by Angelo DePalma, Ph.D., Childrens Health Defense:
People who consume higher-than-normal quantities of erythritol, a popular sugar substitute sold under a variety of brand names, are at greater risk of having a heart attack or stroke, according to a study in Nature Medicine.
The risk of heart disease can last for years after consuming erythritol. This is concerning because “the very people who are being targeted for foods that contain erythritol” — those with diabetes, obesity, or a history of cardiovascular diseases — “are the same people who already are at increased risk for cardiovascular events,” according to one of the study’s authors.
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Stanley Hazen, M.D., Ph.D., a cardiologist at the Cleveland Clinic, led the study, which consisted of four experiments.
The first two experiments considered associations between erythritol blood levels and cardiovascular events. The third experiment found erythritol caused blood platelets to become stickier. And the fourth found ingesting erythritol raised blood levels to concerning levels for over two days.
Breaking down the study
Among 1,157 patients undergoing heart-health exams, those whose blood contained non-sugar sweeteners and their breakdown products were more likely to have a heart attack or stroke during a three-year follow-up period.
Researchers identified several artificial sweeteners in the patients’ blood, but erythritol seemed to have the strongest connection with heart attack and death.
Because the sweeteners are related chemically and several were present, researchers initially could not be sure that erythritol was to blame.
They began a second investigation among 2,149 U.S. and 833 European subjects undergoing heart tests. This time, they analyzed blood in a way that allowed them to detect only erythritol and its effects.
After categorizing subjects into four groups of increasing blood erythritol levels, those in the highest-level group were more than three times as likely to have a heart attack or stroke during the following three years.
In both the U.S. and European study groups, the highest erythritol blood levels were found in patients with the most serious heart conditions and those who went on to suffer a serious cardiac event during the study.
The risk for heart attack or stroke in the highest-level group, compared with the lowest-level group, increased by 164% for the U.S. subjects and 348% for the European subjects.
Results did not change when investigators factored in sex or existing cardiovascular risk factors like obesity or smoking.
This led Hazen to conclude that erythritol was “independently associated” with death, heart attack and stroke — meaning that consuming it is risky regardless of a person’s health status or risk factors.
In a third experiment, researchers found that adding erythritol to blood samples made platelets stickier, which could lead to increased clotting and higher heart attack and stroke risk.
Finally, investigators were interested in seeing if erythritol reached unhealthy blood levels after ingestion of a drink containing 30 grams of the sweetener — a dose typically found in one diet drink or serving of diet ice cream.
Baseline levels started low, increased a thousandfold just 30 minutes after consuming the drink, and remained elevated for more than two days. Levels surpassed thresholds established earlier in this study linked to platelet changes and a higher risk of heart problems.
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