Speaking of erythritol, it has really been called the "top class" in the sugar substitute industry in recent years. If you go to the beverage freezer in a big supermarket or a small convenience store, you will find that at least half of the "Sugar-free sweet drinks" all use erythritol as a sweetener. The zero-calorie and ice-sweet temptation is undoubtedly the first choice for most friends who are greedy and afraid of getting fat.

The information conveyed by the slogans in the beverage industry is generally as follows: erythritol, a healthy sweetener from natural sources, has almost no calorie burden, will not affect blood sugar fluctuations, and is not easy to cause gastrointestinal discomfort... buy it!

　　However, recently the authoritative British journal "Nature" sub-journal "Nature Medicine" published a study in charge of the Cleveland Clinic (Cleveland Clinic), a well-known medical research institution in the United States, indicating that the commonly used artificial sweetener erythrose Alcohol may speed up the formation of blood clots, increasing the risk of stroke and heart attack.

This view quickly triggered discussions and controversies in the industry about whether erythritol is really harmful. Today, let’s popularize this “red” sugar substitute erythritol for several years, and how we should treat it.

　　What the hell is erythritol?

　　Compared with other sugar alcohols, it has 4 advantages

　　Erythritol, which is used as an additive in food, uses glucose as the main raw material, and is fermented into erythritol by Candida lipolytica, Mycocystis sp. Food additive erythritol crystal product.

　　Unlike "non-nutritive sweeteners" such as aspartame, erythritol, similar to other sugar alcohol sweeteners, is a "nutritive sweetener", that is, it does not completely provide energy after consumption.

Since it is not zero-calorie, why does erythritol stand out among various sugar alcohols and be popular?

Because of its 4 advantages:

　　Low energy: only 0.21kcal/g (5% of sucrose calories), significantly lower than other sugar alcohol sweeteners.

Xylitol is 2kcal/g (50% of equivalent sucrose calories), and maltitol is 2.1kcal/g.

　　High sweetness: The sweetness is higher among nutritive sweeteners, second only to xylitol and maltitol.

The sweetness of erythritol is equivalent to 60%-80% of the sweetness of an equivalent amount of sucrose, and it can produce a mild cooling effect in the mouth without the common "aftertaste" of some sweeteners.

　　Natural: Widely present in natural vegetables, fruits (such as melon, watermelon, pears, grapes, etc.) A single dose of no more than 35 grams) is not likely to cause gastrointestinal symptoms such as flatulence, diarrhea, and nausea.

Its maximum non-diarrheal dose is significantly higher than that of other sugar alcohols (take xylitol as an example, it is 2 times that of xylitol. That is to say, if you want to cause the same gastrointestinal symptoms, you need to consume more than 2 times the dose of xylitol erythritol).

　　Good for oral health: Erythritol cannot be transformed by bacteria in the oral cavity, will not cause dental caries, and is beneficial to the oral health of children and adults.

　　At the same time, it has the advantages of other sugar alcohol sweeteners, that is, the metabolic pathway has nothing to do with insulin, and the average glycemic index and insulinemia index are 0 and 2 respectively, which will not cause blood sugar fluctuations. Friends with diabetes are friendlier.

　　In addition, previous small-scale, short-term human studies, as well as in vitro and animal experiments found that erythritol can help delay gastric emptying and hunger, and help improve the level of glycated hemoglobin HbA1c and small Vascular endothelial function.

Therefore, it is believed that erythritol has potential anti-diabetic and anti-obesity effects, and is the preferred sugar substitute for diabetic patients.

　　How safe is erythritol to eat?

　　Inventory related official information

　　In June 1999, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) established the Expert Committee on Food Additives (JECFA, an agency that assesses the safety of food additives) approved the use of erythritol as an edible sweetener, and There is no need to specify the Acceptable Daily Intake (ADI for short, which refers to the amount of this substance that a person can safely consume each day for a lifetime).

　　In 1997, erythritol was certified by the US FDA as a safe food ingredient GRA, and the label "beneficial to dental health" is allowed to be marked on the food packaging containing erythritol in the United States.

　　After 2001, the US FDA gradually approved the use of erythritol in various foods as a sweetener, stabilizer and thickener, such as bakery fillings, cakes and biscuits, frozen dairy desserts, puddings, yogurt , chewing gum, candy, and low-calorie drinks.

　　In 2003, the European Food Safety Authority EFSA approved the use of erythritol as a food additive to be safe, and a few years later allowed the use of erythritol in all foods.

　　In my country's national standard "GB 2760-2014 Standards for the Use of Food Additives", the use of erythritol does not specify the maximum amount of use as it does for sweeteners such as aspartame, acesulfame potassium, and steviol glycosides. Note, but a simple sentence: "It can be used in appropriate amounts in various foods according to production needs."

　　At present, erythritol has passed the safety assessment of international authoritative organizations and multinational regulatory agencies such as Codex Alimentarius Commission, US Food and Drug Administration, EU Food Science Committee, Australia New Zealand Food Standards Agency, etc., and can be used as a food additive in production middle.

　　Is it reasonable to question this type of research?

　　Are there holes in the research itself?

　　Let’s go back to the controversial research article. Nearly a week after it was released, stakeholders questioned it one after another, pointing out that the research has limitations, and there is no need to panic to appease consumers.

The reason is: it is only a prospective study, only involving correlation, not causality; the research subjects are mainly middle-aged and elderly people with high cardiovascular risk, and it is not universal; in the experiment of 8 volunteers, 30 In the daily life of Asians, it is difficult to eat so much erythritol by eating processed foods such as biscuits and coffee cubes containing erythritol.

"It's very difficult to reach the intakes in the study without eating a very large amount of food at one time."

In volunteer experiments, although the plasma erythritol level rose sharply, it did not remain high for a long time, and it dropped significantly the next day, and returned to normal levels within 7 days...

　　I read the original text carefully, and also carefully searched some studies and reviews on erythritol. I feel that the overall design of this "research" in "Nature Medicine" is relatively rigorous, and the discussion is relatively in-depth, and it is not so unbearable. .

However, the research team did not collect detailed dietary history in the cohort study.

The amount of erythritol circulating in the blood does include both natural food sources and exogenous intake in the form of food additives.

Therefore, in the absence of a dietary history, it is indeed not possible to directly equate blood erythritol to exogenous intake.

However, the research team has a rigorous and clear statement on this aspect, and did not assert that the amount of blood erythritol is taken in the form of sugar substitutes.

　　We can understand that this is just a possibility and a warning put forward by the research team.

As for whether this possibility can be concluded as a causal relationship, more high-quality human studies are needed to explore and confirm.

Although previous remarks have almost overwhelmingly praised erythritol for its "more benefits and fewer harms", there is almost a complete lack of long-term controlled clinical trials supporting erythritol as a "beneficial dietary ingredient"-this point, in many studies on erythritol Trials and reviews of thucitol are mentioned.

Is erythritol really beneficial to us without any harm?

Sorry, can't say yet.

　　Can erythritol sugar substitute drinks still be drunk?

　　Avoid "drinking a lot" and "drinking continuously" at the same time

　　So the question is, since there is no conclusion, can erythritol sugar substitute drinks still be safe to drink?

My personal answer is: to drink, to drink in moderation, and to drink selectively.

　　As the authors of this research article concluded, although continued erythritol intake was found to be associated with a risk of major adverse cardiovascular events and contributed to thrombosis, more research is needed to confirm the "causality" ".

At the same time, more research is needed on the safety of various sweeteners to ensure that what we eat is not a hidden danger of cardiovascular disease, especially for people at high risk of cardiovascular disease.

　　Therefore, for friends who are already at risk of cardiovascular disease or have been diagnosed with cardiovascular disease, when you drink this type of beverage containing erythritol, try to avoid the simultaneous occurrence of "a large amount" and "continuous".

For example, if you want to drink today, you can choose a 200-300ml capacity, but don't choose a 550-600ml capacity.

　　For friends who have no risk of cardiovascular disease or family history, you may be able to relax a little bit in terms of single drinking amount and drinking frequency.

However, it is still necessary to hold a relatively cautious attitude to avoid large and continuous.

　　Regarding sugar substitutes, zero-calorie sugars and their foods

　　A few must-know notes

　　1. Sugar-free drinks and "sugar-free foods" flavored with zero calorie sugar cannot lose weight.

　　It just helps us control our energy intake from that bottle of fluid, not from all the food we eat and drink.

What's more, some foods and beverages that use sugar substitutes as sweeteners may themselves be high in carbohydrates and/or high in fat.

The use of sugar substitutes does not fundamentally reverse the reality of their own energy "bombs".

　　2. Low-calorie or zero-calorie sweeteners are not a perfect solution to added sugar.

　　With the increase in the amount and number of years of use of sugar substitutes by humans, relevant research continues to increase, and sugar substitutes have also been exposed to more and more shocking human health hazards or harm.

Although they may have their own advantages and disadvantages, just as added sugar has its own advantages and disadvantages, they cannot help human beings achieve "sweet freedom" after all.

Moreover, some sugar substitutes will even aggravate the "sweet addiction" of human beings, make human beings more addicted to sweetness, and induce us to eat more high-carbohydrate, high-fat, and high-calorie foods to satisfy The brain's need for pleasure with a rising threshold.

Thus, making us fatter and fatter.

If the use of sugar substitutes makes us more intemperate about food, it can only be a BE (sad end).

　　3. Sugar-free drinks should not be the main way of "rehydration" in life.

　　Clear water is the most precious liquid endowed by nature to human beings and all living things. We should cherish and make good use of it.

Of course, under the premise of individual tolerance, appropriate amount of tea, coffee, herbal tea, etc. can also be used as a supplement for pleasure.

　　Text/Liu Suiqian

　　(Science popularization worker, clinical nutritionist, member of Chinese Nutrition Society)