Erythritol vs Modified Food Starch: which is worse?

What is Erythritol?

Erythritol is a four-carbon sugar alcohol naturally occurring in small amounts in fruits, fermented foods, and mushrooms. Commercially produced via fermentation of glucose by yeasts such as Moniliella pollinis, it has approximately 70% of sucrose's sweetness, provides 0.24 kcal/g, and has a glycemic index of 0. It is nearly completely absorbed in the small intestine and excreted unchanged in urine, which explains its unusually low laxative effect compared to other polyols.

What is Modified Food Starch?

Modified food starch is starch (derived from corn, wheat, potato, rice, or tapioca) that has been physically, enzymatically, or chemically treated to alter its properties such as thickening ability, heat stability, or freeze-thaw stability. The term 'modified' refers to chemical modification, not genetic modification. Dozens of specific modifications exist, each designated with E numbers E1400–E1450 in the EU.

Documented risks

Erythritol: A 2023 observational study published in Nature Medicine (Hazen et al., Cleveland Clinic) found that elevated blood erythritol levels were associated with increased risk of major adverse cardiovascular events (MACE), including heart attack and stroke. Additionally, erythritol was found to enhance platelet aggregation in vitro. This study was widely reported and has generated significant scientific debate; critics note that it was observational (not causational), and that the study population had pre-existing cardiovascular risk factors. Regulatory agencies have not changed their approval status. The long-term cardiovascular implications require further research.

Modified Food Starch: Modified food starches are generally recognized as safe by the FDA and EFSA. Modified starches from wheat must be declared as allergens in the EU. Phosphorylated starch modifications (E1412, E1414) are permitted at specific maximum levels by EFSA, which noted no safety concerns at authorized levels in its 2017 re-evaluation. Concerns have been raised about the use of modified starch in infant foods — EFSA's Scientific Panel set conservative limits for infants. For healthy adults, dietary exposure via processed foods poses no identified risk.