Is erythritol bad for you? The common sweetener is associated with an increased risk of heart attack and stroke, according to a study by the American Cleveland Clinic published in ‘Nature Medicine’. The researchers examined data on over 4,000 people between the US and Europe, noting that “those with the highest levels of erythritol in their blood showed a high risk of serious adverse cardiac events such as” precisely “heart attack, stroke or death”. The authors also analyzed the effects of adding erythritol to whole blood or isolated platelets, noting that erythritol promoted platelet activation which gives rise to clots. Even preclinical studies have confirmed that the ingestion of erythritol increases the formation of blood clots.
The scientists emphasize the importance of follow-up studies to confirm these findings in the general population. In fact, the published work has several limitations, they specify, including the fact that “clinical observation studies – they point out – demonstrate the association and not the causality”. They indicate that is the link between two events (in this case high blood levels of erythritol and an increased risk of life-threatening heart attacks or strokes), but not the cause and effect relationship.
The researchers suggest talking to your doctor or a board-certified dietitian to learn about healthy food choices and get personalized advice.
“The popularity of sweeteners like erythritol has grown rapidly in recent years, but more research into their long-term effects is needed,” says study senior author Stanley Hazen, chair of the Department of Cardiovascular and Metabolic Sciences at the Lerner Research Institute and Co-Head of Preventive Cardiology at the Cleveland Clinic – Cardiovascular disease is on the rise and is the leading cause of death globally. We need to make sure the foods we eat are not contributing to it.”
Products sweetened with erythritol – scientists report – are often recommended to people suffering from obesity, diabetes or metabolic syndrome, patients at increased risk of cardiovascular attacks such as heart attacks and strokes. Erythritol has a sweetness equal to about 70% that of sugar and is produced through the fermentation of corn. After ingestion it is poorly metabolised by the body, enters the blood and is mainly eliminated in the urine. The human body naturally produces low amounts of erythritol, so any additional consumption can add up. Erythritol is generally recognized as safe by the US Food and Drug Administration, which means, the researchers point out, that no long-term safety studies are required.
“Our study indicates that when participants consumed an artificially sweetened beverage with an amount of erythritol found in many processed foods, they showed markedly elevated levels” of the substance “in their blood for days.” Levels “well higher” than those which, based on observations, have been found to increase the risk of clotting. “It is important that further safety studies are conducted – urges the author – to examine the long-term effects of artificial sweeteners in general, and erythritol in particular, on the risk of heart attack and stroke, especially in people most at risk of cardiovascular disease”.