from corncobs or hardwoods. Xylan is then passed through the hydrolysis process where it is converted into xylose and then it is formed into xylitol. A recently done rat study showed that xylitol has lesser side effects as compared to other artificial sweeteners. The study also showed that the caloric value and the carcinogenic value is lower than sucrose.

Now let us look at the production of xylitol. The French and German chemists were the first to discover xylitol in the 19th century. It first became popular in Europe as a sweetener, which had no effect on the insulin levels of diabetic patients. Xylitol is generally produced when xylose is passed through a hydrogenation process. This converts sugar into an alcohol. Xylitol can also be obtained from different natural resources. It can also be obtained from birch trees to birch sap. Xylitol can also be produced through the microbial process. This includes the biocatalytic and fermentative processes in bacteria, fungi and yeast. Candida guilliermondii and Candida tropicalis are the yeast cells generally used for producing xylitol. The importance of xylitol in dentistry was found by scientists in Finland in the 1970s. The researchers in the study showed that xylitol have many dental benefits; these studies are also known as “Turku sugar studies” (8).


About 2.4 kilocalories are present in 1 gram of xylitol. One gram of sugar contains 3.87 kcal. There is no aftertaste present in xylitol. So, it is completely safe for hyperglycemia and diabetic patients. Scientists suggest that this tolerance is due to the fact that xylitol has no effect on the blood sugar of a person. It also has a very low glycemic index (GI) level which is 7. The carcinogenic and toxic properties of xylitol show that it is completely safe. It has also been considered safe by the FDA (Food and Drug Administration).

Benefits of Xylitol

Now let us look at some health benefits of xylitol. There are a number of health benefits of xylitol. These benefits have been mentioned below:

1. Dental care

Xylitol is a sugar alcohol which is nonfermentable and tooth-friendly. It has more dental benefits as compared to any other polyalcohol. Tridentate Ligand is present in the structure of xylitol. This gives xylitol the ability to rearrange with polyvalent cations. The Ca+2 are transported through the gut wall due to this and also through saliva. Some studies were done in Finland in the 1970s which show that xylitol leads to fewer missing teeth or cavities when compared to other sugars (9). Xylitol can’t be used as a source of energy because it is non-fermentable. The harmful bacteria in the teeth are killed when xylitol is taken, which allows the teeth to be healed with less interruptions. This is probably one reason why xylitol is considered unsuitable for bread making. Dentists suggest that about 6 gm of xylitol are needed per day to be beneficial for teeth.

The saliva is secreted when xylitol is consumed. This leads to it acting as a buffer against the environment caused by dental plague. The pH levels are increased by the consumption of xylitol and the level quickly comes within the normal range. There have also been some studies recently done which show that xylitol has no more effect on dental caries, as a topical fluoride. The FDA has recognized xylitol as a food additive. Xylitol sweetened products have labels that clearly state that it doesn’t cause dental cavities.

2. Lower glycemic index

A major problem with the addition of sugar in the diet is that it quickly raises the blood sugar levels in the body. This can cause many metabolic problems due to the excess of fructose. But xylitol has zero fructose. So, xylitol isn’t harmful in the way sugar is. The glycemic index of xylitol is just 7 which is quite low as compared to other sugars. Xylitol is a good food additive for people having diabetes and obesity.

3. Reducing ear infections

Another major benefit of xylitol is that it reduces the ear infections and fights yeasts. There is a connection between the mouth, ear and nose. So, a bacteria living in the mouth can cause infection in the ears. This is a common problem with children. Xylitol starves the bacteria in the mouth which kills them. A study in which the ear infections in children were studied showed that xylitol reduces the infection rate by 40%. Xylitol is also helpful in fighting the yeast Candida albicans, which stops infection and lessens the ability of the yeast to stick on different surfaces (10).

4. Bacteria and yeast in the gut

Xylitol is actually a prebiotic which means that it helps in the formation of good flora. A flora is a healthy friendly microorganism present in the gut. Unhealthy bacteria and yeast are formed by the sugar present in the gut. Some artificial sweeteners help in the growth of yeast in the gut region. But xylitol stops the formation of yeast in the gut.

5. Health of the sinus

Many people now-a-days use Neti pot for treating sinus infections, cold and allergies. A Neti pot is actually a container which is especially made to wash the debris of the nasal cavity. You should add xylitol in your diet because it has antibacterial properties. You can also add some amount of xylitol in your neti therapy. You can start from little amount like 1/4 teaspoon. You can also add 1/4 teaspoon sea salt and 1/4 teaspoon baking soda.

6. Producing alkalinity

Xylitol alkalinizes the body which basically means that it keeps the harmful viruses, fungi and bacteria away from the body. Your body stays more healthy and balanced when the body is alkaline. An acidic environment is created by the sugar which helps the bacteria and viruses and weakens the immune system of the body.

7. Xylitol for bone health

Researchers have recently found that xylitol remineralizes the tooth enamel. Therefore, they are now searching whether it has the ability to strengthen the bone tissues. Different studies done on animals have shown that xylitol is beneficial for the bone health. The researchers suggest that xylitol may help in increasing bone density in humans.

Side effects of xylitol

Xylitol is quite a beneficial sugar alcohol. But it has a few side effects too. One of the major side effect of xylitol is that it leads to gastrointestinal problems just like other sugar alcohols. Some other common side effects of xylitol when consumed in excess are diarrhea, bloating and nausea. The major side effects of xylitol usually occur when the daily dosage becomes more than 40 to 50 gm per day. The amount of xylitol in packaged foods varies from food to food. So, you should read the labels before buying xylitol containing food products. A hard candy may contain about 5 gm of xylitol whereas, a sugar-free candy bar contains about 29 gm of xylitol. Sensitivity to xylitol varies from one individual to the other. Some people can endure a small amount of xylitol only.

One thing is important to mention here and it is that you shouldn’t eat xylitol in excess thinking that it is sugar-free. The reason is that xylitol contains some amount of calories in it. About 2 to 3 calories per gram are present in xylitol. It has already been discussed that you will experience gastrointestinal problems when you consume xylitol in excess. You can also suffer from weight gain if you take xylitol in excess.

Toxic for dogs

It has been known that xylitol is like a toxic to dogs. The ASPCA Animal Poison Control Center suggest that the xylitol toxicity cases have significantly increased since the first reports in 2002. It has been seen that the blood pressure levels of the dogs who have ingested xylitol has been quite low. This can prove to be fatal if appropriate measures aren’t taken. Depression, loss of coordination and sudden collapse are just some of the symptoms experienced by low blood sugar levels. The dogs who take high doses of xylitol suffer from liver failure. One of the main reasons of the cause of hypoglycemia (low blood sugar level) in dogs is that the xylitol is absorbed slowly in the body and is consumed over a long period of time.


This article describes and compares three different substances: erythritol vs stevia vs xylitol. As you can see each of these sugar alcohols has specific benefits and specific side effects. They should be consumed with moderation and as they are frequently part of our daily foods and drinks you should carefully check food labels when shopping. 

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Written by: Michal Vilímovský (EN)
Education: Medical student, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
Article resources: See numbered references within the article
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Published: June 13, 2015 6:44 PM
Next scheduled update: June 13, 2017 6:44 PM
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