A recent study has added to growing concerns about the artificial sweetener erythritol and its potential impact on heart health. Researchers from the Cleveland Clinic have found a link between consuming 30 grams of erythritol, a quantity smaller than that in a can of sweetened soda, and increased platelet activity in the blood. This heightened platelet activity can raise the risk of blood clots, which may lead to heart attacks or strokes.
Erythritol is a sugar alcohol that the body produces in small amounts and is found naturally in fruits and vegetables. It is also manufactured as a sugar substitute and is commonly used in products like sugar-free gum, candy, baked goods, and beverages.
People with diabetes or those on low-carbohydrate diets often choose products containing erythritol, according to Michelle Routhenstein, MS, RD, a preventive cardiology dietitian at Entirely Nourished.
Despite being classified as “generally recognized as safe” (GRAS) by the Food and Drug Administration (FDA), research has increasingly questioned the safety of erythritol. The new study, although small, aligns with previous findings linking erythritol with blood clotting, heart attacks, and strokes.
Study Details and Findings
The Cleveland Clinic’s research builds on two earlier studies that highlighted the potential risks of erythritol and its widespread use in processed foods. Stanley Hazen, MD, the senior author and co-section head of preventive cardiology at the Cleveland Clinic, led the study.
The study involved 20 participants with no history of cardiovascular disease, hypertension, or diabetes, averaging 30 years of age. After fasting overnight, half of the participants consumed a drink containing 30 grams of sugar, while the other half drank a mixture with 30 grams of erythritol. Blood samples were collected before and 30 minutes after consumption.
The researchers measured clotting potential by analyzing platelet markers such as serotonin and CXCL4. Participants who consumed erythritol showed a significant increase in blood erythritol levels, over a thousand times higher than normal. This was accompanied by increased platelet reactivity and clotting potential. No such changes were observed in those who consumed glucose.
The study did not explore the exact mechanism by which erythritol affects platelet activation, but Hazen noted that erythritol appears to interact with platelets in a way that alters their signaling.
Hazen and his team have informed the FDA and the European Food Safety Authority about their findings, suggesting that erythritol’s safety should be reevaluated.
Need for Further Research
Experts emphasize that more research is needed to fully understand the effects of erythritol on blood clotting and heart health. Arsalan Rafiq, MD, a cardiologist at Tufts Medical Center, pointed out that the study was conducted with a small group of participants and did not address the long-term effects of erythritol consumption. While the study’s findings are concerning, it did not directly lead to clot formation but rather to processes that could contribute to clotting.
Routhenstein also highlighted the need for more extensive research to make definitive recommendations about erythritol’s safety.
Should You Avoid Erythritol?
The study and similar research might leave consumers uncertain about the best choices for sweeteners. Excessive added sugar can lead to health issues such as heart disease and diabetes, but the safety of erythritol remains unclear.
Rafiq noted that there is not enough evidence to definitively label erythritol as unsafe but also insufficient data to confirm its safety. He, Hazen, and Routhenstein recommend limiting the intake of sweetened foods and focusing on a diet rich in whole foods that provide protein, fiber, healthy fats, vitamins, and minerals.
For those seeking a sweet treat, Hazen suggests opting for natural options like fruit or using small amounts of regular sugar or honey in moderation.
