An ingredient in sugar-free and low-calorie foods that could increase the risk of heart attack and stroke.
Erythritol is a sugar substitute made from wheat or maize and commonly used as an additive in foods and medications.
According to a study, consumption of erythritol over the long-term could increase the risk of heart attack and stroke.
Over 4,000 European and American adults took part in the study.
The researchers noticed that participants with elevated levels of erythritol in their blood samples were more likely to suffer from heart failure, stroke, or other major adverse cardiovascular events (MACE), and death.
To identify why this sweetener has such an effect on human health, the team examined the changes made by erythritol in the blood and isolated platelets.
Platelets are small blood cells that clump together to form clots when a blood vessel is damaged.
They found that erythritol increased platelet reactivity and the formation of blood clots (thrombosis).
Past studies have also suggested that erythritol ingestion would increase blood clotting.
Dr Stanley Hazen, the study’s senior author, said:
“Sweeteners like erythritol, have rapidly increased in popularity in recent years but there needs to be more in-depth research into their long-term effects.
Cardiovascular disease builds over time, and heart disease is the leading cause of death globally.
We need to make sure the foods we eat aren’t hidden contributors.”
In recent years table sugar has been extensively replaced with erythritol or other artificial sweeteners in low-carb, low-calorie, and keto meals.
People with diabetes, obesity, or metabolic syndrome or those who want to lose weight have been advised to eat sugar-free foods which often contain erythritol.
However, these people are at increased risk of adverse cardiac events such as heart failure and stroke.
Erythritol is a natural sweetener largely made from fermenting corn and it is 70 percent as sweet as sugar.
Erythritol when ingested can’t be eliminated easily from the body, alternatively, it will be absorbed into the bloodstream and some passes through urine.
Our body naturally makes a very small amount of erythritol but its long term consumption will only lead to accumulation of this compound in the body.
The other issue is that artificial sweeteners are difficult to measure and minimum labelling requirements are applied to these ingredients.
In addition, The United States Food and Drug Administration (FDA) has listed erythritol in the ‘Generally Recognized As Safe’ (GRAS) group meaning there is no need for specific research to evaluate its long-term safety.
Dr Hazen said:
“Our study shows that when participants consumed an artificially sweetened beverage with an amount of erythritol found in many processed foods, markedly elevated levels in the blood are observed for days—levels well above those observed to enhance clotting risks.
It is important that further safety studies are conducted to examine the long-term effects of artificial sweeteners in general, and erythritol specifically, on risks for heart attack and stroke, particularly in people at higher risk for cardiovascular disease.”
The study was published in the journal Nature Medicine (Witkowski et al., 2023).
