Zero-calorie sweetener erythritol linked to higher rates of heart attack, stroke

The team found that the presence of the sweetener made it easier for platelets to cause clotting.

ISLAMABAD, (ONLINE) - Nature Medicine reports that the popular artificial sweetener erythritol was found to be linked to a greater risk for cardiovascular events like heart attack and stroke.

The researchers also looked at what happened when they added erythritol to whole blood or isolated platelets. PlateletsTrusted Source, according to the National Cancer Institute, are small pieces of cells found in the blood that help blood clot and aid in wound healing.

The team found that the presence of the sweetener made it easier for platelets to cause clotting, which might potentially increase risk. Additionally, they noted that pre-clinical studies confirmed erythritol had the same effect when consumed orally.

Dr. Stanley Hazen and his colleagues at Cleveland Clinic explained in their report that while erythritol is becoming more and more commonplace in foods and other products — to the point that it has even been detected in ground and tap water — little is known about its long-term effects.

Further, people with conditions like obesity and heart disease are often advised to use artificial sweeteners in order to lose weight. However, the authors noted that epidemiological studies have previously found an association between using these artificial sweeteners and the very conditions they are intended to help.

They said that this makes it especially important to determine just how these substances might be influencing people’s risk.

Did this study prove that erythritol is dangerous?

Liz Weinandy, a registered dietitian at The Ohio State University Wexner Medical Center and instructor of practice in medical dietetics, said the first thing we need to consider is that the study did not actually prove that erythritol causes heart disease and stroke.

“There’s a big difference between association and causation,” she explained. “Several aspects of this study were in vitro and in vivo which can provide us with information, but do not necessarily mean they translate into the same effects in humans as seen in the laboratory.”

The authors themselves also acknowledge this limitation in their study, recommending that more studies are needed in order to confirm this effect.

It should also be noted that, even if it increases cardiovascular risk, it may be more a matter of quantity rather than erythritol being inherently dangerous. It is naturally occurring in fruits and vegetables, albeit in much smaller quantities than what is being consumed in artificially sweetened foods.

The human body does a poor job of metabolizing it so any excess is shunted into the bloodstream. It is this excess erythritol that might be problematic, according to the study authors.

How to avoid excess erythritol consumption

Samantha Coogan, Program Director, Didactic Program in Nutrition & Dietetics at the University of Nevada, Las Vegas, reiterated the distinction between naturally occurring erythritol, which is found in foods including grapes, watermelon, mushrooms, and fermented foods like wine, cheese, and soy sauce. It is not necessary to avoid these foods.

She further explained that artificial erythritol is found mostly in chewing gum and zero-sugar sodas, such as Blue Sky.

“If you’re a gum chewer, you can try choosing gums sweetened with xylitol for its added benefit to dental health that can help combat dental bacteria,” said Coogan.

“And instead of diet or zero-sugar soda, try flavored sparkling/mineral water … or make your own ‘spa’ water by infusing whole fruits/cucumbers into water in a water bottle or pitcher.”

Sharon Palmer — registered dietitian, author, and blogger at The Plant-Powered Dietitian — added that it can also be found mixed in with other artificial sweeteners, like aspartame and stevia. Additionally, it can make an appearance in foods and products like candy, protein and nutrition bars, baked goods, fruit spreads, frozen desserts, and even mouthwash.

However, while many foods, drinks, and products do contain added erythritol, it’s actually fairly simple to determine which ones they are. “Reading the ingredients on the food label will clearly tell if a product has erythritol in it or not because it has to be listed by law in the U.S.,” said Weinandy.