According to a new study published inNature Medicine, Erythritol, a popular sugar substitute & zero calorie artificial sweetener found in Truvia and used in many of no-sugar and keto-friendly products, can cause blood clotting and increase the risk of heart attack/cardiac arrest and stroke.
The study concluded that people with the highest levels of erythritol in their blood were two times likely to have a heart attack, stroke, or death compared to people with others with lowest levels.
“The results were striking”, says senior authorStanley Hazen, MD, PhD, chairman for the department of cardiovascular and metabolic sciences at the Lerner Research Institute and co-section head of preventive cardiology at Cleveland Clinic in Ohio.
“That puts this (Erythritol) on par with the same risk of the strongest of the cardiac risk factors, such as having diabetes. It’s even arguably stronger than the risk ofhigh cholesterolor blood pressure,” he added.
Adding his opinion, Mandeep Kainth, MD, an associate director of preventive cardiology at the Stony Brook Heart Institute in Stony Brook, New York, who did not take part in the research said; “This is an incredibly important study that provides significant evidence for how the use of artificial sweeteners, in particular the sugar substitute erythritol, may also increase the risk of cardiovascular diseases such as heart attacks, stroke, and death.”
According to Dr. Hazen, researchers did not initially set out to study erythritol. The discovery was made while studying different compounds that naturally occur in the human blood to see if any predicted later heart attack or stroke. It was during the research that the scientists discovered that people with naturally high levels of erythritol — which our bodies produce naturally as a byproduct of metabolism, appeared to be at higher risk.
After that, researchers then focused on erythritol and measured it in about 3,000 people in the United States and Europe. They discovered that people with the highest levels of erythritol (the top 25 percent) in their blood had twice the risk of heart attack, stroke, or death compared to people with the lowest levels of the compound.
The scientists also examined the effects of adding erythritol to either whole blood or isolated platelets, which are cell fragments that clump together to stop bleeding and help form blood clots. They found that erythritol made platelets easier to activate and form a clot. Blood clots can become dislodged and travel to the heart where they become dangerous and can lead to a heart attack, or a stroke – if the blood clot gets to the brain.
Consuming Erythritol in Processed Foods Can Increase Plasma Levels of the Compound by 1000%
Erythritol is produced by fermenting corn. It can be sold alone or included as part of an ingredient in stevia- and monk fruit-based sweeteners. It’s about 70 percent as sweet as sugar, hence, can be used as a sugar substitute.
However, after being consumed, erythritol is poorly broken down by the body. It goes into the bloodstream and leaves the body mainly through urine.
After discovering the risk of high levels of erythritol and its impact on clotting, Hazen and colleagues decided to look at how it might accumulate in people who consumed it through processed foods. In a small pilot study, healthy volunteers were given one to two servings of erythritol in products such as sweetened ice cream or lemonade.
According to Hazen, “the plasma levels of erythritol increased by about 1,000 percent higher, and then stayed above the levels that were observed, to enhance clotting risks in earlier experiments for days.”
People Erroneously Thought Taking Sugar Substitutes Was Healthier
Many people with underlying cardiac risk factors have been consuming products sweetened with erythritol because they believed it was a better and healthier option. However, the results of this study imply that those very products are putting people at an even higher risk of cardiovascular disease.
In 2018, theAmerican Heart Association (AHA)had advised short-term replacement of sugar-sweetened beverages with beverages containing low-calorie sweeteners, including artificially sweetened beverages, as a reasonable approach to calorie reduction and weight loss, says Kainth.
This study builds on research data from theWomen’s Health Initiativethat showed that women who consumed at least 24 ounces on average per day of artificially sweetened beverages had an elevated risk of cardiovascular disease.
“Given that the safety of these sugar substitutes has not been studied in detail, I believe the topic of artificial sweeteners and their impact on our health deserves more attention. This article brings up some very compelling questions that are important to address,” Kainth said.
However, the findings added that follow-up research will be needed in order to have a firm confirmation. The study had several limitations, including that observation studies demonstrate association and not causation.
“To further strengthen these findings, we need more solid scientific evidence in the form of randomized controlled trials with larger population sizes, which can effectively assess the direct impact these products have on cardiovascular disease,” he says.
