September 24, 2014

by Vivian KanchianCertified Alternative Nutrition Expert

All of my articles generally start with a question for which I personally would like to know the answer.  In this case, it was about alternative sweeteners.  It seems like only yesterday that agave was being touted as a panacea to all our ‘sweet tooth’ cravings.   Today, we’re hearing increasingly about sugar alcohols (all sweeteners ending in –ol).

After  a brutal Los Angeles heat wave, I knew I needed something more than just water to replenish the electrolytes I was losing over these long, sweaty summer days!  I wanted a healthy option.  While picking up lunch one day, I noticed Zero Vitamin Water (ZVW) was on sale: 10 bottles for $10; Vitamin Water’s “healthier” cousin.  I scanned the ingredients list, which was relatively minimal and was delighted to find that each bottle contained less than 1 gram of sugar per serving (from a blend of erythritol, fructose, stevia), plus added vitamins and minerals.   The bottles came in all the colors of the rainbow, and in appealing flavors like blueberry, pomegranate, and acai.  And the taste?   Just like liquid jell-o– delicious!

What makes these sweeteners especially attractive is their relatively sugar-like flavor, low glycemic index, low calorie content, and prevention of dental caries (cavities).  Sugar alcohols are now used in diet and diabetic foods, chewing gums, toothpaste, and mouthwash.

Here’s what my investigations into Zero Vitamin Water turned up:

Erythritol  (ERT) is cheaply produced in large quantities using certain yeasts. In a healthy person, about 90% of the sweetener goes from the small intestine (bypassing the large intestine) directly to the bloodstream and is then excreted via the urine.  It was approved in 2001 by the FDA as a food additive.

ERT is usually combined with other highly concentrated sweeteners, because it is only mildly sweet on its own.  In the case of VitaminWater, that concentrated sweetener is Crystalline Fructose (CF) which usually consists of a whopping 98% pure fructose!  CF is usually made from corn starch, sucrose, or table sugar. Since corn is so cheap and readily available, it is highly likely that corn starch is the starting ingredient.  Consumers are left to guess, since Coke doesn’t disclose the origins of their CF.  HFCS used to come in two forms (HFCS55 : 55% fructose, 45% glucose or HFCS42 : 42% fructose, 58% glucose).  By all appearances, High Fructose Corn Syrup just got a new makeover to appear more consumer-friendly.  And the problem with fructose is that 100% of the metabolic burden is placed on the liver.

Sugar alcohols : Are they a safe alternative?


Studies show that Xylitol helps prevent cavities [7].

Xylitol may inhibit Streptococcus pneumoniae virus [1].

Erythritol and Xylitol in particular taste very much like sugar.

Very low in calories.

Very low glycemic index makes them appealing to diabetics and the overweight population.

Erythritol has a much higher digestive tolerance compared to some of the other sugar alcohols (varies depending on a person’s gut health).


Only a handful of in vitro studies evaluating the genotoxicity of Erythritol exist. These results have found no mutagenic/ carcinogenic properties.  However, it is difficult to predict a human outcome based solely on lab studies; and limited ones, at that.

Erythritol is being investigated as a natural insecticide; studies show it’s toxic to some flies [5].

Limited studies in rats have shown a potential link between the ingestion of sorbitol and/ or mannitol on the formation of  medullary lesions which are associated with neurological disorders [4]; human studies are currently lacking.


In those with digestive issues*, excess fluid accumulates in the lumen resulting in bloating, gas, and diarrhea due to the fermentation of intestinal contents.  Over time, this can lead to or exacerbate chronic nutrient-deficiencies, weight loss or gain, and related health conditions. * an estimated 60-70 million Americans [2]

Combining short-chain carbohydrates (also called FODMAP’s) like sorbitol, maltilol, xylitol, erythritol, and fructose can trigger Irritable Bowel symptoms in those with visceral hypersensitivity .  Interestingly,  a 50/50 ratio  (minimum 50% glucose) of fructose and glucose inhibits these effects.  To learn more about the FODMAP’s diet, click here [6]. intestines

Studies have shown that short term supplementation with ERT can be a potential diuretic agent which could lead to dehydration (the opposite of what Vitamin Water is meant to do).

May contribute to altered gut flora, which could lead to a vast array of disorders [8] and obesity [3].

What about Stevia?

A 2013 study [9] revealed that Stevia has the potential to alter the gut flora by inhibiting certain strains of Lactobacilli .

While the human studies are currently insufficient, there is reason to believe that Stevia can play a role in triggering or inhibiting the release of some hormones [10].

Bottom Line: 

Until more comprehensive, conclusive studies have been conducted… avoid or limit all of the above if you can.

Take fructose only in whole fruit form or with other glucose containing foods.*

*For juice cleanses containing fruit, add psyllium husk to the regimen  

All written contents are copyright 2014 by Vivian Kanchian, Certified Alternative Nutrition Expert.

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