Is Erythritol Powder Good for Diabetics?

Excessive sugar consumption is one of the main causes of chronic diseases in humans, leading to high rates of diabetes, obesity, cardiovascular disease and cancer. At the same time, about 90% of people suffer from dental health problems due to a high sugar diet. Therefore, the development of sugar substitutes with low calories, low glycemic index and anti-caries properties is essential for health [1]. Erythritol is a four-carbon polyol widely found in fruits (such as grapes, melons, pears and peaches) and fermented foods (such as soy sauce, wine and beer). It is produced by the hydrolysis of aldehyde or ketone groups in carbohydrates and can accumulate as metabolites or compounds in algae and fungi [2-4]. As a low-calorie sweetener, erythritol does not stimulate insulin production, and is less caloric than traditional sugar. Due to its unique nutritional properties, it is beneficial for people with diabetes and obesity, and is therefore widely used in the food, pharmaceutical and medical industries [5].

Xylitol, mannitol, sorbitol and erythritol are four representative sugar alcohols. Commercial erythritol is mainly produced by microbial conversion of liquid culture media containing high concentrations of pure carbon sources. The liquid culture media can be selected from a wide variety, so erythritol is more popular with food companies than other sugar alcohols [6, 7]. In 2019, the global market size of erythritol erythritol market size exceeded 195 million US dollars, and is expected to grow at a compound annual growth rate of 6.5% from 2020 to 2026, which is significantly higher than the total output value of erythritol in 2017 (81 million US dollars). Due to microbial fermentation production of erythritol has a variety of carbon sources, such as glycerol, monosaccharides, xylose, molasses, etc. The production of erythritol through biological fermentation is selective and economical, so it can better meet the global demand for erythritol [7-9]. This article reviews the structure, physical and chemical properties, functional characteristics and application in beverage development of erythritol, with the aim of providing a reference for the functional exploration of erythritol and the research and development of sugar-free beverages.

1 Introduction to Introduction to erythritol

Erythritol has excellent structural and physicochemical properties, and is widely available, so it can be used as a sweetener, flavour enhancer, humectant, stabiliser and thickener in food [3, 6]. In addition the polyol also has the potential to be used as a platform chemical for the synthesis of butadiene, 1,4-butanediol, 2,5-dihydrofuran and tetrahydrofuran [10].

1. 1. The structure and physical and chemical properties of erythritol

Erythritol is a white powder or crystalline four-carbon polyhydric alcohol compound with the chemical systematic name of 1,2,3,4-butanetetrol and the molecular formula C4H10O4 (relative molecular mass 122.12). are shown in Figure 1 (from the open source database ChemSpider, http://www.chemspider.com/Chemical-Structure.13835932.html) [11]. Erythritol glycol is easily soluble in water, has a high osmotic pressure in solution, is hygroscopic, and has high stability to acids and heat. Its sweetness is about 70% that of sucrose, and it has a sweet taste that is not bitter aftertaste compared to other sweeteners, and can mask other negative aftertastes, such as astringent and strong irritating sweeteners taste [12-14]. Erythritol is usually present in an intermediate state, and because it has a high negative heat of solution, it has a strong cooling effect when dissolved [15].

1.2 Sources and synthetic pathways of erythritol

Erythritol in the human body comes from two sources: one is exogenous food intake, and the other is endogenous synthesis in the human body. Exogenous food comes from fruits, fermented foods, seaweed, fungi, etc., but because the content of erythritol is low, it cannot meet large-scale production [2]. Research on the endogenous synthesis of erythritol in the human body has progressed slowly. First, Hoot- man [16] and others proved that glucose in the human body produces erythritol through the pentose phosphate pathway. As further research, researchers found that sorbitol dehydrogenase and alcohol dehydrogenase 1 use the cofactor NADPH to catalyze the final step of glucose synthesis of erythritol (i.e., the conversion of red blood cells to erythritol) [17].

Currently , erythritol is now recognized as an ideal sugar substitute with broad application prospects in areas such as daily diet, pharmaceutical manufacturing, and special diets for obese or diabetic patients [18]. In recent years, the wide range of applications and interesting properties of erythritol have attracted increasing attention from the food and pharmaceutical industries. As a result, erythritol is rapidly gaining ground in the sweetener market. The industrial synthesis of The industrial synthesis of erythritol mainly includes chemical synthesis and biotechnological synthesis. Chemical synthesis mainly involves the catalytic conversion of organic acids and sugars (such as l-tartaric acid and starch bi-aldehyde), but this reaction process requires special high-pressure (4MPa~200MPa) and high-temperature (120℃ ~200℃) conditions [19]. In addition the chemical synthesis process often produces by-products such as sorbitol and ethylene glycol, resulting in low element utilization.

Therefore, low yields, high complexity and harsh operating conditions make chemical synthesis a production method that is not conducive to commercial application. Compared with chemical synthesis, the use of microorganisms to produce erythritol is considered a better production method [20]. technological process as a sustainable alternative, the industrial biotechnological production of erythritol using microorganisms has some unique advantages, namely suitable production conditions, the versatility of the substrates that can be used (including natural, non-natural and impure substrates), and the selectivity of the strains [21]. For example , various fungal strains of the genera Candida, Yarrowia, Torulopsis or Pseudocerevisia can convert these carbon sources to erythritol via the pentose phosphate pathway when the high osmotic pressure of the microorganism is caused by excess sugar, glycerol or salt in the extracellular medium [10].

2  Erythritol erythritol functional properties

erythritol as a natural sugar substitute, unlike other artificial sweeteners, has many beneficial functional properties and biological activities due to its unique structure and physical and chemical properties [22].

2.1 Low calorie, low insulin levels and its special metabolic pathway

As a sugar substitute that is naturally found in fruits, vegetables and fermented foods, erythritol does not affect blood glucose or insulin concentrations. Relevant studies have shown that acute doses of erythritol intake within the range of 20g to 75g will not affect blood glucose or insulin levels, regardless of whether the person is obese or thin, or whether they have diabetes[23,24]. According to According to the national standard for the energy coefficient of erythritol, Article 24 of the Q&A (revised edition) of the “General Principles for Nutrition Labelling of Prepackaged Foods” (GB 28050-2011) stipulates: “Given that sugar alcohols are currently used in some types of food, for the purpose of scientifically calculating energy, it is recommended that the energy coefficient of erythritol be 0kJ/g, and the energy coefficient of other sugar alcohols be 10kJ/g. Article 24 of the revised version of the “National Standard for Food Safety: General Rules for Nutrition Labelling of Prepackaged Foods” (GB 28050-2011) stipulates: “Given that sugar alcohols are currently used in some food categories, for the purpose of scientifically calculating energy, it is recommended that the energy coefficient of erythritol be 0 kJ/g and the energy coefficient of other sugar alcohols be 10 kJ/g.” [25].

Erythritol erythritol molecules consist of 4 carbon atoms, and compared to other common sugar alcohols such as xylitol (5 carbon atoms), sorbitol (6 carbon atoms) and mannitol (6 carbon atoms), erythritol molecules have a smaller spatial volume and lower relative molecular weight, and erythritol is absorbed through the small intestine by passive diffusion that is dependent on molecular size. Therefore erythritol is absorbed into the blood faster than sugar alcohols with a higher molecular weight. Once it enters the bloodstream, 80% to 90% of erythritol is not metabolised by the body and is excreted in the urine. After consuming 20 g of erythritol, about 90% of it is not absorbed by the body and is excreted in the urine within 24 hours, and about 80% is excreted in the urine within 24 hours after ingesting 1 g/kg of erythritol [22]. However , there is currently ongoing academic debate about the fate of the remaining 10% to 20% of erythritol and how it is utilized. However, in vitro experiments have shown that erythritol is completely resistant to bacterial fermentation within 24 hours. Therefore, based on the above data, it can be concluded that erythritol is mainly absorbed in the human intestine, not metabolized by the body, and excreted through the kidneys [26].

Regarding blood glucose and insulin levels after ingesting erythritol, Meyer-Gers- pach [27] and others conducted a randomized, double-blind, crossover trial on 50 volunteers. Erythritol was ingested as a 75 g solution in 300 mL of water, and blood samples were collected for testing of blood glucose and insulin levels. The results showed that erythritol had no effect on blood glucose or insulin levels. In addition, explore whether long-term intake of erythritol affects glucose absorption in obese patients, Bordier [28] and others conducted a randomized trial on 8 obese patients, causing them to take 3 g of erythritol 3 times a day for 3 w to 7 w. The results The results showed that long-term intake of the natural sweetener erythritol does not affect glucose absorption in the intestines of obese people, and also shows that erythritol can be safely consumed in terms of glucose absorption, as it does not affect the body's glucose homeostasis.

2.2 Beneficial effects on metabolic diseases such as diabetes

Diabetes is one of the fastest growing diseases in the world. In 2019, there were about 463 million people with diabetes worldwide, and this number is expected to rise to 51% by 2045 [29]. Diabetes is a group of metabolic disorders characterized by high blood sugar and a disturbance of carbohydrate, protein and fatty acid metabolism. Type 2 diabetes is the most common type of diabetes, accounting for more than 90% of all diabetes cases. It is mainly caused by a defect in insulin secretion, where the cells cannot use the insulin secreted by the pancreatic β cells, resulting in high blood sugar [30].

Compared with sucrose compared to sucrose, the effect of erythritol on blood sugar is negligible, so it is used as a sucrose substitute or sugar substitute sweetener for diabetics. At present, many many animal and human experimental studies have shown that the intake of erythritol has a beneficial effect on some indicators in diabetic patients [31–34]. The replacement of sucrose with erythritol in patients with type 2 diabetes can improve endothelial function and reduce aortic central stiffness. Endothelial dysfunction is involved in the pathogenesis of cardiovascular disease in type 2 diabetes and can predict cardiovascular events [35]. In summary erythritol may be a good dietary supplement and a preferred sugar substitute for the treatment of hyperglycemia, especially for patients with type 2 diabetes.

In addition to diabetes, the potential impact of erythritol on metabolic diseases such as obesity, cardiovascular disease, and hyperuricemia also needs attention. These metabolic diseases are often associated with multiple risk factors such as insulin resistance, elevated blood lipids and uric acid, and increased systemic inflammation [36]. Wolnerhanssen [ 37] and others showed that erythritol had no significant effect on blood lipids and uric acid concentrations when 12 healthy volunteers ingested it via a nasogastric tube over four study days. There were no abdominal pain, nausea or vomiting during the test. Being overweight or obese is a common metabolic disease. With the gradual acceleration of the fast-paced eating process, the number of obese people is increasing worldwide, and it is causing many potential health problems [38].

Studies have shown that intake of sugary drinks is significantly associated with body mass index and positively associated with the incidence of type 2 diabetes [39]. Therefore, replacing sucrose with erythritol as an artificial sweetener may be a solution to the problem of obesity or overweight. Gastrointestinal satiety satiety hormones are a group of hormones that control delayed gastric emptying, feelings of fullness, and signals for reduced food intake. They mainly include cholecystokinin (CCK), glucagon-like peptide 1 (GLP-1), and peptide tyrosine tyrosine (PYY), among others [40]. It has been reported that It has been reported that erythritol induced the release of CCK, GLP-1 and PYY in a similar way to glucose, significantly delaying gastric emptying. Recent studies have also shown that erythritol stimulates the secretion of human gastrointestinal satiety hormones [23, 37, 41]. In summary , erythritol may be a sugar substitute with no significant effect on metabolic diseases, and it may also help to a certain extent with blood lipids, uric acid and obesity.

2.3 Improving dental health and preventing tooth decay

Medical trials have been found to improve human dental health and prevent tooth decay. However, when it comes to these functional sugar alcohols, people often think of sorbitol or xylitol [42]. However, more and more academic studies have found that erythritol can also be used as an effective sugar substitute or sugar alcohol to improve dental health, and its properties are superior to those of sorbitol and xylitol [43–45].

Regarding the inhibition of plaque formation and bacterial growth, Ghezel- bash [46] and others studied the inhibitory effects of xylitol and erythritol on Streptococcus strains and the formation of Streptococcus biofilms. The results showed that erythritol was more effective than xylitol in inhibiting the growth and biofilm formation of the Streptococcus strains used in this study. In addition, erythritol erythritol was shown to inhibit the growth of cariogenic Streptococcus species isolated from paediatric dental plaque patients and plaque formation [43], possibly due to the passive penetration of erythritol across the cell membrane of bacteria and interference with their growth [47]; Falony [48] and others 485 local Estonian primary school students before and after 3 to 6 years of consuming erythritol candies. The results showed that compared to the control group (consuming potassium sorbate candies), children with mixed dentition who consumed erythritol had a preventive effect against tooth decay.

Erythritol In addition to improving human dental health, recent animal studies have shown that erythritol can also improve and prevent animal periodontal disease and inhibit the growth of related dental pathogens. For example, T io[49] and others have demonstrated through in vivo and in vitro experiments that erythritol can significantly inhibit the growth of Porphyromonas gingivalis, which is associated with periodontal disease in dogs, thus indicating that erythritol has a bacteriostatic effect on bacteria associated with periodontal disease in dogs. Xylitol, although is also a sugar alcohol that inhibits the growth of oral bacteria, but xylitol is toxic to dogs, and ingestion of xylitol can lead to hypoglycemia and liver failure [50]. In order to verify whether erythritol has a bacteriostatic effect on oral bacteria in dogs comparable to that of xylitol (erythritol is not toxic to dogs), Shimizu [51] and others isolated bacteria were isolated and the in vitro antibacterial effect of adding erythritol to oral bacteria was studied. The results showed that the antibacterial effect of erythritol on periodontal disease-related bacteria was comparable to that of xylitol.

3 Application of erythritol in beverage development

As mentioned above, erythritol has good physical and chemical properties and functional characteristics, so it is widely used in the development of zero-sugar or low-sugar foods, such as beverages, confectionery and baked goods. Currently, about 90% of erythritol is used in the beverage industry, mainly because it has a good taste, a mild sweetness and can be used in combination with other sweeteners when preparing sugar-free beverages [52]. Regarding the taste of erythritol Andersen [53] and Kim [54] and others have conducted sensory evaluations of sucrose replacement samples by trained sensory panels.

The results show that erythritol has sensory characteristics similar to sucrose, and can simulate sucrose to produce the same sensory taste. In addition, erythritol can be mixed with other sweeteners such as maltitol to better replace sucrose in acidic drinks. In addition erythritol is a sugar substitute with a relatively high feeling of satiety. Sorrentino [55] and others conducted a randomized double-blind crossover trial on a group of healthy non-overweight subjects. The participants consumed beverages containing erythritol daily, and the intake a beverage containing aspartame. The results showed that oral administration of high osmotic pressure erythritol in a non-caloric beverage can effectively induce satiety and suppress gastric hunger hormones. As for the intestinal tolerance of erythritol beverages, studies have shown that 4- to 6-year-olds who quickly consume 15 g (6% w/v) of erythritol beverage between meals have good erythritol drinks, studies have shown that 4- to 6-year-olds have a good tolerance to a rapid intake of 15 g (6% w/v) erythritol drinks between meals, and there is no significant effect on diarrhea or severe gastrointestinal symptoms [56].

Erythritol is mainly used in low-sugar or sugar-free drinks in the fields of tea drinks, carbonated drinks and functional drinks. In terms of tea drink research, Zhang Yanhong [57] and others conducted an experimental analysis of the effects of different sugars on the quality of oolong tea drinks. During the sterilization process, erythritol had the best protective effect on the color, vitamin C and catechins in the tea broth. During storage the storage process, erythritol also has the best protective effect on the color and polyphenols of the tea broth, indicating that the use of erythritol as a sugar substitute in beverages can improve the physical and chemical properties of oolong tea and the functionality of its active ingredients to a certain extent.

At the same time, erythritol has also been shown to be useful in making lemon green tea with a good taste and flavor[58]. And in lemon juice drinks, erythritol can not only be used as a substitute for sucrose or white sugar, but also to a certain extent, it can protect the vitamin C in lemon juice drinks. Gao Shengjun[59] and others have proved through relevant experiments that a 2% erythritol addition concentration can maximize the activation of the vitamin C degradation reaction in lemon juice during storage. In carbonated drinks drinks, Qiu Fanyu [60] and others used erythritol as the main sweetening additive in combination with sucralose to prepare sugar-free peach soda.

The optimal amount of erythritol was analyzed using a response surface method to be 34.2 g/L. Similarly, erythritol can also be used to improve the process formulation of coconut water. Gong Shenghua [61] et al. believe that 1.66% is the optimal amount of erythritol to add to coconut water drinks. In addition to the above In addition to the aforementioned studies on liquid beverages, erythritol has also been shown to be useful in the preparation of solid beverages such as low-sugar soy milk powder. Pourahmad [62] and others used erythritol in combination with the other two natural sugar substitutes to prepare soy milk powder with better organoleptic properties and excellent physical and chemical properties.

4 Conclusion and prospect

In summary, erythritol, as a natural sweetener, has unique structural and physicochemical properties. It is highly soluble in water, has a high osmotic pressure of the solution, dissolves well in cooling, and has high stability to acid and heat, with the characteristics of a sweetener. In terms of functional properties, erythritol has low calories, low insulin levels and a special metabolic pathway. It is not metabolized by the body and can be used to replace sucrose to also improve the potential harm of metabolic diseases such as diabetes. It can also prevent tooth decay and improve dental health.

The excellent structural, physical and chemical, and functional properties of erythritol have made it widely used in the food industry. Most erythritol is currently used in the development of beverage products, including tea drinks, carbonated drinks and functional drinks. However, the application of erythritol in the beverage industry is still in the exploratory stage. It is urgent to conduct in-depth research on the solubility of erythritol, the effect of its combined use with other sweeteners, and the development and utilization of its functionality throughout the beverage production process. These studies will further promote the development of the food and beverage industry in the direction of low-sugar and sugar-free products.

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