It’s no secret that artificial sweeteners have been gradually replacing sugar in our daily diets, becoming increasingly prevalent in a variety of food and beverage products. One of the most commonly used sugar substitutes is Erythritol, which is often used in your morning coffee, protein bars, and a wide range of low-carb dietary products.
This sugar alternative is often hailed as a miracle solution for individuals looking to manage their weight or reduce calorie intake. However, what if I told you that this seemingly harmless artificial sweetener could actually be increasing our risk of heart attack and stroke?
A new study led by Dr. Stanley Hazen, a well-known expert in cardiovascular and metabolic sciences, suggests that this sweetener might not be as harmless as it seems.
Defining “artificial sweeteners”
Artificial sweeteners serve as substitutes for sugar in various foods and beverages, providing a sweet taste without the added calories. These substances are often significantly sweeter than sugar, which means that only a small quantity is needed to achieve the desired flavor profile.
Common examples include aspartame, saccharin, and sucralose, which have gained popularity in “sugar-free” or “diet” products. This appeal is particularly relevant for individuals aiming to lower their sugar intake for health reasons, such as managing weight or controlling blood sugar levels in diabetes.
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The use of artificial sweeteners has ignited debate regarding their safety and potential long-term health effects. However, regulatory bodies like the FDA have classified these sweeteners as safe when consumed within established limits.
Understanding erythritol
Erythritol is a popular pick for anyone trying to cut back on sugar. You’ll find it in lots of low-calorie, low-carb, and “keto” products. It’s about 70% as sweet as sugar, but with way fewer calories.
Unlike sugar, erythritol isn’t really processed by the body, so it just passes into the bloodstream and gets flushed out through urine.
On the surface, it seems harmless enough, especially since the U.S. Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) have labeled it as “generally recognized as safe” (GRAS). This means it can be used in food products without any restrictions.
Here’s the catch: while erythritol does naturally occur in fruits and veggies and is produced in small amounts during glucose metabolism, the levels we get from artificial sweeteners are much higher. This difference is what has scientists, like Dr. Hazen, taking a closer look.
Risks of erythritol and sugar substitutes
A recent study by Dr. Hazen’s team at the Cleveland Clinic looked into how erythritol affects blood clot formation, adding to a larger set of questions about the physiological effects of common sugar substitutes.
The results were surprising. Healthy volunteers who consumed erythritol at levels typically found in a “sugarless” soda or muffin experienced a staggering spike in blood erythritol levels to well over 1,000 times the baseline.
More concerning, this consumption was accompanied by a significant increase in blood clot formation.
To put these findings into context, when the same participants consumed glucose, their blood didn’t show the same tendency to clot.
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This difference is important because it emphasizes that erythritol itself — not just any artificial or natural sweetener — could be a unique risk factor.
What does this mean for consumers?
These findings have serious implications, particularly for individuals at high cardiovascular risk — those with conditions like obesity, diabetes, or metabolic syndrome.
“Many professional societies and clinicians routinely recommend that people at high cardiovascular risk consume foods that contain sugar substitutes rather than sugar,” says Dr. Hazen. But with evidence mounting against erythritol, it’s time to reconsider that advice.
Dr. Hazen’s research isn’t the first to cast doubt on the safety of erythritol. A previous study published last year in Nature Medicine revealed that cardiac patients with high erythritol levels were twice as likely to experience a major cardiac event within three years.
Moreover, adding erythritol to blood samples increased clot formation, a finding that was confirmed in pre-clinical studies.
These consistent results suggest that erythritol, even in amounts typically consumed, may not be as safe as once thought.
Expert urge caution
Given the potential risks, experts are urging caution. “This research raises some concerns that a standard serving of an erythritol-sweetened food or beverage may acutely stimulate a direct clot-forming effect,” says Dr. W. H. Wilson Tang, a co-author of the study and research director for Heart Failure and Cardiac Transplantation Medicine at Cleveland Clinic.
He emphasizes the importance of more research, especially long-term studies, to really get a handle on the cardiovascular safety of erythritol and other sugar substitutes.
Adding to the worry is that xylitol, another popular artificial sweetener, has shown similar effects in studies.
Just like erythritol, xylitol was linked to higher plasma levels and impacted platelet aggregation in healthy volunteers. The similarities between these sweeteners hint that the risks might not be exclusive to erythritol.
Erythritol and the future of sugar substitutes
So, where does that leave us? Right now, it’s smart to be cautious about artificial sweeteners, especially for those at high risk for heart disease.
Research by Dr. Hazen and his team is still ongoing. We can expect more findings in the coming years.
As Dr. Hazen concludes, “Cardiovascular disease builds over time, and heart disease is the leading cause of death globally. We need to make sure that the foods we eat aren’t secretly contributing to this crisis.”
This hints that the food industry and regulators might need to rethink their stance on erythritol and other sugar substitutes.
To sum it all up, while the convenience and low-calorie perks of these sweeteners are definitely appealing, we should think about their potential impact on our long-term health.
The discussion around these products goes beyond personal choices. The use of artificial sweeteners, like erythritol, xylitol, also has broader and concerning implications for public health.
The full study was published in the journal Arteriosclerosis Thrombosis and Vascular Biology.
