Erythritol & the Low FODMAP Diet
Erythritol is a bit tricky when it comes to the low FODMAP diet. Erythritol is generally well absorbed in our small intestines, which means it should be low FODMAP. However, research shows it does promote fructose malabsorption, which is problematic for people who react to FODMAPs (1). This means many FODMAP dietitians recommend avoiding erythritol in the elimination period (2).
What is Erythritol?
Erythritol is a four-carbon sugar alcohol that is well absorbed in our small intestines, when compared to the high FODMAP sugar alcohols (sorbitol, mannitol, xylitol, maltitol or isomalt) (1). Research indicates that only 10% of the erythritol ingested makes it to our large intestine, and gut bacteria do not rapidly ferment erythritol in our large intestines (1 3). In theory erythritol should not increase irritable bowel syndrome symptoms (IBS) and this is why erythritol was considered FODMAP friendly.
So Why is Erythritol a Problem?
Recent research suggests that erythritol promotes the malabsorption of fructose, which can then cause IBS symptoms (1 4). When erythritol is consumed with fructose it reduces the absorption of fructose in the small intestine, the fructose then travels to the large intestines where it is rapidly fermented by gut bacteria and can cause IBS symptoms (1 5). This means that erythritol by itself might be low FODMAP but it has a high FODMAP effect when combined with other foods. Patsy Catso, a well-known low FODMAP dietitian, no longer considers erythritol safe for the elimination phase (2).
Personally, I have found that the erythritol in a powdered stevia sugar blend called Natvia, increased my tummy troubles when I consumed it with safe low FODMAP fruit. It was not a pleasant experience and I was in agony for hours!
Where is Erythritol Found?
Erythritol is found naturally in some fruits, mushrooms, and fermented foods like sherry, wine, and soy sauce (1 8). On the low FODMAP diet some wines, soy sauce, and certain fruits are considered safe and do not need to be removed from the diet. Erythritol can also be semi-artificially produced by the fermentation of glucose, derived from wheat or cornstarch, by using non-pathogenic yeasts (8). This type of erythritol is used as an artificial sweetener in chewing gum, confectionery, jams, coffee syrups, beverages, and sugar substitutes (it is often added to stevia sugar substitutes like Natvia and Truvia) (1 6 7 8). Pure stevia without added erythritol is low FODMAP. Erythritol can also be labeled as E968 (8).
I would recommend avoiding semi-artificial erythritol that has been added to products during the elimination phase of the low FODMAP diet. If you do decide to consume erythritol avoid having it with fructose containing foods. Remember to check chewing gum, confectionary, diet drinks and sugar substitutes (like stevia blends) for erythritol (or E968) before consuming to avoid tummy troubles.