Glycemic index of sweeteners: xylitol, erythritol, stevia (table)

Sugar substitutes are usually lumped together under the label "healthy," but the differences between them are enormous. An analysis of data on glycemia and insulinemia after consuming polyols attributes a glycemic index of 0 to erythritol, 13 to xylitol, and 35 to maltitol, with 65 for sucrose (Livesey, Nutrition Research Reviews 2003). This range is significant for anyone monitoring their sugar intake, yet the label does not provide this information because the law does not require it. Below you will find a complete table with glycemic and insulin indices, energy values from the label in accordance with EU law, as well as what sweetener advertisements remain silent about: cardiovascular signals associated with erythritol and xylitol and consumption limits established by EFSA for children.

KEY INFORMATION
• Erytrol ma indeks glikemiczny 0, ksylitol 13, maltitol 35, a sacharoza 65 (Livesey, 2003).
• Erythritol and xylitol are associated in cohort studies with a higher risk of cardiovascular events.
• EFSA has established an acceptable intake for erythritol of 0.5 g per kilogram of body weight per day.
• Children exceed this limit with high consumption.

What is the glycemic index and why does it matter for sweeteners?

The glycemic index describes how quickly and how high a given carbohydrate raises blood glucose levels within two hours after consumption, on a scale where pure glucose is 100. For sucrose, international tables provide a value of 65 with a deviation of 4 (Atkinson i in., Diabetes Care 2008).

With sweeteners, this indicator becomes more important than with regular products, as the label rarely mentions it. Brand names emphasize naturalness or sugar-free status, rather than what the substance does to glycemia. Polyols, or sugar alcohols, are absorbed to varying degrees, and some of them do indeed enter circulation as a source of glucose.

Alongside the glycemic index, it is worth looking at the insulin index, which reflects the pancreatic secretory response. Livesey provides both in parallel, and the differences can be striking: the insulin response for erythritol is 2, while for maltitol it is 27. A person with insulin resistance who replaces sugar with maltitol under the impression that the polyol is neutral by definition is making a real mistake. We discuss insulin resistance more broadly in our post about apple cider vinegar and insulin resistance.

What glycemic index do individual sweeteners have?

The table below compares polyols according to one analysis, so the values are comparable to each other. The column with calories does not provide the measurement result in a specific product, but rather the conversion factor that the manufacturer must use on the label in the European Union.

The index values come from Livesey's analysis from 2003, and the energy coefficients from Annex XIV to Regulation (EU) No. 1169/2011, where polyols have 2.4 kcal/g, erythritol 0 kcal/g, and other carbohydrates 4 kcal/g. Steviol glycosides are not included in the table because they are not polyols and do not have an assigned index in this analysis. A meta-analysis of 29 randomized studies involving 741 people, including steviol glycosides, did not show an increase in blood glucose levels after consuming non-caloric sweeteners (Nichol i in., European Journal of Clinical Nutrition 2018).

Erythritol or xylitol: which to choose and for what?

In terms of glycemia, erythritol wins, as it has an index of 0 compared to 13 for xylitol, and a zero energy coefficient on the label. Erythritol is obtained through fermentation involving fungi Moniliella pollinis or Moniliella megachiliensis, is absorbed in the small intestine, and is excreted unchanged in urine, only being slightly converted to erythronate (EFSA, 2023).

Xylitol makes up for it in the kitchen, as it sweetens similarly to sugar and dissolves well in hot beverages. However, its reputation was built on its anti-cavity action, and this is where it is worth tempering enthusiasm. A Cochrane review included 10 studies involving 5903 people and found only one effect worth noting: toothpaste with fluoride and a 10% addition of xylitol reduced cavities by 13% compared to toothpaste with just fluoride, with low-quality evidence. For gums, tablets, and wipes, the evidence was deemed insufficient (Riley i in., Cochrane Database of Systematic Reviews 2015).

A separate issue concerns dogs, and this is not an overstatement. In a series of eight cases, after consuming xylitol, dogs were taken to the clinic with vomiting and bleeding, and were diagnosed with acute liver failure and coagulation disorders. Three animals were euthanized, and two died (Dunayer i Gwaltney-Brant, JAVMA 2006). If you have a dog at home, keep products containing xylitol out of its reach.

Does zero calories mean zero effects on the body?

No. This is the most important change in knowledge about sweeteners in recent years and also the one that is the slowest to appear on labels. Two major studies from the same team link both of the most popular polyols to the risk of cardiovascular events, while a third shows the impact of non-caloric sweeteners on the microbiome and glucose tolerance.

W badaniu opublikowanym w Nature Medicine The concentration of erythritol in the blood was measured in a discovery cohort of 1157 people and in two independent validation cohorts, one American with 2149 and one European with 833 patients undergoing planned cardiological diagnostics. Individuals in the highest quartile had a higher three-year risk of death, heart attack, or stroke: an adjusted risk ratio of 1.80 and 2.21 compared to the lowest quartile. Erythritol also increased platelet reactivity and thrombus formation (Witkowski i in., Nature Medicine 2023).

A year later, the same team described in European Heart Journal an analogous result for xylitol: an adjusted risk ratio of 1.57 for the highest tercile, increased platelet reactivity, and thrombosis in an animal model. In an interventional study, a xylitol-sweetened drink raised plasma levels and intensified platelet response in all ten participants (Witkowski i in., European Heart Journal 2024). The authors of both studies say the same thing: long-term safety studies are needed.

The third thread is the microbiome. In a randomized study, 120 healthy adults consumed saccharin, sucralose, aspartame, or stevia for two weeks in doses below the acceptable intake. Each of the sweeteners altered the composition of the gut and oral microbiome, and saccharin and sucralose significantly worsened the glycemic response. The reaction was strongly dependent on the individual (Suez i in., Cell 2022).

Does stevia lower blood sugar levels?

There is no evidence that it lowers them. There is evidence that it does not raise them. Nichol's meta-analysis included 29 randomized studies involving 741 people and examined aspartame, saccharin, steviol glycosides, and sucralose. The authors' conclusion is cautious: the consumption of these substances did not raise glucose levels, and the effect size varied slightly depending on age, body weight, and the presence of diabetes.

Stevia is the common name for the plant Stevia rebaudiana. The sweetening agents are steviol glycosides, designated in the European Union by the symbols E 960a to E 960d. They are many times sweeter than sugar, so they are used in very small amounts, and a product "with stevia" almost always contains a carrier. If that carrier is maltodextrin, the glycemic index of the finished mixture has nothing to do with stevia itself.

The acceptable daily intake of steviol glycosides is 4 mg per kilogram of body weight, converted to steviol equivalents. In 2024, EFSA considered a request to raise it to 6 or 16 mg and refused, deeming the justification insufficient; with the proposed extension of applications, the limit would be exceeded in small children at the 95th percentile (EFSA, 2024). The statement about stevia as a substance that cannot be overdosed is therefore unfounded.

How to use erythritol and xylitol in cooking?

Replacing sugar with a sweetener is not a one-to-one substitution, and not just because of sweetness. Sugar in baking is responsible for moisture, browning of the crust, and the structure of the crumb, while polyols replicate only some of these functions.

We noticed three differences in kitchen trials that most often ruin the first bake. Erythritol crystallizes upon cooling, causing creams and fillings to become gritty, and it gives a distinct cooling effect in the mouth. Cakes made with erythritol come out lighter than those made with sugar because browning is weaker. Xylitol behaves more like sugar and works better in hot drinks, where erythritol dissolves more slowly.

The practical conclusions are simple. For creams and ice creams, mix erythritol with another ingredient to limit crystallization. Xylitol is more convenient for tea and coffee. Dose steviol glycosides in pinches, as higher concentrations lead to bitterness, which manufacturers mask with the addition of erythritol.

There is also intestinal tolerance to consider. Polyols are not completely absorbed and at larger portions act osmotically, resulting in bloating or diarrhea. EFSA deemed this effect significant enough to base its limit for erythritol on it. Other ingredients affecting glycemia are covered in separate entries, for example about berberynie oraz o chromie na apetyt i poziom cukru.

Are sweeteners safe for children?

The answer changed after the re-evaluation of erythritol in 2023 and came out differently than suggested by most packaging. EFSA established an acceptable daily intake for erythritol at 0.5 g per kilogram of body weight, taking as a reference point the lower limit of the dose at which diarrhea was not observed.

Exposure estimates came out above this limit. At the 95th percentile, chronic intake was 742 mg per kilogram of body weight in children and 1532 mg in adolescents, while acute exposure reached 3531 mg per kilogram per meal in children at the 99th percentile. The panel stated that individuals with high intake may experience adverse effects and did not support the request to exempt erythritol from the requirement to include a warning about its laxative effect.

For steviol glycosides, the picture is similar: the limit of 4 mg per kilogram of body weight can be exceeded in small children at upper levels of consumption. The practical conclusion is not to "ban" but to "not treat as neutral." A sugar-free drink consumed instead of water still introduces a substance with an established limit into the body, and with polyols, there is also the intestinal reaction, which a child will feel faster than an adult.

Frequently Asked Questions

Which sweetener has the lowest glycemic index?

Erythritol, with a glycemic index of 0 and an insulin index of 2 (Livesey, Nutrition Research Reviews 2003). Next are lactitol with an index of 6 and sorbitol and isomalt with 9. Xylitol has 13, and maltitol 35, which is over half the value of sucrose at 65.

Is erythritol better than xylitol?

In terms of glycemia, yes, because it has an index of 0 compared to 13 and a zero energy coefficient on the EU label. Xylitol wins in the kitchen because it sweetens similarly to sugar. However, both have a described cardiovascular signal, so the difference between them is smaller than what would be suggested by the table alone.

Does stevia raise blood sugar levels?

No. A meta-analysis of 29 randomized studies involving 741 people did not show an increase in glucose after consuming non-caloric sweeteners, including steviol glycosides (Nichol et al., 2018). However, there is no evidence that stevia lowers glycemia. Products "with stevia" that use maltodextrin as a carrier are a different matter.

Are sweeteners safe for insulin resistance?

Erythritol and stevia do not significantly raise glycemia or insulinemia. Maltitol has an insulin index of 27, so it is not a good choice. In a randomized study involving 120 people, saccharin and sucralose showed a worsening of glycemic response after two weeks (Suez et al., Cell 2022).

How many calories does erythritol, xylitol, and stevia have?

On the label in the European Union, erythritol has 0 kcal/g, while other polyols, including xylitol, have 2.4 kcal/g. Sucrose has 4 kcal/g. Steviol glycosides are used in such small amounts that their energy contribution is negligible. The values come from Annex XIV to Regulation (EU) No. 1169/2011.

Are erythritol and xylitol safe for the heart?

This is an open question today. In cohorts of patients referred for cardiological diagnostics, higher concentrations of both substances were associated with a higher risk of heart attack, stroke, or death, and mechanistic studies showed increased platelet reactivity. The authors do not claim causality and call for research on long-term safety.

The article is informational and educational in nature and does not replace consultation with a doctor. If you are pregnant, breastfeeding, taking medications, or have chronic conditions, consult the use of supplements or herbs with a specialist.

Author: Michał Waluk · Opublikowano: 2026-07-06 · Aktualizacja: 2026-08-15