Xylitol, Erythritol, Sorbitol…What’s That "Ol" About?

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I probably get more questions about this category of sweeteners than any other, and for good reason. They’re called sugar alcohols, but they’re not sugar, and they’re not alcohol.

You may have seen some of the “-itol” sweeteners in diabetic candy and wondered, “Is that an artificial sweetener?”

You may see xylitol in your toothpaste and wonder the same.

You may have heard of an “-itol” that causes diarrhea and discounted it immediately, kind of like Olestra.

Or you may have heard praises sung by trusted nutrition sources and hoped that an “-itol” would be a good alternative sweetener without the calories.


(Sugar Cane Photo Source)

Initial Thoughts

I have to say, I think what amazes me most about this entire category is how prevalent they are, and yet how unquestioned. Many stevia blends have much more erythritol than stevia, yet people aren’t asking, “What’s that thing?” They’re just saying, “Is stevia safe?” because that’s the only sweetener listed on the FRONT of the package.

I’m not even sure if my antennae have been trained enough to catch all the “-itols” that might be buried in ingredients lists, as I’ve been so hyper-vigilant about completely artificial sweeteners.

Find the rest of the Sweet, Sweet Summer series HERE.

How is a Sugar Alcohol Processed

There are a lot of choices in this category, all “generally recognized as safe” or GRAS as far as the FDA is concerned. What does that mean? No one has proven it harmful. Innocent until proven guilty it kills someone and they can prove it.

Here’s a list with which to train your label-reading antennae:

  • sorbitol
  • xylitol
  • erythritol
  • mannitol
  • lactitol
  • isomalt
  • maltitol
  • hydrogenated starch hydrolysates (HSH) – a family of sweeteners including hydrogenated glucose syrup, maltitol or sorbitol syrup

Sugar alcohols aren’t alcohol but have some chemical resemblances to it, and they often begin with a sugar but are also not sugar.

I keep trying to wrap my brain around exactly how these things are produced (clue number one that it’s not really food), and I just can’t do it. They all begin with some sort of natural starch or sugar (sometimes a chemical equivalent nowadays), then are fermented – some sources say hydrogenated or hydrolysed – into a sugar alcohol. How this all plays out is beyond me…but let’s move on.

In case you’re wondering just what you’re eating, these are the initial sources for the “-ose” – the sugar/starch found in nature – from which the “-itols” are derived:

    • sorbitol, from glucose
    • xylitol, from xylan, in birch bark – likely any sweetener that has “birch bark” in its title is xylitol
    • erythritol, from corn
    • mannitol, from glucose syrups
    • lactitol, from lactose
    • isomalt, from sucrose


Benefits of Sugar Alcohols

Similar to artificial sweeteners, the goal of sugar alcohols seems to be to reduce calories and glycemic load. Sugar alcohols are not calorie-free, but have 1/20 to 1/2 as many calories as sugar (from 0.2 to 2.7 calories per gram, compared to 4 calories in sucrose, table sugar). Sometimes they are listed as a “zero calorie sweetener,” though, so there must be a labeling loophole like the “zero grams trans fat” that allows manufacturers to list “zero” when it’s less than 0.5 g per serving.

They have fewer calories only because they’re not fully absorbed by the gut, passing on through without impacting the system. Or at least…without being absorbed. There’s something that doesn’t sit right with me about avoiding calories by eating things that are supposed to go right through you. Where’s the research on the safety there?

Whole corn goes right through most of the time, too (you know?), so does that mean it doesn’t contribute any calories to the meal? I just don’t know about that…

Unlike artificial sweeteners, which are usually 30-300 times sweeter than sugar, the sugar alcohols are less sweet than sugar, with 30-90% of the sweetness, depending on which one we’re talking about.

Almost all sugar alcohols are found naturally in some fruits (which fuels the labeling “all natural” even though they’re made in labs nowadays).

They do have an impact on insulin, but sugar alcohols require far less insulin response than other sweeteners, so they are lower on the glycemic index and often recommended for diabetics. It is important to note that some or most (?) DO incur an insulin response and are not “freebies.”

From a podcast by Pharmacist Ben (Ben Fuchs): xylitol will not touch insulin levels (although recent literature suggests that just the sweet taste of something may raise insulin). He calls it a “sweetener that’s like a nutritional supplement” and is a fan.

None of them impact cavities and tooth decay, which gives them a leg up over other natural sweeteners and sugar.

A few sugar alcohols have particular benefits worth mentioning:

  • Xylitol may increase absorption of B-vitamins and calcium, re-mineralize tooth enamel and fight ear infections
  • Erythritol is often lauded as the best of the sugar alcohols – zero calories, zero glycemic effect, and it may even have an antioxidant effect.

Nutritional Profile of Sugar Alcohols

The nutrition facts for one teaspoon (4g) of a sugar alcohol:

    • sorbitol: 8 cal., 4 g carbs
    • xylitol: 10 cal., 4 g carbs, glycemic index = 7
    • erythritol: 0.8 cal., 4 g carbs, glycemic index = 0
    • mannitol: 6.4 cal., glycemic index = 0
    • lactitol: 8 cal., glycemic index = 6
    • isomalt: 9 cal., glycemic index = 9
    • maltitol: 10.8 cal., glycemic index = 36
    • maltitol syrup: 12 cal., glycemic index = 52
    • to contrast, here’s sucrose (table sugar): 16 cal., 4 g carbs, glycemic index = 65 (glucose = 100)
    • Note: the carbs in sugar alcohols are “sugar alcohol” carbs, which are often not “counted” for diabetic or low-carb diets…
    • source


Possible Disadvantages of Sugar Alcohols

They’re not pleasant.

Because sugar alcohols can (a) ferment in the intestines and (b) are not absorbed fully, thereby enacting “passive diffusion” in the colon; in larger amounts, they can cause gas, bloating, and diarrhea, plus painful cramping in many individuals with just a small amount.

In that case, I feel like I wouldn’t recommend sugar alcohols to anyone who has any digestive weakness: IBS, Crohn’s, colitis, constipation, ETC., just in case. As a mom, I would include children on that list, too. It doesn’t seem worth it to experiment on them…

Sugar alcohols, although found in nature, have only been separated from their whole foods and used as sweeteners for a short time: erythritol was approved in 1990, for example.

Andy Bellatti, my favorite online dietician, admits that sugar alcohols are better than artificial sweeteners for those who need to avoid glycemic load, but he’s big on reminding people that we need to wean ourselves off the addiction to a sweet taste on our tongues, period:

Since they still add a lot of sweetness to foods, they do absolutely nothing in terms of helping our palates get used to lower amounts of sugar in our diets.

Award-winning cookbook author and nutrition expert Rebecca Wood puts xylitol in the category of artificial sweeteners and says this:

Xylitol is dangerous—even life-threatening—for pets according to the American Society for the Prevention of Cruelty to Animals. Xylitol, a pure crystalline chemical, or hydrogenated polyol, is typically a byproduct of the plywood industry but it may also synthesized from cornstalks. Yes, data correlates xylitol with the reduction of dental caries, however there are more wholesome ways of preventing tooth decay.

And the Weston A. Price Foundation website, although not coming down on sugar alcohols as a non-food to be avoided at all costs (which surprised me), list the following side effects:

[Sugar alcohols can cause] metabolic acidosis, which can lead to acid reflux and an increased risk of cancer of the larynx. …also promote dehydration and loss of electrolytes, creating feelings of excessive thirst. …Those who are trying to avoid carbohydrates and burn body fat should also know that sugar alcohols will immediately take the body out of ketosis, the state wherein fat reserves rather than dietary calories are being metabolized. . . assuming that the body was in a state of ketosis to begin with.

Additional concerns with sugar alcohols stem from the fact that they seem to increase the frequency of seizures in epileptics, and children are especially sensitive to the gastrointestinal side effects, possibly due to their propensity for bingeing on sweet foods. Children who regularly consume sugar alcohols also seem to have an increased incidence of childhood obesity.105

Erythritol Stands Out

Many sources seem to peg Erythritol as the safest, easiest to use sugar alcohol.

Erythritol is the easiest to digest, with up to 90% absorbed by the small intestine before it can enter the colon and cause digestive distress. It is heat stable so can be used for baking, and it’s a white powder that people can understand when they sub it for sugar.

Ben Fuchs, a pharmacist, deems xylitol the best sweetener for diabetics.

How to Use Sugar Alcohols

More than using them, it’s important to know where they’re already used in packages, if you ask me, especially if they give you pause as a class of sweeteners.

Erythritol, for example, is often blended with other  natural (stevia) and artificial (aspartame) sweeteners and tends to be the main add-in in those stevia baking blends. You think you’re buying stevia, but you’re really buying erythritol enhanced with a little stevia, since it’s not as sweet as sugar.

Xylitol is equally as sweet as sugar, so you can use it with a 1:1 ratio. It is heat stable and can be used in baking. (But it’s more likely to cause gas/diarrhea/bloating.)

In packages, you’ll find it everywhere in toothpaste, “natural” or not, plus quite often in gum and medicines.

I’ll address my experiences with the alternative/sugar alcohol blends HERE.

Have you had good luck using sugar alcohols?

Find the rest of the Sweet, Sweet Summer series HERE.

Sources: WAPF, Organic Lifestyle Magazine, Rebecca Wood, Andy Bellatti, Calorie Control, Livestrong, Body Ecology

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55 Bites of Conversation So Far

  1. Gidget via Facebook says

    Well said. I have my doubts about sugar alcohols too. My favorite is still good old honey. I do also use evaporated cane juice in small amounts.

  2. Jessica says

    There is a label loophole. I think that they can get away with saying zero calories if the item has less than 5 calories per serving.

  3. says

    I just recently found out that my daughter’s organic whole foods vitamin has a high concentration of lead (what the??!!!!). So, I ordered her some of my brand, which is Vitamin Code”, only to find out that they have the Xylitol, which I already knew was something artificialish.

    Do you have any suggestions for a good vitamin source or regimen for young children (she is 19 months). We alrady take cod liver oil and sambucus, and I am going to start using probiotics, and I learned that you don’t get a wide spectrum just from yogurt or other fermented food. Thanks!

    • says

      I really don’t, so sorry! But I think if xylitol was in a vitamin in small amounts, I might look the other way. ??? It doesn’t seem like it’s nearly as bad as artificial sweeteners, although I’d rather see stevia as a sweetener.
      :) Kati

    • Jean C. says

      Healthy children dont need all those supplements. I cant imagine that cod liver oil is helpful or that a healthy child needs extra vitamins which can be so hard on the system. Why not let nature take its course and act only if a problem arises.

    • Jane says

      I always look for xylitol in my chewable vitamins because it is good for your teeth, I buy the childrens vitamins specifically for that reason.

  4. says

    Xylitol is good for brushing teeth (i use it in a 60/40 blend with baking soda) and i’m comfortable with having it as a sweetener for gum.

    I’ve tried using it as a food and it doesn’t work for me. I used it as a sweetener for ice cream. Even tho all the ingredients were wholesome, the result was not and it tasted like Cool Whip. It was a huge disappointment, and i developed severe gastric problems as well. So, i stick with using it for tooth powder. I like stevia.

    It is my understanding that while xylitol was originally from birch, most of it is now from corn.

    • Farhaana says

      Oh great! Does this mean that most Xylitol is GMO, since most corn is now too?
      I have just started using it make a tooth powder for my family. (I don’t think the kids would go for straight baking soda :)
      I have also started using xylitol gum…although after some of these comments….hmmm

      • says

        I would probably look for organic. Mine is not marked as organic, but it is from NOW brand, which generally has a good product.

        I suppose i should worry more, but i use so little of it. (I’d much rather have even a GMO Xylitol to brush my teeth – i don’t swallow it! – than any commercial toothpaste out there. I am severely sensitive to fluoride and many of their other ingredients.

  5. Devion says

    Hi! I’m new to your blog via Diaper Diaries. Interesting that I stumbled upon your blog when you had this post. I am allergic to all of the “sugar alcohols” as well as aspartame. I’m tellin’ ya…it’s getting TOUGH to find products without some form or another of artificial out there! I struggle to find toothpaste and usually have to settle for toothpaste with sodium sacchrine in it, because that is what I’m *least* allergic to. The only gum without artificials in it is the original Dentyne, which is nearly impossible to find. With all of the crazy sweeteners people are filling themselves with, it is no wonder the health problems plaguing our world!!! I’ll just stick with my God-made sugars! :)

  6. Kathleen K says

    Thanks Katie, I’ve been wondering about these. I think I’ll just stick with one of my usual rules: if I can’t make it in my reasonably equipped kitchen, I shouldn’t eat it. The fact that some of these make animals so sick should tell us something! If enough people refuse to buy a product, the companies will eventually change. (Remember “new” Coke?)

  7. says

    Everyone, as we consider the artificial sweeteners in gum, and try to weigh if they are good for us, please remember that almost all gum is itself PLASTIC. In fact, it is a plastic that Canada tried to ban, because of potential health concerns, but the gum industry was strong enough to win that battle. So, the sweetner in gum is only one problem–bigger to me is the unhealthy plastic components we are chewing on and leaching into our bodies!

    If you don’t believe me, see the following:



    I know Trader Joe’s had a real natural gum base gum, sweetened with sugar. Fine for your body, not so much for your teeth. ; ) So, I guess everyone has to choose what they think is best for their bodies, but I would just like to throw out the idea that we should really not be chewing gum at all, just like we should be weaning ourselves from so much sweet in our overall diets.

    • says

      Whoops–after looking it up, the Trader Joe’s gum is Glee Gum, mentioned in the second link. So, there is possibly still some plastic in that one too.

      I used to enjoy gum, and now just can’t even bear the thought of putting it in my mouth. Or my kids’!

    • Katie says

      I agree! Nothing really helpful about gum, and I heard Jordan Rubin speak and say that we have a certain amount of saliva digestive enzymes for our lifetime, and gum uses them up! So you ultimately harm your digestion processes, big time, by chewing gum.
      Thanks for reminding us!
      :) Katie

  8. Christine Robinett says

    the source syrups these are synthesized from all come from HFCS (high fructose corn syrup) even the Lactitol, and I guarantee you the syrups are GMO derived. Also watch out for Erythorbic Acid which is used to preserve freshness as it is approved for fresh vegetables and fruits at salad bars.

    ii’m planning on making my own dentifrice and stop chewing gum even thoug it’s only occasional for dry mouth when I can’t get water/ run out. I don’t make a regular habit of chewing gum.

    Waging “war” on our food supply is a backdoor war on women’s rights in an attempt to force us to stay home and out of the workforce.

  9. Maureen says

    I’d like to mention a risk with xylitol that not many people are aware of: Xylitol is *extremely* toxic to dogs. Dogs digest xylitol differently than humans, even a small amount can cause a rapid drop in blood sugar resulting in liver damage and even death. With so many products such as gum, candy and baked goods containing xylitol, if you’re a dog owner you need to be aware of this. My yellow lab (who will eat ANYTHING) ate a pack of gum containin xylitol that he found in my purse. Not having any idea of the dangers of xylitol, I induced vomiting but called my vet just to be safe. He had me immediately take him to the emergency vet hospital for treatment and monitoring. A couple of thousand dollars later, my lab was okay, but it was an expensive lesson to learn. A simple internet search of “dogs and xylitol” convinced me there should be warning labels on products containing xylitol and we would never have this product in our house. Even two sticks of gum is enough to kill a small dog. If it’s not good for my dog, it’s not good for my family.

  10. Kathy says

    Donna Gates/Body Ecology Diet does think non-GMO Erythritol is ok and that candida do not feed on it. She also sells a blend of non-GMO erythritol and lo hanguo. I currently use Erythritol & stevia as my sweeteners and they have done well by me. I buy them seperately then blend myself so that nothing else is hidden in them. Truvia lists “natural flavors” in the ingredients, whatever they are. I can’t use any type of sugar.

  11. Deborah Jennings says

    I am so excited! I found Stevia in my grocery store here in Texas and they have it in the big bags! There was also some Stevia “raw sugar”. I didn’t look at it real close as I was looking for Wheat Germ. Wasn’t even on the same isle. Silly me thought it’d be on the baking isle. Nope, on the cereal isle.

    • Katie says

      Just be careful – much stevia in grocery stores has a ton of additives…the “stevia in the raw” is likely no good…sorry to burst your bubble!
      :) Katie

      • Deborah Jennings says

        Katie, my bubble wasn’t busted. But I didn’t have time to look at it any closer than the outside of the package. I would check it out before I even put it in the cart. I am becoming a major ingredients reader. LOL And hubby reads how much of what is in it. He is diabetic and has chronic and acute pancreatitis, and I am pre-diabetic. He can have limited amounts of sugar and no sugar alcohol.

  12. Ash says

    So glad you mentioned Xylitol and dogs (and Maureen mentioned it above) my husband is an ER vet and he sees so many dogs come in having eaten a pack of sugar free gum or toothpaste containing xylitol. It’s extremely toxic and often leads to a terrible outcome.

  13. Laura in SC says

    Katie, thanks for such a well researched article on the alcohol (free) sugars.
    The only real experience I have had is a couple of times I bought some candy that was sweetened with a couple of the alcohol sugars, sorbitol was one, and for the next 4 hours or so I had the biggest stomach growlings of my life followed by a real unpleasant blow out. The first time I thought it might have been something I had eaten earlier. The second time I knew what had caused the distress both the first and second times! That candy was so tasty, too.
    The other reason that gives me pause about using them is that xylitol is so poisonous to dogs and we have 2 that are precious. And 5 cats. I haven’t researched what it does to cats.
    Xylitol might be a good ingredient for formulating toothpaste due to its ability to ward off cavities, but I don’t think I would use it in my foods. I use toothpaste from Tropical Traditions and like it very much. I’m glad I haven’t chewed gum since the good ole days. I think artificial sweeteners are poison and I can’t stand the after taste even with stevia. I just try to use less sugar and other natural sweeteners.

  14. says

    Great post! I am grateful for the amount of research you put into all your posts.
    My husband and I cut sugar and artificial sweeteners (along with quasi-artificial and stevia) from our diet (with the exception of a very occasional treat) and have never regretted it. Using sugar replacements only maintains the sweet tooth and who knows what else it is doing in the body.

  15. Wendy C says

    This particular article on sweeteners piqued my interest. My toddler and I use xylitol-based toothpaste, and I use xylitol mouthwash and mints as well. I am concerned about the safety of this sugar alcohol, but I still think this is the better alternative to using fluoride-based dental products. But, it is an ongoing search as to which xylitol-based dental products are safest to use.

  16. says

    I have been completely sugar free for almost a year (on full-GAPS diet). At a recent doctor’s appointment, my doctor told me my B12 level was too low (it was in the 200’s and he wants it over 800), so he suggested 5000mcg of sublingual methyl-b12 daily. I couldnt find a single sublingual b12 supplement without a sugar alcohol. The one I chose has xylitol, but I am hoping it must be a small amount, and hoping that since it is disolving in my mouth that it won’t cause too much damage to my digestive system. Any thoughts?

    • Katie says

      I agree – I don’t think xylitol is truly dangerous, especially compared to low vit B12…I’m sure it’s a small amount in the sublingual. Hope it gets your levels back where they need to be! :) Katie

  17. Deborah Jennings says

    I take the B-12 sublingual liquid. The only other way I have ever taken it is a shot once a month.

    I do know that low B-12 caused my uncle’s children to think he had Alzheimers disease. They finally got him in to see a doctor and he was real low on his B-12. After a couple of months, he was almost his old self.

      • Deborah Jennings says

        This is what is listed under the B vitamins. It says it is a fast acting formula. I don’t know what some of these things are and need to ask hubby. He knows all this stuff.
        In a base pf distilled water, vegetable glycerine, sorbitol, citric acid, sodium bicarbonate, fruit flavors and sodium benzoate.

  18. Jan J. says

    Another sugar I don’t see mentioned often is coconut sugar – I LOVE this stuff and it is supposedly low glycemic – 35 – and is not really processed, just dried. It makes an amazing coffee – like adding caramel. I use Madhava Organic and I do mix it with stevia as I am diabetic and don’t want to get too much, but it is sustainable, organic and pretty much unprocessed, so that makes me happier about using it.

  19. Mish says

    Just a note–to the other gum-chewers out there–Glee Gum is pure cane sugar. It’s the only gum I can find around here anymore that doesn’t have any questionable stuff in it…and I can only get it at the little local dry goods store. (Yes, I know–gum chewing is bad for you, but it’s either that or start smoking again!)

    Thank you, Katie, for confirming what my stomach already knew (the hard way)–that anything that is manufactured in a lab isn’t going to work around here. I avoid these sugars like we do Nutrasweet and Splenda…for good reason!

  20. Jesse says

    People that keep talking about how xylitol is bad for pets…Please stop commenting. Because it sounds like u shouldn’t have a pet in the first place. ANY SUGAR IS DANGEROUS FOR PETS BECAUSE THEIR BODIES ARE NOT BUILT LIKE OURS TO ABSORB SUGARS. I hope none of you people feed your pets chocolate chip cookies then u will really see a big medical bill.

    • Katie Kimball @ Kitchen Stewardship says

      True, Jesse, but I think xylitol could be a danger if the pet gets into toothpaste on accident – not that these pet owners are feeding their pets human food at all. :) Katie

  21. Lesley says

    I am starting my diabetic cat on liquid B12 comples for his peripheral neuropathy. I noticed sorbitol is on the list of ingredients. He needs 4 cc’s a day. Should I be concerned?

  22. dp says

    I can’t believe this isn’t getting more attention. All of these are slowing making there way into all types of food products. To make things worse they are in most of the products sold to alive the problems they cause. I am basing this on personal experience, so it may just affect me, but I believe this is the root of all the gi ailments they come up with new cool names for like celiac disease, gluten intolerance,etc. I am 99% certain they were the cause of progressively worsening gut issues I experienced over the last 6-7 years. I got much better when I removed all the food and drinks containing any of them from my diet (too many items to list, but stevia soda and dentyne fire gum for example). Pretty much completely gone after finally finding and eliminating it from my toothpaste and hair gel (yes, sorbitol). Why does Sorbitol have a msds sheet as a pesticide???
    One other note. I thought it might be responsible for my vitamin/mineral malabsorption issues also. Putting it in vitamin supplements must be great for repeat business. Complete elimination of these and other fake sugars along with an iodine supplement and I feel leaner and healthier than I have since childhood. I will hardly eat out for fear of it being in the food, but it is so worth it.
    So glad I woke up to this.

  23. Diana says

    I was freaked out for a minute there by the comment from Westin Price that using sugar alcohols will immediately kick a person out of ketosis. I have been maintaining ketosis for a little over a month now and just started using Xylitol. Luckily I have a monitor which tests for ketones in my blood and so far I have still maintained ketones will within the range considered as being in ketosis. I am making a strong effort to retrain my palate to not require sweets but sometimes really really enjoy a treat!!

  24. Yvonne says

    I experienced major problems with gas for several months but the problems disappeared on a recent trip. When I returned home, the problems returned. After much thought, I realized a major difference was the sweetener I was using in my coffee, which is mostly Erythritol. I have eliminated it from my diet and all is now good. I can’t believe how long I suffered before I figured this out.

  25. says

    Katie, Thanks for this topic. Yes, I have tried it once after spending a small fortune to buy a small bag. Taste could fool ya but I definitely got the gas and bloating and diarrhea. I am definitely not going down that path again! Especially after doing a search on it and discovering it has a !hazard! warning on it on its Wikipedia page – made me take a double take. I will use non-GMO sugar or honey. That’s all now. Just use it in moderation and be done with it. As for the corn point, it does raise sugar levels in the body so at least some of it is absorbed – it is horrible on diabetics too, though we splurge on it sometimes and have corn chowder. Makes me think though that even though they say fake sugars doesn’t make a difference in the glycemic index, that, as the Weston Price Foundation shared, something gets absorbed for it to be making a difference in other areas. Good research and writing Katie from another good perspective! Keep it up! -Sherra

  26. says

    My friend does not belive that setvia sweetner is heathy, only start from a plant. My Mom use’s Trim heathy Mama sweetner that’s called Thm. I really want to know is there are some other stevia sweetners or there are just one that some people just put bad stuff in it that can cause people cancer.

    • says

      There are LOTS of kinds of stevias. You can even grow your own plant and make extract just like vanilla extract! I’d recommend looking into liquid stevias (Sweetleaf and NuNaturals are good brands) or making your own. That’s the most unadulterated version. :) Katie

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