SSugar replacements are ubiquitous in foods and beverages. But despite their ubiquity, the scientific verdict on whether or not they pose health risks ebbs and flows. Every once in a while, however, a study is released with a conclusion so shocking that it forces people to reevaluate their pantries. February 27 study published in the magazine Natural medicine now appears to have dealt a major blow to the sweetener erythritol, with data suggesting a connection between the ingredient and cardiovascular events such as clotting, stroke, and heart attack.
But before you clear your shelves of all erythritol-containing products, keep in mind that no study, including this one, should be taken as the final word on whether or not a product is healthy. The research is still evolving.
The researchers recruited several groups of people with pre-existing cardiac risk factors in the US and Europe, and tracked their health over Liberal-news after taking blood samples to measure the amount of various compounds in the body. Stanley Hazen, director of the Center for Cardiovascular Diagnosis and Prevention at the Cleveland Clinic’s Lerner Research Institute, says his team had no real intention of studying erythritol and instead stumbled upon his new findings. “Our original intention was to see if we could find compounds in the blood whose levels would predict the future development of heart attack, stroke, or death,” he says. “Looking at the data, the highest-ranking compound…was erythritol.” Of the 4,000 people included in the study data set, those with high blood erythritol levels were more likely to have a major cardiac event within three years than those with lower levels.
The study includes many other experiments to elucidate the connection between erythritol and heart disease, including feeding the sweetener to mice, which the researchers say promoted blood clots, and feeding it to eight people, which the researchers showed it was still present in blood plasma after a day of fasting. Other experiments, which included exposing blood, platelets, and plasma in a laboratory to erythritol, showed the same risk of clotting; in washed human platelets, an increase in collagen “stickiness” was almost instantly apparent. The amounts of erythritol they tested in these lab experiments were “completely within the range of what we’re seeing in the [blood] circulation of patients,” says Hazen. “And the effect is quite fast. Just being in the presence of erythritol for minutes was all it took to change platelet function and make them more prone to clotting.”
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Erythritol is considered one of the more “natural” sugar substitutes that has emerged as an alternative to the artificial options popularized over the last half century. This older group of synthetic sugar substitutes includes sucralose (found in the original version of Splenda), saccharin (found in Sweet’N Low), and aspartame (found in Equal, Nutrasweet, and more). While these artificial options are generally considered safe in small amounts, studies in animal models (and some observational research in humans) have linked them to different heat hazards. Aspartame, for example, It has been found have a potentially causal relationship with cancers, while long-term saccharin consumption has been tied to obesity, diabetes and other conditions in animal models.
Over the past decade, food manufacturers have begun to favor more “natural” types of sugar-free sweeteners to help avoid these potential health problems. This category includes sweeteners like stevia leaf and monk fruit extracts, along with erythritol and others. sugar alcohols or polyols—Recreations of low-calorie substances found in fruits and plants. (If you shop at a typical grocery store, there’s a good chance you have something with erythritol in your kitchen right now.) Erythritol is also popular as a keto-friendly sugar substitute in baking, as it is known to have a less artificial aftertaste than some other sweeteners. Despite careful research, erythritol and other polyols have has not been previously linked to any long-term health or disease risk, although in the short term they can cause laxative effects and other gastrointestinal problems.
But in determining how concerned you should be about the current study, it’s important to know that the appearance of erythritol in the blood before a cardiac event does not necessarily mean that erythritol is causing the event. previous investigation discovered that excess erythritol, which is also produced and metabolized by the human body, tends to stay in higher concentrations in blood before a cardiac event, London-based dietitian Nicole Guess noted on an Instagram mail about the study Erythritol in the body may be an indicator of cardiometabolic disease, but it’s not clear if that volume is determined by diet or by what the body has that it simply doesn’t get rid of.
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The production of erythritol in the body has has even been shown to increase when a person is under oxidative stress, a state that often leads to disease, says Dr. Idrees Mughal, a British physician with a master’s degree in nutritional research. These potentially confounding variables mean that the scary headlines about erythritol don’t always match up with the more complicated reality, since correlation is not causation. “I think the main problem with the media was simply the claim that was being made, that consumption of this sweetener was the reason for the increased risk of stroke or heart attack,” he says.
Experts have also taken issue with the fact that the data set used for the analysis included only people older than 60, all of whom had pre-existing cardiovascular disease or were rated as high risk for developing it.
Of course, it would be difficult to definitively link erythritol intake and heart disease. “You’re not going to easily do a randomized trial where your intention is to try to see whether or not you cause a heart attack,” Hazen says.
So should people give up their erythritol-containing snacks? “At this point, I would recommend avoiding erythritol and not worrying or bothering about very modest amounts of sweeteners that are natural,” such as honey or plain sugar, Hazen says. In his opinion, reducing the intake of sweets is safer and more effective than using a sugar substitute. For those looking to lose weight, for example, the data not bear that skipping sugar in favor of low-calorie and no-calorie alternatives actually contributes to weight loss. However, eating too much sugar has health risksadds Mughal, and in his opinion, “the risks associated with excess refined sugar far outweigh any of the sweeteners.”
The bottom line? Like so many foods that are the focus of nutritional research, more research is needed before purging your pantry.
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