Erythritol, a popular sugar substitute commonly found in sugar-free and low-calorie products, is now facing serious scrutiny following a groundbreaking study linking its consumption to an increased risk of blood clotting, heart attacks, and strokes. The study has sparked widespread concern, especially among those who rely on artificial sweeteners for weight management or to control conditions like diabetes. As erythritol has long been considered a safe alternative to sugar, these findings have left many consumers questioning its true impact on health.
What Is Erythritol?
Erythritol is a type of sugar alcohol (polyol) that occurs naturally in certain fruits like grapes and melons, as well as in fermented foods such as wine and cheese. It’s widely used in food manufacturing because it closely mimics the taste of sugar without contributing calories or significantly affecting blood glucose levels.
This sweetener is popular in sugar-free candies, low-calorie baked goods, and beverages, as well as in many products marketed for diabetics and those following keto or low-carb diets. Unlike other sugar alcohols, erythritol is absorbed in the small intestine and largely excreted through urine without being metabolized. This allows it to avoid the digestive side effects common with other artificial sweeteners, like sorbitol or xylitol, which can cause bloating and diarrhea.
However, despite its perceived safety, new research suggests that erythritol may not be as harmless as once believed, particularly when it comes to cardiovascular health.
The Study Linking Erythritol to Blood Clotting
In early 2023, a study published in Nature Medicine by researchers from the Cleveland Clinic examined the effects of erythritol on cardiovascular health. The study followed over 4,000 participants in the U.S. and Europe, many of whom were already at high risk for cardiovascular disease. Researchers measured the participants’ blood levels of various sweeteners, including erythritol, and tracked cardiovascular events such as heart attacks, strokes, and deaths due to cardiovascular complications.
The results were alarming. Higher levels of erythritol in the blood were linked to an increased risk of blood clot formation, which can lead to heart attacks and strokes.
Key Findings of the Study:
- Increased Platelet Activity: Erythritol was shown to promote platelet aggregation, the process by which blood cells clump together to form clots. While this is a necessary function to stop bleeding, excessive clotting can block blood flow to the heart or brain, causing life-threatening events like heart attacks and strokes.
- Elevated Cardiovascular Risk: Participants with higher blood erythritol levels were more likely to experience major adverse cardiac events (MACE), such as heart attacks or strokes. This risk was particularly elevated in individuals with preexisting conditions like diabetes, obesity, or hypertension, all of whom are more likely to consume sugar substitutes to manage their health.
- Rapid and Sustained Blood Levels: When participants consumed beverages containing erythritol, their blood levels of the sweetener spiked and remained elevated for several hours. This prolonged exposure could potentially maintain a heightened cardiovascular risk in regular consumers.
Why These Findings Matter
For years, erythritol has been marketed as a healthier alternative to sugar, largely due to its low-calorie content and negligible effect on blood sugar levels. This made it an attractive option for diabetics, people looking to lose weight, and those trying to avoid the harmful effects of sugar, like tooth decay or blood sugar spikes.
However, this new research challenges the assumption that erythritol is inherently safe for everyone. The link between erythritol and blood clotting introduces serious questions about its long-term impact on cardiovascular health, particularly for individuals who are already at risk for heart disease or stroke.
Implications for Consumers
The study’s findings have raised legitimate concerns about the safety of erythritol, especially for people with cardiovascular risk factors. Many individuals may be unknowingly consuming erythritol in “healthy” sugar-free or low-calorie products, believing they are making safer dietary choices.
Here’s what you need to consider if you regularly consume erythritol:
- Higher Cardiovascular Risk: If you have a history of cardiovascular disease, diabetes, or obesity, the study suggests you may be at a higher risk of experiencing blood clot-related complications if erythritol is a significant part of your diet.
- Reevaluation of “Healthy” Foods: Many products marketed as sugar-free or low-calorie alternatives may now need to be reconsidered. The assumption that erythritol is safe simply because it is low-calorie may no longer hold, particularly when cardiovascular health is at stake.
Understanding the Broader Context of Sweeteners
Artificial sweeteners have long been positioned as better alternatives to sugar, helping individuals manage weight, diabetes, and other health conditions. Erythritol, in particular, has been favored for its neutral taste, zero-calorie profile, and minimal impact on blood glucose levels. But are all sugar substitutes truly better?
Research over the years has shown that not all sweeteners are created equal. Some, like aspartame and sucralose, have been linked to other health concerns, such as changes in gut bacteria, metabolic issues, and in some cases, even cancer risks. While erythritol was considered safer than these, the new findings suggest that even “natural” sweeteners may carry unforeseen risks.
What’s Next for Erythritol?
This new research will likely prompt further investigations into erythritol’s effects on cardiovascular health. More extensive studies involving larger, more diverse populations are needed to confirm these initial findings and fully understand the sweetener’s long-term health impacts.
- Regulatory Implications: Currently, erythritol is classified as “generally recognized as safe” (GRAS) by the U.S. Food and Drug Administration (FDA), meaning it can be added to food products without requiring extensive pre-market testing. However, with this new evidence, regulatory agencies like the FDA and the European Food Safety Authority (EFSA) may need to reassess their guidelines on erythritol’s safety.
- Public Health Guidance: Health experts are urging caution but not panic. While the findings are concerning, they are not yet definitive enough to warrant an immediate ban or drastic dietary changes for most individuals. However, people with heart disease, diabetes, or other cardiovascular risk factors should be especially mindful of their erythritol intake and consider discussing it with their healthcare provider.
Practical Takeaways for Consumers
If you’re concerned about erythritol’s potential risks, here are some practical steps to take:
- Monitor Your Intake: Check product labels to see if erythritol is a primary sweetener in your food. It’s often found in sugar-free gum, diet drinks, keto snacks, and certain protein bars. Reducing consumption of products high in erythritol may help lower potential risks.
- Explore Other Sweetener Options: Consider trying other sugar substitutes such as stevia, monk fruit, or allulose, which may offer similar benefits without the clotting risks linked to erythritol. Each alternative has its own advantages and drawbacks, so it’s important to do your research or consult a healthcare professional.
- Consult with a Doctor: If you have a history of cardiovascular disease, diabetes, or any related conditions, it’s a good idea to talk to your doctor about these findings. They can help you understand how erythritol may affect your health and whether you should limit its use in your diet.
Conclusion: A Closer Look at Erythritol’s Safety
The discovery that erythritol may increase the risk of blood clotting, heart attacks, and strokes is a wake-up call for consumers and healthcare professionals alike. While erythritol has been praised for its low-calorie and blood sugar-friendly profile, this new evidence suggests that the long-term effects on cardiovascular health may be far more complex than previously thought.
As more research is conducted, it’s important for consumers to stay informed and mindful of their sweetener choices, particularly those with underlying health conditions. As with all dietary decisions, balance and moderation are key. While this new study is concerning, it doesn’t mean erythritol is dangerous for everyone—but it does suggest that a closer look is needed.
