The effect of erythritol on fructose absorption in healthy nondiabetic adults

Fructose is absorbed from the intestine by facilitated diffusion, but large doses of free fructose (≥) are often malabsorbed. Erythritol is a sugar alcohol that is well‐absorbed from the intestine, presumably via the paracellular route. The objective of the study was to determine if the simultaneous intake of erythritol enhances fructose absorption in healthy subjects. Methods Healthy adult subjects (n=37) consumed solutions of 50 g fructose and 50 g glucose (F + G), an equimolar mixture of 50 g fructose and 33.3 g erythritol (F + E), and 50 g of fructose (F). Arterialized blood samples from a heated dorsal hand vein were collected at baseline and for 3 hours postprandially. Hydrogen (H 2 ) breath tests were performed for 8 h postprandially to assess carbohydrate malabsorption. Results Breath H 2 area under the curve (AUC) were 1098±269, 4636±809, and 9611±1516 ppm ·min for the F+G, F, and F+E treatments, respectively ( P <0.05). Serum erythritol AUCs were negligible in the F and F+G treatments (0.3±1.0 mmol·min·L −1 ), but increased to 727.7±22.2 mmol·min·L −1 in the F+E treatment ( P <0.05). Serum fructose levels were 12 and 20% lower in the F+G and F+E groups, respectively, compared with F ( P <0.05). Conclusions The F+E treatment caused the greatest increase in breath H 2 , indicating the most carbohydrate malabsorption. While breath H 2 testing cannot distinguish which substrate is being fermented, the considerable rise in serum erythritol, coupled with the lower serum fructose AUC in the F+E treatment, suggests that erythritol was absorbed at the expense of fructose. Supported by Abbott Laboratories Ross Products Division