Erythritol vs Xylitol: Which Sugar Alcohol Is Better for Your Health?

As more Americans seek healthier alternatives to traditional sugar, two sugar alcohols have emerged as popular choices: erythritol and xylitol. Both offer sweetness without the calories and blood sugar spikes of regular sugar, but they have distinct characteristics that make each suitable for different health goals and dietary needs.

Understanding the differences between erythritol and xylitol can help you make an informed decision about which sweetener best fits your lifestyle, whether you’re managing diabetes, protecting your dental health, or simply trying to reduce your sugar intake.

Understanding Sugar Alcohols: The Basics

Sugar alcohols, also known as polyols, are a type of carbohydrate that occurs naturally in certain fruits and vegetables. Despite their name, they contain no ethanol (the type of alcohol found in alcoholic beverages) and won’t make you intoxicated.

These compounds are processed differently by the body compared to regular sugar. They’re only partially absorbed in the small intestine, which means they provide fewer calories and have a minimal impact on blood glucose levels. This unique property makes them attractive alternatives for people watching their calorie intake or managing blood sugar levels.

Common sugar alcohols include sorbitol, maltitol, mannitol, xylitol, and erythritol. Among these, xylitol and erythritol have gained the most attention due to their favorable taste profiles and health benefits.

What Is Xylitol?

Xylitol is a naturally occurring sugar alcohol found in small amounts in many fruits and vegetables, including berries, plums, corn, and birch bark. Commercially, it’s typically extracted from corn cobs or birch trees through an industrial process.

Nutritional Profile of Xylitol

Xylitol contains approximately 2.4 calories per gram, which is about 40% fewer calories than regular sugar (4 calories per gram). It has a sweetness level nearly equal to table sugar, making it an easy one-to-one substitute in recipes.

The glycemic index of xylitol is 7, significantly lower than sugar’s glycemic index of 60-70. This means it causes a much smaller rise in blood sugar levels compared to regular sugar.

How Xylitol Works in the Body

When you consume xylitol, only about 50% is absorbed by your digestive system. The rest passes through to your colon, where gut bacteria ferment it. This incomplete absorption is responsible for both its reduced caloric impact and potential digestive side effects when consumed in large quantities.

Health Benefits of Xylitol

Xylitol and Dental Health

One of xylitol’s most well-documented benefits is its positive effect on oral health. Unlike regular sugar, which feeds harmful bacteria in your mouth, xylitol actually inhibits the growth of Streptococcus mutans, the primary bacteria responsible for tooth decay.

Studies have shown that regular xylitol use can reduce cavity-causing bacteria by up to 75%. It works by preventing these bacteria from adhering to teeth and disrupting their ability to produce the acids that damage tooth enamel. Additionally, xylitol stimulates saliva production, which helps neutralize acids and remineralize teeth.

The American Dental Association recognizes xylitol as beneficial for dental health when used as part of a comprehensive oral care routine. For optimal cavity prevention, dental professionals recommend consuming 6-8 grams of xylitol spread across multiple exposures throughout the day.

Xylitol for Blood Sugar Management

For people with diabetes or those monitoring their blood sugar levels, xylitol offers a significant advantage over regular sugar. Its low glycemic index means it causes minimal increases in blood glucose and insulin levels.

Research suggests that xylitol may also improve glucose metabolism over time. Some studies indicate it could help improve insulin sensitivity and support better long-term blood sugar control, though more research is needed to fully understand these effects.

Xylitol and Ear Infections

Interestingly, xylitol has shown promise in reducing the occurrence of ear infections, particularly in children. The same bacteria that xylitol inhibits in the mouth (Streptococcus pneumoniae) is also a major cause of middle ear infections.

Clinical studies have found that children who regularly consume xylitol in gum or syrup form experience fewer ear infections compared to those who don’t. This makes xylitol a potentially useful preventive measure for children prone to recurrent ear infections.

What Is Erythritol?

Erythritol is another naturally occurring sugar alcohol found in fruits like grapes, melons, and pears, as well as in fermented foods such as wine, sake, and soy sauce. Commercially produced erythritol is typically made through the fermentation of glucose by specific yeasts.

Nutritional Profile of Erythritol

Erythritol stands out among sugar alcohols because it contains virtually zero calories—only about 0.2 calories per gram. This is because approximately 90% of erythritol is absorbed in the small intestine and excreted unchanged in urine, rather than being metabolized for energy.

With a sweetness level of about 60-80% that of regular sugar, erythritol may require slightly more volume to achieve the same level of sweetness. However, it has no bitter aftertaste, which is a common complaint with some artificial sweeteners.

The glycemic index of erythritol is zero, meaning it has no effect on blood sugar or insulin levels whatsoever.

How Erythritol Works in the Body

Unlike other sugar alcohols, erythritol is unique in how the body processes it. Most of it is absorbed in the small intestine before it can reach the colon, where fermentation and digestive discomfort typically occur. This absorption pattern is why erythritol generally causes fewer digestive issues than other sugar alcohols.

Health Benefits of Erythritol

Erythritol for Weight Management

With essentially zero calories, erythritol is an excellent choice for those looking to reduce caloric intake without sacrificing sweetness. It can be used in baking, beverages, and cooking without adding to your daily calorie count.

Because it doesn’t spike blood sugar or insulin levels, erythritol doesn’t trigger the same hunger and craving cycles that sugar can cause. This may help with appetite control and weight management efforts.

Erythritol and Diabetes

Erythritol is particularly well-suited for people with diabetes. Its zero glycemic index means it won’t affect blood glucose levels at all, making it one of the safest sugar substitutes for blood sugar management.

Research has consistently shown that erythritol doesn’t impact insulin secretion or blood glucose levels, even in people with type 2 diabetes. This makes it a reliable option for maintaining stable blood sugar while still enjoying sweet flavors.

Erythritol and Oral Health

Like xylitol, erythritol doesn’t feed cavity-causing bacteria and therefore doesn’t contribute to tooth decay. While it may not have the same actively antibacterial properties as xylitol, it’s still far superior to sugar for maintaining dental health.

Antioxidant Properties

Some research suggests that erythritol may function as an antioxidant in the body, helping to protect cells from oxidative stress and potentially supporting cardiovascular health. Studies have shown it may help scavenge free radicals and reduce oxidative damage to blood vessels.

Erythritol vs Xylitol: Direct Comparison

Calorie Content

Winner: Erythritol

Erythritol contains virtually zero calories (0.2 per gram), while xylitol has 2.4 calories per gram. For strict calorie counting, erythritol has a clear advantage.

Impact on Blood Sugar

Winner: Erythritol

Erythritol has a glycemic index of 0 and causes no blood sugar spike whatsoever. Xylitol has a glycemic index of 7, which is still very low but not completely negligible. For people with diabetes or those following ketogenic diets, erythritol is the superior choice.

Sweetness Level

Winner: Xylitol

Xylitol is approximately as sweet as sugar on a 1:1 basis, making it easier to substitute in recipes. Erythritol is only 60-80% as sweet, so you may need to use more or combine it with other sweeteners.

Dental Health Benefits

Winner: Xylitol

While both are non-cariogenic (don’t cause cavities), xylitol has the added benefit of actively fighting cavity-causing bacteria. Research comparing the two has found xylitol to be more effective at preventing dental caries and promoting oral health.

Digestive Tolerance

Winner: Erythritol

This is perhaps the most significant difference. Erythritol is absorbed in the small intestine and doesn’t reach the colon where fermentation occurs, making it much less likely to cause digestive discomfort. Xylitol, on the other hand, is only partially absorbed and can cause gas, bloating, and diarrhea when consumed in amounts exceeding 30-40 grams per day.

Taste and Aftertaste

Winner: Tie

Both xylitol and erythritol have clean, sugar-like tastes without the bitter aftertaste common with some artificial sweeteners. However, erythritol can have a slight cooling effect in the mouth, similar to mint, which some people notice and others don’t. This cooling sensation is more pronounced in concentrated amounts.

Baking Performance

Winner: Xylitol

Xylitol behaves more like sugar in baking, helping with browning and moisture retention. Erythritol doesn’t caramelize like sugar and can crystallize when cooling, potentially creating a grainy texture in some baked goods.

Potential Side Effects and Concerns

Xylitol Side Effects

Digestive Issues: The most common side effect of xylitol is gastrointestinal distress, including bloating, gas, and diarrhea. This typically occurs when consuming more than 40-50 grams per day, though individual tolerance varies.

Toxicity to Pets: This is critically important—xylitol is extremely toxic to dogs and can be fatal even in small amounts. It causes rapid insulin release in dogs, leading to severe hypoglycemia and potential liver failure. Even tiny amounts can be dangerous, so products containing xylitol must be kept away from pets.

Blood Sugar Concerns: While xylitol has minimal impact on blood sugar, people with diabetes should still monitor their response when first introducing it.

Erythritol Side Effects

Digestive Effects: While generally well-tolerated, consuming very large amounts of erythritol (more than 50 grams at once) can still cause digestive upset in some people, though this is less common than with other sugar alcohols.

Cardiovascular Concerns: Recent research has raised questions about potential links between erythritol consumption and cardiovascular events. A study published in Nature Medicine found an association between high erythritol levels in blood and increased risk of blood clots. However, it’s important to note this was an observational study showing association, not causation, and more research is needed. The amounts studied were also much higher than typical dietary intake.

Dehydration: Because erythritol is excreted through urine, consuming large amounts may have a mild diuretic effect. Staying well-hydrated is recommended.

Who Should Choose Xylitol?

Xylitol may be the better choice for you if:

• You’re primarily concerned with dental health and cavity prevention
• You want a 1:1 sugar substitute for recipes and baking
• You have good digestive tolerance to sugar alcohols
• You’re looking to reduce ear infections in children
• You don’t have pets, or can safely store products away from them
• You prefer a sweetener that tastes most like regular sugar

Who Should Choose Erythritol?

Erythritol may be the better choice for you if:

• You have diabetes and need a zero-impact sweetener on blood sugar
• You’re following a ketogenic or very low-carb diet
• You have a sensitive digestive system
• You’re focused on weight loss and calorie reduction
• You want to minimize digestive side effects
• You have pets in your home and want to reduce toxicity risks
• You’re looking for the sweetener with the most research supporting cardiovascular safety (noting recent concerns require more study)

Can You Use Both Together?

Yes, many commercial sugar-free products actually combine erythritol with xylitol or other sweeteners. Combining them can offer several advantages:

• Better taste profile by balancing erythritol’s cooling effect
• Improved sweetness level closer to sugar
• Some dental health benefits from xylitol
• Better digestive tolerance than using xylitol alone
• Improved baking performance

If you choose to use both, you can experiment with ratios to find what works best for your needs. A common blend is 70% erythritol and 30% xylitol.

Safety Considerations and Recommendations

Both xylitol and erythritol have been approved as safe by major regulatory bodies, including the U.S. Food and Drug Administration (FDA), the European Food Safety Authority, and the World Health Organization’s Joint Expert Committee on Food Additives.

However, as with any dietary change, it’s wise to:

• Start with small amounts to assess your tolerance
• Gradually increase consumption rather than immediately using large quantities
• Stay within recommended daily limits (typically under 50 grams for erythritol, under 40 grams for xylitol)
• Keep xylitol products securely away from pets
• Monitor your body’s response, especially if you have existing digestive issues
• Consult with your healthcare provider if you have diabetes, are pregnant, or have other health conditions

Cost Comparison

Generally, erythritol tends to be less expensive than xylitol, particularly when purchased in bulk. Xylitol’s production process is more complex and costly, which is reflected in its price. However, prices vary by brand and source, and both are more expensive than regular sugar.

When considering cost, factor in that you may need to use more erythritol to achieve the same sweetness level as xylitol or sugar, which could offset some of the price difference.

Environmental Considerations

For environmentally conscious consumers, the production methods matter. Xylitol derived from birch trees may be more sustainable than corn-based production, though this depends on forestry practices. Erythritol production through fermentation can be quite efficient, but the glucose source matters.

Look for products that specify sustainable sourcing if environmental impact is a priority for you.

The Verdict: Which Is Better?

There’s no one-size-fits-all answer to whether erythritol or xylitol is better—the right choice depends on your individual health goals, dietary needs, and tolerance.

Choose erythritol if: You prioritize digestive comfort, have diabetes requiring strict blood sugar control, are counting every calorie, have pets, or follow a ketogenic diet.

Choose xylitol if: Dental health is your primary concern, you want the closest substitute to sugar for baking, you can safely store it away from pets, or you’re using it to help prevent ear infections in children.

Many nutrition experts suggest that erythritol edges out xylitol slightly for general use due to its superior digestive tolerance and zero caloric impact. However, xylitol’s dental health benefits make it uniquely valuable for oral health applications.

Beyond Sugar Alcohols: A Holistic Approach

While both erythritol and xylitol are significantly healthier than refined sugar, it’s important to remember that the best approach to health is reducing overall reliance on sweeteners of all kinds.

The American Heart Association recommends limiting added sugars to no more than 6 teaspoons (25 grams) per day for women and 9 teaspoons (36 grams) per day for men. Using sugar alcohols can help you meet these guidelines, but whole, unprocessed foods should still form the foundation of a healthy diet.

Consider these strategies:

• Gradually reduce sweetness in your diet to retrain your taste buds
• Use whole fruits to satisfy sweet cravings
• Drink water or unsweetened beverages instead of sweetened ones
• Read labels carefully—many “sugar-free” products are still highly processed
• Focus on nutrient-dense foods that naturally stabilize blood sugar

Final Thoughts

Both erythritol and xylitol offer viable alternatives to sugar with unique benefits and considerations. Erythritol’s excellent digestive tolerance and zero impact on blood sugar make it ideal for most people, while xylitol’s powerful dental health benefits give it a special niche.

Whichever you choose, use them as tools to help transition away from excessive sugar consumption rather than as license to consume unlimited sweets. Monitor your body’s response, stay within recommended amounts, and remember that moderation is key to any healthy dietary practice.

If you have specific health concerns, diabetes, or other medical conditions, consult with your healthcare provider or a registered dietitian before making significant changes to your sweetener use. They can help you determine which option best fits your individual health needs and goals.

Sources:

• American Dental Association – Sugar Substitutes
• Mayo Clinic – Artificial Sweeteners and Sugar Substitutes
• American Heart Association – Added Sugars
• American Diabetes Association – Sugar Substitutes
• National Institutes of Health – Health Potential of Polyols as Sugar Replacers
• Nature Medicine – Cardiovascular Disease Risk Study