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Staying away from refined sugar and lowering your carb intake, is generally a good thing.  However, many leaders in the Keto and Low-Carb space have promoted the use of Erythritol, a sugar substitute that allows you to enjoy keto ice-cream🍨, brownies, and drinks with zero impact on blood sugar or insulin.

Proponents of Erythritol have claimed it’s a naturally occurring substance found in foods like watermelon🍉, mushrooms🍄, and grapes🍇 and that the FDA says it’s generally recognized as safe.

As a sugar substitute, Erythritol is artificially manufactured through the fermentation of corn🌽.  It tastes very similar to sugar, with no aftertaste, which is why it has become so popular in many processed foods.  The amounts that are added to foods and beverages is far higher than what is naturally present in natural fruits and vegetables.

Erythritol is a “sugar alcohol” similar to sorbitol, maltitol, and xylitol.  Personally, I have always recommended avoiding these due to the impact on the gut microbiome.  Although most of these sugar alcohols get absorbed in the small intestine and excreted through your urine, some can make it to your colon, causing gas and bloating 😧 in sensitive individuals.

This week, a study was published in Nature Medicine showing that Erythritol increases the risk of heart attack, stroke, blood clots, and death.  The study followed over 1000 patients at higher risk for heart disease (due to obesity, diabetes, or hypertension) who were consuming foods with Erythritol for 3 years, and found a significant increase in these adverse outcomes.  It then went on to confirm these findings in a test tube (in vitro), showing that Erythritol added to human blood causes increased platelet clumping.  Finally, when a normal healthy subject was given a drink that had 30 grams of Erythritol, their blood Erythritol level remained elevated for over 2 days! 😱

What’s the takeaway?  Stick with whole food and avoid processed foods full of chemicals that pretend to taste like sugar!  Just because the label says “zero sugar,” “low carb,” or “keto-friendly” does not make it healthy!

Many of you may have noticed that in all my recipes for healthy baked goods, my preferred sweetener is maple syrup🍁.  Although maple syrup raises blood sugar and insulin, I recommend it because it’s a “real” food from nature.  The goal is to use as little as possible to make the dish sweet enough, but not too sweet!  Finally, always stay active to burn off the carbs and real sugar.

Warm regards,

Rajsree Nambudripad, MD