Erythritol, a common artificial sweetener increases risk of clots and stroke

Medical News: In recent years, erythritol has gained popularity as a go-to sugar substitute for those seeking to reduce calorie intake, manage diabetes, or follow low-carbohydrate diets. Found in everything from baked goods and beverages to gum and candy, this artificial sweetener has been widely regarded as a safe alternative to sugar. However, a growing body of research is challenging this perception, with new evidence suggesting that erythritol may pose serious risks to cardiovascular health.


Erythritol, a common artificial sweetener increases risk of clots and stroke.

The Cleveland Clinic Study: A Wake-Up Call
A groundbreaking study from the Cleveland Clinic-USA that is covered in this Medical News report has shed new light on the potential dangers of erythritol. The research reveals that consuming foods containing erythritol may increase the risk of major cardiovascular events, such as heart attacks and strokes. The study found that erythritol can make blood platelets more active, thereby increasing the likelihood of blood clot formation - a key factor in the development of cardiovascular complications.
 
The study involved healthy volunteers who consumed erythritol and sugar (glucose) in controlled settings. The results were alarming: while glucose had no significant impact on platelet activity, erythritol led to a marked increase in clot formation. This finding suggests that erythritol, despite being marketed as a healthier alternative to sugar, may in fact contribute to the very health issues it is intended to prevent.
 
The Growing Evidence Against Erythritol
The study is not the first to raise concerns about erythritol. Previous research by the same team, published in Nature Medicine, found that cardiac patients with high levels of erythritol in their blood were twice as likely to experience a major cardiac event within three years compared to those with lower levels. These findings were corroborated by preclinical studies, which demonstrated that erythritol could increase clot formation when added to blood samples or platelets.
 
The latest study takes this research a step further by directly observing the effects of erythritol ingestion on healthy individuals. In a group of 20 volunteers, researchers measured erythritol levels before and after consumption of a typical dose found in sugar-free products like soda or muffins. The results were striking: erythritol levels in the blood increased by over 1,000 times, accompanied by a significant rise in blood clot formation. In contrast, no such changes were observed in volunteers who consumed glucose.
 
“These findings underscore the importance of further long-term clinical studies to assess the cardiovascular safety of erythritol and other sugar substitutes,” said Dr Stanley Hazen, senior author of the study and chair of Cardiovascular and Metabolic Sciences at the Cleveland Clinic’s Lerner Research Institute. Dr Hazen's team has been at the forefront of investigating the physiological effects of common sugar substitutes, and their work is prompting a reevaluation o f ingredients once deemed safe.
 
Regulatory Status and the Need for Reevaluation
Despite these troubling findings, erythritol remains classified as a "Generally Recognized as Safe" (GRAS) ingredient by both the U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA). This classification allows erythritol to be used without restriction in food products. The rationale behind this designation is that erythritol is a sugar alcohol naturally found in fruits and vegetables and is a byproduct of glucose metabolism in human tissue, albeit in small quantities.
 
However, the recent studies from the Cleveland Clinic suggest that this regulatory status may need to be reconsidered. The evidence indicates that erythritol, in the amounts typically consumed in processed foods, may not be as harmless as previously thought. Given the widespread use of erythritol in low-calorie, low-carbohydrate, and "keto" products, the potential public health implications are significant.
 
Dr Hazen's research is part of an ongoing investigation into the factors that contribute to residual cardiovascular risk. His team has made several pioneering discoveries in the field of atherosclerosis and inflammatory disease research, including the seminal discovery linking gut microbial pathways to cardiovascular and metabolic diseases. The team's findings on erythritol are particularly concerning, as they suggest that even common dietary choices may inadvertently contribute to cardiovascular disease.

Erythritol and Xylitol: A Broader Concern
The concerns raised by the Cleveland Clinic’s research are not limited to erythritol alone. Another artificial sweetener, xylitol, has also been implicated in similar cardiovascular risks. In a study conducted by the same research group, xylitol was found to produce similar increases in plasma levels and affect platelet aggregation in healthy volunteers, much like erythritol. Large-scale observation studies have shown that high levels of xylitol are associated with an increased risk of heart attack, stroke, or death over the following three years.
 
These findings suggest that the potential dangers of artificial sweeteners may extend beyond erythritol, warranting further investigation into other commonly used sugar substitutes. “Erythritol and other sugar alcohols that are commonly used as sugar substitutes should be evaluated for potential long-term health effects, especially when such effects are not seen with glucose itself,” said Dr W. H. Wilson Tang, co-author of the study and research director for Heart Failure and Cardiac Transplantation Medicine at Cleveland Clinic.
 
What Should Consumers Do?
In light of these findings, consumers may wonder how to navigate the complex landscape of artificial sweeteners. While erythritol and xylitol have been marketed as safe alternatives to sugar, the evidence suggests that they may carry their own risks, particularly for individuals with existing cardiovascular concerns.

“I feel that choosing sugar-sweetened treats occasionally and in small amounts would be preferable to consuming drinks and foods sweetened with these sugar alcohols, especially for people at elevated risk of thrombosis such as those with heart disease, diabetes, or metabolic syndrome,” advised Dr Hazen. His recommendation highlights the need for moderation and careful consideration of the potential long-term effects of sugar substitutes.
 
As cardiovascular disease remains the leading cause of death globally, understanding the impact of dietary choices on heart health is more critical than ever. The research serves as a crucial reminder that what we consume can have hidden consequences, and that the safety of commonly used ingredients should be continually reevaluated in light of new scientific evidence.
 
For those concerned about the potential risks of erythritol, consulting with a healthcare provider and making informed dietary choices is essential. As research into the effects of artificial sweeteners continues, consumers will need to stay informed and vigilant about the ingredients in their food.
 
This study, like many others in the field, emphasizes the importance of ongoing research into the long-term health effects of commonly used food additives. As the debate over the safety of erythritol and other sugar substitutes continues, one thing is clear: more research is needed to fully understand their impact on human health. For now, caution may be the best approach when it comes to artificial sweeteners.
 
The findings from the Cleveland Clinic’s study will undoubtedly fuel further investigation into the safety of erythritol, potentially leading to changes in how it is regulated and consumed.
 
The study findings were published in the peer reviewed journal: Arteriosclerosis, Thrombosis, and Vascular Biology.
https://www.ahajournals.org/doi/10.1161/ATVBAHA.124.321019
 
For the latest updates on this topic and other health-related news, readers are encouraged to follow updated research developments and coverages at Thailand Medical News.
 
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