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Dr. Sears' Blog

Breaking down the latest research on Anti-Inflammatory Nutrition
Written By: Dr. Barry Sears, Ph. D | Creator of the Zone Diet

Written by Dr. Barry Sears
on May 04, 2023

Sugar has many things going for it. It is sweet, it is cheap, and it is addictive. Along with fat and salt, it is one of the mainstays of the industrialized food industry to make their otherwise bland products both edible and desirable. But unfortunately, it is also a cause of insulin resistance, the underlying cause of various chronic diseases. No wonder the food industry is constantly seeking sugar substitutes, but only if they are cheaper than sugar and nearly as sweet.  One such candidate has been sugar alcohols and, in particular, erythritol. And it is safe, or at least we thought so until a recent study (1). 

This study found that a quarter of individuals who consumed the most erythritol had a doubling of their risk of a heart attack. To put this in perspective, this is about the same increase in cardiovascular risk level as having type 2 diabetes.   

OK, that was only an association. To confirm their initial finding, they gave healthy volunteers a dose of 30 grams of erythritol to see what would happen. This level of erythritol is similar to what many people consuming keto-friendly products typically consume daily. However, this level of erythritol caused significant amounts of excess clot formation in their blood. The study's lead author stated that they weren’t even looking for this connection. And if this is true for erythritol, it is likely to occur with other typical sugar alcohols like sorbitol, xylitol, maltitol, mannitol, and others. However, unlike erythritol, these other sugar alcohols have more significant laxative effects. 

Does this mean everyone should return to dumping good old sugar into their foods to make them more palatable? That’s probably not a good idea unless you want to increase insulin resistance which makes you gain weight, have lower mental and physical performance levels, and accelerate aging. I forgot to mention that insulin resistance is also strongly associated with the development of diabetes, heart disease, and Alzheimer’s. 

Fortunately, there is a way out of this dilemma, and it is a different type of sugar known as allulose. First, a little information on sugar. Sugar is a disaccharide with one glucose molecule linked to one fructose molecule. The link between these two sugars is rapidly broken down in the stomach, so the sugar you initially put in your mouth enters the small intestine as pure glucose and pure fructose. Both are quickly absorbed. The glucose goes directly into the blood to cause insulin secretion. Still, the fructose goes directly to the liver to induce the synthesis of palmitic acid (it’s called de novo lipogenesis). Excess levels of either glucose or fructose can cause insulin resistance.  Allulose is different. It is also quickly absorbed, but your kidneys just as quickly excrete it into your urine. However, allulose has another critical benefit: it stimulates AMPK production (2). Why is that important? AMPK is the master regulator of your metabolism, and it reduces insulin resistance (3).  

This background is why we reformulated our ZoneRx® shakes and bars and our future products will contain allulose to help reduce insulin resistance, resulting in greater metabolic efficacy while lowering the likelihood of developing chronic diseases associated with insulin resistance. Losing weight and living longer is what food technology should be about. 


  1. Witkowski et al.  The artificial sweetener erythritol and cardiovascular event risk. Nature Med.  2023 Feb 27. doi: 10.1038/s41591-023-02223-9.
  2. Lee et al. D-allulose ameliorates adiposity through the AMPK-SIRT1-PGC-1α pathway in HFD-induced SD rats .Food Nutr 2021 Dec 21;65. doi: 10.29219/fnr.v65.7803.
  3. Sears and SahaDietary Control of Inflammation and ResolutionFront Nutr. 2021 Aug 10;8:709435. doi: 10.3389/fnut.2021.709435

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