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Discomfort after drinking Genki Forest reported, study: erythritol can cause allergies

Early one morning in August 2021, Gao Hong, 39, was thirsty and opened a bottle of Genki Forest sparkling water and took several sips. The package of sparkling water was printed with fresh fruit and marked “sugar-free” in a prominent red font, which looked refreshing and thirst-quenching. But soon, Gao Hong felt some itchiness on her body, “Maybe it’s a bug?” She didn’t care until she finished most of the bottle.

Within a few minutes, Gao Hong’s eyes swelled up, followed by a deformed face, followed by itching all over the body. “My whole body was itching like crazy, and I was so scared that I rushed to the hospital, where the doctor told me not to scratch, gave me a hangnail, and told me to drink more water to speed up my metabolism.” Ms. Gao said she did not have a history of allergies and her body’s reaction puzzled her.

Gao Hong recalled that she didn’t eat anything on the day of the allergy, and only drank Genki Forest sparkling water. The drink’s nutrition factsheet shows that it contains carbohydrates mainly from erythritol. Gao Hong said she had an allergic reaction to yogurt containing erythritol after that, “basically I’m sure I’m allergic to erythritol”.

In recent years, as erythritol has been widely used in the food industry, many consumers on the Internet said they had allergic reactions after drinking drinks containing erythritol. Is erythritol really the “culprit” of allergy? How should manufacturers label their use of erythritol?

The “sugar aristocrat” is favored

Gao Hong noticed that the publicity gimmick of the sparkling water is “0 sugar, 0 fat, 0 calories”, and the description at the bottom of the nutrition factsheet says, “Although this product contains 1.9g of carbohydrates per 100ml, it meets the national standard of no sugar; the carbohydrates contained are mainly from erythritol, which is a sugar alcohol produced by microbial fermentation. sugar alcohol produced by microbial fermentation method…”.

Erythritol, also known as protoalgae alcohol, erythritol, is a new polyol sweetener, widely present in fungi, fruits and all kinds of fermented foods, and also exists in human or animal tissues and body fluids as erythritol component. Because of its low calorie, it has been favored by food manufacturers in recent years, and is known as “the noble of sugar”.

Liu Liping, senior engineer of Shandong Food Fermentation Engineering Key Laboratory, said that erythritol, compared with xylitol, sorbitol, maltitol and other types of functional sugar alcohols, has a lower molecular weight, high osmotic pressure of the solution, low hygroscopicity and other characteristics.

Liu Liping introduced that the energy value of erythritol is only 5%-10% of sucrose energy, which is one of the lowest energy among all polyglycol sweeteners. Since there is no enzyme system to metabolize erythritol in the human body, erythritol does not participate in the metabolism of sugar after entering the human body. A 2003 study noted that 90% of erythritol in food is rapidly absorbed by the intestine and excreted directly through the urine; the remaining 10% passes through the intestine and can theoretically be used by bacterial fermentation.

As early as the 1980s, Japan was the first to introduce sugar-free tea drinks with erythritol, and Japanese brands such as Kirin and Suntory became the leaders in the field of sugar-free drinks with erythritol drinks. The Joint Food and Agriculture Organization (FAO) and World Health Organization (WHO) Expert Committee on Food Additives (JECFA) approved erythritol as an edible sweetener in 1999, and there is no need to specify the ADI (Acceptable Daily Intake). China’s former Ministry of Health officially approved erythritol in May 2008 in all kinds of food according to the production needs of the appropriate amount of use.

Liu Liping introduced that, because xylitol, sorbitol and other products before erythritol into the Chinese market, so their market share is still large, but after years of development, xylitol, sorbitol and other products have nearly saturated the market. With people’s increasing health consciousness, erythritol, as a new safer and natural sugar alcohol, has shown a strong market demand.

On December 13, 2021, Genki Forest’s sugar substitute supplier Baolingbao Biological Co., Ltd. (hereinafter referred to as Baolingbao) announced that it is expected to achieve a profit of 190 million yuan to 210 million yuan in 2021, a year-on-year increase of 281.05%- 321.16%; It is estimated that the net profit deducted from 160 million yuan to 180 million yuan will be realized, a year-on-year increase of 341.23%-396.38%.

Baolingbao said, benefiting from the growth of healthy consumer demand such as zero sugar and sugar reduction, the effective drive of operational management measures, the company steadily promoted the business plan determined at the beginning of the year, and the linkage of various businesses was enhanced; influenced by the strong market demand for sugar substitute products, the supply and demand of the company’s erythritol products in 2021 were strong, and the price increased significantly compared with the same period in 2020, while driving the market demand for other functional sugar products. The completion and production of 13,000 tons of erythritol expansion project in 2021 will further meet the market demand of erythritol products.

How to limit the addition of erythritol?

With erythritol being widely used in beverages, there are also many people on the internet who claim to have allergic symptoms after drinking erythritol drinks.

According to incomplete statistics, there are 35 posts on Zhihu under the question of “Anyone allergic to Genki Forest? Under this question, there were 35 comments from users who said they had experienced discomfort after drinking Genki Forest. On Weibo, since 2019, at least 43 users have posted updates saying they had allergies after drinking Genki Forest. Weibo user @kidskelsey said he broke out in hives all over his body again after drinking Genki Forest for the third time, “proving that I am indeed allergic to Genki Forest,” and the official Genki Forest Weibo commented below, “I think you’re allergic to erythritol Allergic?”

Another consumer, Ms. Ai, also said she sought medical attention three times for drinking Genki Forest’s sugar-free line of drinks. “Twice because of the sparkling water, the third time was oolong tea, immediately after drinking it, I started to get goose bumps, about half an hour, from my scalp to my toes, the whole body was covered.” Ms. Ai said, “but they also faded quickly, after going to the hospital for injections and medication, within 24 hours it subsided.”

Liu Liping introduced that the digestive tract has a high tolerance for erythritol, with a tolerance of 0.8 grams per kilogram of body weight, which is higher than xylitol, lactitol and maltitol. In addition, a large number of animal and clinical trial studies at home and abroad have proved that erythritol is not teratogenic and toxic, does not affect reproduction and development, does not cause chromosomal mutations, does not cause carcinogenesis, and does not stimulate tumor growth.

However, a paper titled “Gastrointestinal Tolerance Study of Erythritol and Xylitol” on the Nature website pointed out that healthy volunteers did not show any symptoms when ingesting drinks containing 20 and 35 grams of erythritol; however, when the intake reached 50 grams, the volunteers showed obvious symptoms of abdominal bloating and nausea.

Foreign studies have also shown that erythritol can cause allergic reactions in individuals. The article “Non-caloric sweeteners in the pediatric era: an analysis of the scientific evidence” published in the Mexican Journal of Pediatrics noted that in 2013, Sugiura et al. reported a case of erythritol allergy in an 8-year-old girl who had several allergic episodes due to the consumption of snacks, chewing gum, milk and milk tea containing erythritol as a sweetener. Prior to this, only four cases of erythritol allergy had been reported worldwide. Most of these cases showed symptoms of allergic urticaria, such as shortness of breath, cough, rash, eyelid edema, and oral discomfort, which mostly resolved with treatment.

International standards have been introduced, Australia, New Zealand requirements, sorbitol, erythritol in food content ≥ 25g/100g (25%), are required to label “may cause diarrhea”. In Canada, erythritol is approved as a sweetener for some carbonated beverages with an upper limit of 1.5%. The European Union approved erythritol as a flavor enhancer for low-energy or no-added-sugar flavored beverages in October 2015, with a limit of 16,000mg/kg.

In China, when erythritol is used as a food additive in the food industry, it must strictly comply with the requirements of national food safety regulations and national food safety standards. The relevant standards involving food additives erythritol mainly include GB26404, GB2760 and GB5009.279, all of which are mandatory national standards.

In the May 24, 2015 implementation of the “Food Safety National Standards for the Use of Food Additives”, the function of the food additive erythritol as a sweetener to the schedule “in all types of food according to the production needs of the list of food additives”, that is, erythritol as a food additive in food use, the maximum use of the column for “moderate use”, and no specific use of the value of the limit.

Allergen mandatory labeling regulations to be introduced

Since some people are allergic to erythritol, does the manufacturer have the obligation to make the corresponding mark on the goods?

Zheng Ying of the State Key Laboratory of Food Science and Technology of Nanchang University said that the allergen labeling, China is now implemented by the former Ministry of Health in 2011 to develop the “General Standard for Food Labeling”, which is the first Chinese standard for allergen labeling requirements.

General Standard for Food Labeling lists allergy-prone foods: cereals containing gluten, crustaceans, fish, eggs, peanuts, soybeans, milk, nuts and processed products containing these eight types of foods, and requires that if one or more of these eight types of foods are used as ingredients, an easily recognizable name should be used in the ingredient list or prompted in a location near the ingredient list.

Zheng Ying said that the standard is only a recommended instruction, and there is no mandatory requirement to label allergy tips, and only few domestic food companies have added allergen tips on food packaging. At present, the National Center for Food Safety Risk Assessment is promoting the mandatory labeling of allergen information, and the mandatory labeling regulations for prepackaged food allergens are still in the research stage.

In addition, Zheng Ying said, for erythritol, if the number of allergy is too small, it will not be included in the scope of mandatory labeling, allergen labeling can only facilitate most allergy patients, other allergy patients can learn about the information from the ingredient list.

Zheng Ying said that for mandatory labeling of prepackaged food allergens, the list of food allergens in China should be reasonably determined based on the data from the large-scale Chinese food allergy epidemiological survey. At the same time, the implementation and supervision of labeling should be based on accurate and efficient allergen testing, which should neither be under-labeled nor exaggerated, but should be based on the actual content.

“At this stage, consumers with food allergies should still be cautious in their choice of prepackaged food, and the situation will improve after the introduction of mandatory allergen labeling regulations.” She said.

(At the request of the interviewee, Gao Hong is a pseudonym) Source

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