I used to love baking desserts and adding artificial sweeteners like erythritol to my cakes, dark unsweetened chocolate, drinks, and yogurt, thinking I was making a healthier choice. However, my perspective on these sweeteners changed when a study revealed a link between erythritol and deadly health problems. I decided 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.

The Study’s Investigation on Erythritol

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. 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 approximately 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 arteries becoming blocked. These experiments 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. Their findings revealed a substantial increase in erythritol levels, which remained elevated for several days and had a notable effect on the clotting of the platelets, These findings suggest that consuming erythritol may increase blood clot formation, potentially raising the risk of heart attacks or strokes. Researchers must further study erythritol’s safety and health risks since it is widely used in artificially sweetened foods.

Dietary Influence

The study also explored the impact of diet on erythritol levels within the human body. Eight healthy volunteers were subjected to a beverage sweetened with erythritol, and their blood erythritol levels were monitored. Astonishingly, the consumption of this beverage led to a staggering 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.

Implications and Future Research on Erythritol

These findings suggest a potential link between erythritol consumption and blood clot formation. However, it’s important to note that researchers need to conduct more extensive research to confirm these adverse effects definitively. Due to the limited scope of current research on erythritol’s health implications, researchers must conduct additional studies to attain a more comprehensive understanding of its impact on human health. Acknowledging concerns about the potential influence of the sugar industry on research funding, it is crucial to maintain rigorous and independent scientific investigations to ensure the validity of findings concerning erythritol and other artificial sweeteners.

Implications for Future Research

The study underscores the importance of researching erythritol’s safety and health risks, particularly in its use in artificial sweeteners. Dr. Stanley Hazen’s plea for comprehensive, long-term sweetener research gains significance given the rising global cardiovascular disease burden. Cardiovascular conditions often develop over extended periods, making it crucial to determine whether dietary choices, including artificial sweeteners, may contribute to the onset or exacerbation of these conditions. Therefore, continued research efforts are essential to provide more precise insights into the health implications of widely consumed sugar substitutes.

In light of these potential concerns surrounding erythritol, individuals seeking healthier sugar alternatives to artificial sweeteners should consider options with a more established safety profile and fewer potential health risks. Making informed dietary choices is critical for safeguarding our long-term health and well-being.

Here are some healthier sugar alternatives to consider

Stevia

Stevia is obtained from the leaves of the Stevia rebaudiana plant. People have used this natural, calorie-free sweetener for centuries. It doesn’t affect blood sugar levels, and individuals should consume it moderately.Stevia is obtained from the leaves of the Stevia rebaudiana plant. People have used this natural, calorie-free sweetener 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 found blended with other sweeteners like erythritol to improve texture and taste. While it offers many benefits, including being suitable for low-carb diets and not raising blood sugar levels, 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 vitamins and vitamin C. However, one should use it in moderation, especially individuals with diabetes or those monitoring their blood sugar levels. It’s also important to note that honey should not be given 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. It contains manganese and zinc, which are beneficial for immune health. Although it has some health benefits, it’s important to 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, derived from the sap of coconut palm trees, 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. Coconut sugar has a caramel-like flavor and can be used as a one-to-one replacement for regular sugar in most recipes. However, like all sweeteners, it’s best to consume it in moderation to maintain a balanced diet and avoid excessive calorie intake.

Date Sugar

Date sugar is produced from ground dried dates and retains some nutrients and fiber from the fruit. It can be a good option for baking special treats, providing a natural sweetness along with some health benefits, such as potassium and magnesium. Date sugar does not dissolve well in liquids, making it more suitable for baked goods rather 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 be beneficial for dental health, helping to reduce the risk of cavities. Xylitol is commonly used in sugar-free gums, mints, and other dental products. However, it should be used in moderate amounts, 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/