I used to love baking desserts and adding artificial sweeteners like erythritol to my cakes, dark unsweetened chocolate, drinks, and yogurt, believing I was making a healthier choice. However, my view changed when a study revealed a link between erythritol and serious health risks. This motivated me to investigate the potential adverse effects of erythritol on my well-being and its possible impact on my thyroid..

Artificial sweeteners have gained immense popularity as a means to reduce sugar and calorie intake, especially among individuals conscious of their dietary choices. Regulatory agencies generally deem these sweeteners safe for consumption. However, concerns about their long-term health consequences continue to mount. Recent evidence has brought attention to a potential link between certain artificial sweeteners and cardiovascular problems, although researchers have not definitively established this connection.

Erythritol, a commonly used artificial sweetener, has become a central topic of discussion. While small amounts of erythritol naturally occur in certain fruits and vegetables, and our cells synthesize it as part of regular metabolic processes, its consumption as a sugar substitute greatly exceeds the levels found in natural foods. Erythritol falls under the sweeteners category known as “sugar alcohols,” but Nutrition Facts labels typically do not list it separately with its specific quantity.

 Erythritol and Cardiovascular Risk

A research team led by Dr. Stanley Hazen at the Cleveland Clinic, funded by the NIH, investigated the connection between erythritol and heart attacks and strokes. Their initial study involving over 1,000 participants looked for compounds in the blood that could predict future heart-related risks. Over three years, they monitored significant adverse cardiovascular events, such as heart attacks, strokes, and deaths. The researchers published the results in Nature Medicine on February 27, 2023. The study showed that an increased risk of cardiovascular events was linked to higher levels of erythritol and related artificial sweeteners.

Studies on Erythritol

To confirm these findings, the researchers studied two more groups of nearly 3,000 individuals in the United States and Europe. They also developed a method to distinguish erythritol from similar compounds better. These additional studies confirmed the association between erythritol and cardiovascular events. Individuals with the highest erythritol levels (top 25%) were about twice as likely to experience cardiovascular events over three years as those with the lowest levels (bottom 25%).

To understand how erythritol influences these health risks, the researchers conducted experiments involving human platelets, which are crucial components in blood clotting. They exposed these platelets to the artificial sweetener erythritol. They observed that this exposure increased the platelets’ responsiveness to signals that trigger blood clotting. Moreover, the researchers conducted experiments with mice, where they increased the levels of erythritol in their bloodstream. This elevation in erythritol levels in the blood had a notable effect: it accelerated the formation of blood clots within the vessels and increased the likelihood of arterial blockage. These findings shed light on how erythritol might promote blood clotting and contribute to the risk of health issues such as heart attacks and strokes.

The researchers also analyzed blood erythritol levels in eight healthy volunteers who consumed a beverage sweetened with erythritol. They found a substantial increase in erythritol levels, which remained elevated for several days and affected platelet clotting. These findings suggest that consuming erythritol could increase blood clot formation, potentially raising the risk of heart attacks or strokes. Researchers need to continue studying erythritol’s safety and health risks since many people use it widely in artificially sweetened foods.

Dietary Influence

The study also explored the impact of diet on erythritol levels in the human body. The researchers gave eight healthy volunteers a beverage sweetened with erythritol and monitored their blood erythritol levels. Astonishingly, the consumption of this beverage led to a 1,000-fold increase in blood erythritol levels, which remained significantly elevated for several days. During this period, erythritol levels exceeded the threshold necessary to induce changes in platelet function. These results highlight the need for further investigation into the long-term effects of consuming foods high in erythritol, particularly in individuals with diets rich in processed foods or artificial sweeteners. While erythritol is considered a low-calorie alternative to sugar, the dramatic increase in blood levels after consumption suggests its potential impact on cardiovascular health may require further investigation, especially when consumed in large amounts or frequently.

Exploring Future Research on Erythritol

Recent findings suggest a potential link between erythritol consumption and blood clot formation. However, the current research is limited, and more extensive studies are needed to confirm these adverse effects definitively. Given the concerns about the sugar industry’s influence on research funding, it is crucial to conduct rigorous and independent scientific investigations to validate findings related to erythritol and other artificial sweeteners.

The study highlights the need for further research into erythritol’s safety and health risks, especially considering its use in artificial sweeteners. With the increasing global burden of cardiovascular diseases, Dr. Stanley Hazen’s call for comprehensive, long-term sweetener research becomes even more relevant. Cardiovascular conditions typically develop over time, making it essential to investigate whether dietary choices, including artificial sweeteners, might contribute to the onset or worsening of these conditions.

In light of these potential risks, individuals looking for healthier sugar alternatives should consider options with a more established safety profile and fewer potential health risks. Making informed dietary choices is crucial for protecting long-term health and well-being.

Here are some healthier sugar alternatives to consider

Stevia

Stevia comes from the leaves of the Stevia rebaudiana plant. This natural, calorie-free sweetener has been used for centuries.  It doesn’t affect blood sugar levels, making it an excellent option for those managing diabetes or looking to reduce their sugar intake. Stevia is available in various forms, including liquid drops, powder, and granules, making it versatile for different culinary uses. However, individuals should consume it moderately to avoid any potential side effects, such as gastrointestinal discomfort.

Monk Fruit Sweetener

Monk fruit extract is another natural sweetener containing mogrosides, which provide sweetness without calories. It is considered safe and is increasingly popular as a sugar alternative. Monk fruit sweetener is often blended with other sweeteners like erythritol to improve texture and taste. While it offers many benefits, it should be consumed in moderation to maintain overall health.

Raw Honey

While honey does contain natural sugars, it offers potential health benefits due to its antioxidants and antimicrobial properties. Raw honey is minimally processed, preserving more of its natural nutrients. It can be a healthier alternative to refined sugar, providing vitamins and minerals such as B and C. However, one should use it in moderation, especially for individuals with diabetes or those monitoring their blood sugar levels. People should not give honey to infants under one year due to the risk of botulism.

Maple Syrup

Maple syrup is a natural sweetener that contains vitamins, minerals, and antioxidants. Opt for 100% pure maple syrup to avoid added sugars and preservatives. Maple syrup provides manganese and zinc, which support immune health. Although it has some health benefits, remember to use it in moderation, as it is still high in sugar. Maple syrup can be a great addition to various recipes, adding a rich flavor while contributing to nutritional intake.

Coconut Sugar

Coconut sugar comes from the sap of coconut palm trees.  It has a lower glycemic index than regular sugar and contains additional nutrients such as iron, zinc, calcium, and potassium. It can be a better alternative for those looking to manage their blood sugar levels. In most recipes, coconut sugar has a caramel-like flavor and can be used as a one-to-one replacement for regular sugar. However, like all sweeteners, it’s best to consume it in moderation to maintain a balanced diet and avoid excessive calorie intake.

Date Sugar

Manufacturers produce date sugar from ground-dried dates, retaining some nutrients and fiber from the fruit. It can be a good option for baking special treats, providing a natural sweetness and some health benefits, such as potassium and magnesium. Date sugar does not dissolve well in liquids, making it more suitable for baked goods than beverages. However, it should be used in moderation, as it still contains sugars and calories, which can add up quickly if consumed in large amounts.

Xylitol

Xylitol is a sugar alcohol like erythritol but is often better tolerated by the digestive system. It has a similar sweetness to sugar with fewer calories and can benefit dental health, helping reduce the risk of cavities. Xylitol is commonly used in sugar-free gums, mints, and other dental products. However, it should be used moderately, as excessive consumption can lead to digestive issues such as bloating and diarrhea. Additionally, xylitol is highly toxic to dogs, so it should be kept out of reach of pets.

 

Sources

Erythritol and cardiovascular events
https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events

Cleveland Clinic Study Finds Common Artificial Sweetener Linked to Higher Rates of Heart Attack and Stroke
https://newsroom.clevelandclinic.org/2023/02/27/cleveland-clinic-study-finds-common-artificial-sweetener-linked-to-higher-rates-of-heart-attack-and-stroke/

Trends in the Consumption of Low-Calorie Sweeteners
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5578610/