Erythritol vs Maltitol: Which Sugar Alcohol Actually Makes Sense for You?

Glycemic Impact: The Key Difference

It’s the most important thing to know for people with blood sugar concerns.

Erythritol’s glycemic index is zero. It’s not going to affect your blood glucose level, it’s not going to cause your body to produce insulin, and it’s not going to count against the net carbs you have to keep track of when following a ketogenic diet. Why? Because it’s a simple structure that’s absorbed in the small intestine and then passes through without being altered on its way out through your urine. It doesn’t get broken down and there’s no glucose to reach the blood.

By contrast, maltitol is metabolized. The GI of powdered maltitol is 35 – still lower than sugar (60 to 65), but it will raise your blood glucose levels. Maltitol syrup (often used in lower-cost sugar-free products) has a higher GI of 52. Almost as high as sugar.

Why maltitol doesn’t belong in keto:

Many foods labeled “keto-friendly” or “diabetic-friendly” are sweetened with maltitol. This is deceptive for a few main reasons:

• Maltitol does increase blood sugar and stimulate some insulin
• At the Glycemic Index (GI) of maltitol syrup (52), a large serving will increase glucose close to the same amount as sugar
• It’s not correct to count maltitol as zero net carbs like erythritol
• Type 1 diabetics must consider maltitol when they’re administering insulin

If you want to control your blood sugar, the choice is overwhelmingly erythritol.

Maltitol vs Erythritol Side Effects: Digestion

Both can cause digestive issues. However, how and at what point.

Erythritol’s digestive profile:

Erythritol is mainly absorbed in the small intestine, instead of making it to the large intestine, which means it doesn’t ferment as strongly as other sugar alcohols. That’s why erythritol is better tolerated on a per gram basis than sorbitol, xylitol and maltitol. Orally, up to about 1g per kg bodyweight, it’s well tolerated. If you go higher, you may feel sick or have diarrhea.

• Good example of a problematic dose: greater than 50g of a single sitting for most people
• Typical daily dietary use (5-25g): generally well tolerated
• Cardiovascular trial doses of 30g are at the high end of expected servings

Maltitol’s digestive profile:

Maltitol is partially digested in the small intestine (and some glucose is released) with the remainder ending up in the large intestine where it is fermented by the microbiota. This results in gas formation and bloating, cramping and diarrhoea at high consumption levels. Most people find that maltitol is more likely to cause GI symptoms than erythritol, on a gram-for-gram basis.

• Most people: 20-30g per day for symptoms to occur
• More likely to cause laxative effect than erythritol at the equivalent dose
• Dependent on dose and can vary from person to person

Practical comparison:

Neither gives you licence to eat as much as you like. But to avoid digestive disturbances, the fact that erythritol is absorbed means it’s more likely to be tolerated. The type of “sugar-free” foods most likely to upset your stomach are those containing high per-serving levels of maltitol or sorbitol (think cheap sugar-free chocolate).

On the Erythritol Heart Study: Here’s What You Need to Know

A study at the Cleveland Clinic, published in Nature Medicine in 2023, reported individuals with the highest blood concentrations of erythritol had about 2 times the risk of major cardiovascular events (heart attack, stroke, death) than individuals with the lowest concentrations over a 3-year period. In 2024, the same researchers published an intervention study in the journal Arteriosclerosis, Thrombosis, and Vascular Biology showing all 20 healthy adults had hyperactive platelets after consuming a beverage containing 30g of erythritol. Erythritol blood concentrations spiked 1,000-fold and took several days to normalise.

It’s important, and it shifted the debate about erythritol. But it’s not as straightforward as frightening headlines imply:

Why you should be concerned:

• The association in the large cohort was reproducible
• Platelet effects occurred in 100% of the intervention study participants
• Erythritol’s unusual pharmacokinetics result in blood concentrations surging rapidly and remaining high longer than other sugar alcohols
• The same authors also observed comparable effects with erythritol’s cousin, xylitol

Arguments for keeping perspective:

• Association, not causality, is seen in observational studies. High blood concentrations of erythritol in individuals may be due to increased endogenous production (erythritol is a byproduct of the pentose phosphate pathway in human metabolism)
• The 30g dose used in the intervention study is towards the high side of single serve so it’s greater than most
• Another 5-week study in obese patients consuming erythritol had no effect on blood vessel function, intra-abdominal fat or glucose tolerance
• The commercial use of erythritol for 50+ years has not resulted in clear causal cardiovascular injury
• The blood from the first cohort was drawn between 2004 and 2011, well before the popular use of erythritol in the US, so the high levels in these high-risk patients may not be due to dietary erythritol intake

What this means practically:

• People who are healthy, and use erythritol in reasonable amounts (a couple of grams in coffee, baking every now and then), don’t need to worry
• Those on anticoagulants or with cardiovascular disease or blood clotting disorders may want to avoid high-dose erythritol products until we learn more
• High doses of erythritol in “keto-compliant” ice creams or pastries (you could potentially eat 20 to 30g in one go) is something to think about, but not sweetened coffee
• There’s no similar research concern about maltitol for the cardiovascular system

Masterchef: Maltitol’s Dish in Terms of Taste

This is also where maltitol really shines when compared to erythritol and why it continues to be used (despite the glycemic issues mentioned above) in food.

Erythritol’s taste issues:

• Has a minty, cooling effect in the mouth due to its endothermic nature (dissolves with heat absorption)
• This is a good thing for minty products but a distraction for chocolate, coffee, bakery products or those with no distinct flavour
• Doesn’t brown like sugar, so can’t be used for caramel in many recipes
• Tends to re-crystallize in some applications
• Not as soluble in cold liquids as sugar

Maltitol’s texture advantages:

• Similar sweetness and taste as sugar, 75 to 90% sweetness
• No cooling effect and tastes like sugar
• Hygroscopic, or moisture-holding, when used in baking to produce a softer texture
• The best choice for sugar-free chocolate, the only widespread sugar alcohol that behaves like chocolate with no off-tastes
• More thermostable than erythritol in many cases

Specific use case guide:

• Sugar-free chocolate: maltitol, no realistic, equivalent alternative with erythritol
• Granulated for coffee or tea: erythritol, or erythritol-monk fruit blend
• Keto-friendly baking: erythritol or blends with erythritol, maltitol defeats the keto goal
• Healthy confectionery (diabetic): erythritol if you want to control blood sugar
• Mint gum or candy: either is fine, cooling effect of erythritol not as much of a factor
• Protein and energy bars: depends on your goal, they often use a combo

Which One is Right for You

Either is better than sugar for some. Neither is right for everyone.

Erythritol is the better choice if:

• You’re closely monitoring blood sugar levels or on a keto diet
• You want almost zero calories with no GI effect
• You’re not using it in products where the cooling or chilled taste is an issue (coffee, many smoothies, some bakery products with strong tastes)
• You want the sugar alcohol that’s least likely to ferment
• You have a low risk of heart disease and you’re not using a lot

Go with maltitol if:

• You’re preparing (or purchasing) sugar-free chocolate and texture is important
• You need a sugar-like taste and function in baking
• You don’t want to use erythritol because of the heart disease studies
• You don’t mind the moderate impact on your blood glucose and it suits your eating plan
• You care more about taste than having a zero GI

Avoid or limit both if:

• You’re on a strict ketogenic diet (maltitol will boot you out of ketosis for significant doses, erythritol can be consumed at this point, but consider the cardiovascular concerns)
• You have IBS or a sensitive stomach
• You’re eating substantial quantities of processed “sugar-free” foods containing either

A Word on Maltitol Syrup vs Maltitol Powder

This is an often-missed ingredient on labels. These are alternate forms of the same substance with different glycemic index (GI) values:

• Maltitol powder: GI approximately 35, much lower than sugar, has a smoother texture, ideal for diabetic-friendly products
• Maltitol syrup: GI around 52, closer to sugar, more cost-effective (often in cheaper sugar-free products)