Erythritol: A Sweet Illusion

Sweet with a Bitter Aftertaste

Since as early as the 1800s, people have been looking for sweet alternatives to replace sugar in their diets, a way to satisfy their sweet tooth without worrying about the calorie count. Sugar alcohols are a popular alternative, especially erythritol, being an almost perfect substitute for normal glucose. However, a recent study by researchers at Cleveland Clinic published in Arteriosclerosis, Thrombosis, and Vascular Biology reveals a troubling connection between erythritol and cardiovascular issues.

The Bitter Truth

The study builds on the team’s previous one from 2023 published in Nature Magazine that suggested that cardiac patients with high erythritol levels were twice as likely to experience a major cardiac event in the next three years. Their recent study similarly raises concerns that erythritol may increase the risk of blood clotting. The possibility that erythritol increases blood clotting is especially dangerous as it can block or restrict the movement of blood and oxygen throughout the body, which is vital to survival. It can also lead to major cardiovascular problems like heart attacks and strokes. 

The researchers studied 20 healthy volunteers with no cardiovascular problems or medical history of bleeding disorders, both female and male, averaging around 30 years old. Half of the participants drank water mixed with 30 grams of regular sugar, or glucose, while the other ten drank water mixed with 30 grams of erythritol. After examining the results of blood tests taken before and after consumption, they found that the participants who consumed erythritol experienced blood levels over 1000 times higher as well as significant increase in platelet activity, which increases risk of blood clotting while no changes were observed in the participants that consumed glucose. 

Is it still safe?

Although this study is significantly troubling, erythritol is still classified by the US Food and Drug Administration (FDA) as generally recognized as safe (or GRAS). However, despite this status, it is still cautioned by many experts to still be careful with erythritol consumption. One of the primary concerns is that most people tend to consume larger amounts of these artificial or low-calorie sweeteners than they would regular sugar, under the perception that they are healthier alternatives and therefore can be used more liberally. 

Significance and Impact

This new information is especially important for us to know because of the impact it may have. It is undoubtedly a public health concern, especially because those who consume these low-calorie alternatives are typically those who are being cautious of their sugar intake for health reasons. These people may be at the greatest risk for experiencing heart attacks or strokes, and yet when they reach for the supposedly healthier alternative, it may be worse for them.

Additionally, other artificial sweeteners have also been found to have related health risks, specifically xylitol, revealing a possibly deeper and more troubling connection between these alternatives and cardiovascular issues. Even more worrisome is that aside from just sweeteners, erythritol can be found in sugar-free gum, energy bars, some diet sodas, and protein shakes, among others. We unknowingly consume much more erythritol than we know every day, the average of which was around 30 grams as of the early 2000s-2010s. 

Informed Choices

As the popularity of these artificial sweeteners continues to rise, it grows increasingly important that consumers are aware of the potential health risks that come with them. This study only contributes to the growing amount of research that proves that the sweeteners we use to be healthier may not be doing that. However, it’s still important that further research is conducted, and the team says they will continue to further reassess the safety of these alternative sugar substitutes, including studying the effect that they have on at-risk patients. By staying up-to-date on the latest research, we can make more informed choices and ensure our own health and safety.

Works Cited

Pelc, Corrie. “Erythritol: Common Low-Calorie Sweetener May Raise Risk of Blood Clots.” Edited by Kelsey Costa, Medical News Today, MediLexicon International, 13 Aug. 2024, www.medicalnewstoday.com/articles/popular-low-calorie-sweetener-sugar-may-raise-blood-clotting-risk#Is-there-a-healthy-sugar-substitute? 

Costa, Kelsey. “Artificial Sweetener Erythritol May Raise the Risk of Blood Clots.” Edited by Andrea Rice and Jennifer Chesak, Healthline, Healthline Media, 13 Aug. 2024, www.healthline.com/health-news/artificial-sweetener-erythritol-blood-clot-risk. 

Cleveland Clinic. “Consuming Foods with Erythritol Increases Risk of Cardiovascular Events, Study Shows.” News-Medical, 8 Aug. 2024, www.news-medical.net/news/20240808/Consuming-foods-with-erythritol-increases-risk-of-cardiovascular-events-study-shows.aspx. 

Witkowski, Marco, et al. “Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers.” AHA Journals, American Heart Association, 8 Aug. 2024, www.ahajournals.org/doi/10.1161/ATVBAHA.124.321019.