Popular artificial sweetener, erythritol, could raise risk of heart attack and stroke: study
A popular artificial sweetener, erythritol, could increase the risk of heart attack and stroke, a new study from the Cleveland Clinic revealed.
Researchers evaluated more than 4,000 people in the US and Europe. Those who consumed large amounts of erythritol had a greater risk of developing serious adverse cardiovascular events, including stroke, heart attack or death.
The study, published in Nature Medicine, found that erythritol may contribute to blood clot formation, a major trigger for cardiac events.
However, there were also some caveats.
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Erythritol is a carbohydrate called a sugar alcohol that has about half the calories of regular sugar, according to WebMD.
It is an ingredient in both Truvia and Splenda Naturals Stevia Sweetener, two popular low-calorie sugar substitutes. The sweetener also occurs naturally in some foods, including grapes, watermelon, pears, mushrooms and fermented cheese.
“Our research shows that when participants consumed an artificially sweetened beverage containing an amount of erythritol found in many processed foods, markedly elevated levels were seen in the blood for days — levels well above the observed clotting risks,” said Stanley Hazen, MD, PhD, in a press release on the Cleveland Clinic website.
He is co-section chief of preventive cardiology at Cleveland Clinic and lead author of the study.
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The U.S. Food and Drug Administration (FDA) approved erythritol for safe consumption in 2001. The World Health Organization (WHO) approved it in 1999.
Erin Palinski-Wade, RD, a New Jersey-based dietitian with a focus on diabetes and nutrition, said erythritol has a sweetness level similar to sugar, making it easy to mix up recipes in equal amounts.
“Because it is not metabolized in the gut, erythritol has a limited impact on blood glucose levels, unlike other sugar alcohols,” Palinski-Wade told Fox News Digital in an email.
“This sweetener also has no aftertaste and only 0.24 calories per gram, making it an attractive choice as a sugar substitute.”
Palinski-Wade, who was not involved in the new study, said erythritol is also added to a variety of foods, including low-carb ice creams, protein powders, low-carb snacks, desserts and some beverages.
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“Sweeteners such as erythritol have grown rapidly in popularity in recent years, but more in-depth research needs to be done on their long-term effects,” says Cleveland Clinic’s Hazen.
“Cardiovascular disease builds up over time and heart disease is the leading cause of death worldwide. We need to make sure the foods we eat don’t have hidden contributions.”
Robert Rankin, the Washington, D.C.-based executive director of the Calorie Control Council, which represents the low-calorie and low-calorie food and beverage industry, said erythritol is a proven safe and effective choice for reducing sugar and calories.
“The results of this study contradict decades of scientific research showing that low-calorie sweeteners such as erythritol are safe, as evidenced by global regulatory approvals for their use in foods and beverages, and should not be extrapolated to the general population, as the participants already had an increased risk of cardiovascular events during the intervention,” Rankin told Fox News Digital in an email.
“More research and long-term studies are needed to fully understand erythritol’s impact on long-term health.”
Palinski-Wade, the New Jersey registered dietitian, said she was surprised by the study’s findings.
“Most of the previous research on erythritol has been quite positive, as it contains beneficial antioxidants and does not affect blood glucose levels or insulin,” she said.
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“More research and long-term studies, including studies in individuals with no current risk factors for cardiovascular disease, are needed to fully understand erythritol’s impact on long-term health,” Palinski-Wade added.
Hazen also recognized the need for further research.
“It is important that further safety studies are conducted to investigate the long-term effects of artificial sweeteners in general, and erythritol in particular, on the risks of heart attacks and strokes, particularly in people at higher risk of cardiovascular disease,” he said.
The limitations of the study
The new study had some limitations that are important to know.
Kim Kulp, a registered dietitian in San Francisco, California, who was not involved in the study, pointed out that while there was an increase in cardiovascular events following higher levels of erythritol in the blood, the people involved in the study were already at a higher risk of heart disease and other health problems.
“Since those who choose to use sugar substitutes are often overweight or have diabetes, they are at greater risk for heart problems to begin with,” she told Fox News Digital in an email.
“The results of the same study could be different if the subjects were all healthy individuals.”
Palinski-Wade said the best strategy is to follow the Dietary Guidelines of Americans (from the U.S. Department of Health and Human Services) recommendation to limit added sugars to less than 10% of total daily calories — and to avoid all sweeteners, both caloric and non-calorie, in moderation.
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“Working to limit added sweeteners in the diet while boosting our intake of foods that contain naturally occurring sugars, such as whole fruit, is the best strategy when it comes to improving long-term health,” said she.
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“Based on the findings of this study, people with risk factors for cardiovascular disease should talk to their doctor to see if erythritol is right for them.”