A new study from the Cleveland Clinic has raised concerns about the safety of erythritol, a popular low-calorie sweetener commonly found in “keto-friendly” foods, baked goods, and candies. Researchers found that erythritol, a sugar substitute, may pose greater cardiovascular risks than regular sugar.
Dr. Stanley Hazen, a cardiologist at the Cleveland Clinic and lead author of the study, compared the effects of erythritol and glucose on heart health. “We compared the results, and glucose caused none of the problems,” said Hazen. The study, published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, is the first to directly assess the impact of erythritol on blood levels after consumption.
The research suggests that sugar alcohols may make blood platelets stickier
Erythritol is part of a growing list of nonsugar sweeteners in low-calorie and sugar-free products. While it and xylitol are sugar alcohols that mimic the sweetness of sugar with fewer calories, recent studies from Hazen’s lab have linked these substances to an increased risk of heart attacks and strokes. The research suggests that sugar alcohols may make blood platelets stickier, increasing the likelihood of clotting, which can lead to blocked veins or arteries.
In the latest study, Hazen’s team tested the heart effects of erythritol and glucose by enrolling 20 healthy middle-aged volunteers. After fasting overnight, the participants were divided into two groups: one consumed erythritol, and the other glucose. Blood samples were taken before and after the consumption of 30 grams of the respective sweeteners.
The results showed that those who consumed erythritol experienced increased platelet aggregation, a condition that makes blood more prone to clotting. In contrast, those who drank glucose showed no changes in platelet activity. The erythritol group also exhibited a 1,000-fold increase in blood erythritol levels, far surpassing the naturally occurring trace levels in the body.
“The amount in sugar substitutes is thousands of folds higher than what is made in our bodies, so to call it ‘natural,’ it’s not,” Hazen emphasized. He advised avoiding sugar substitutes, particularly sugar alcohols, due to the acute increase in clotting risks associated with their consumption.
FDA currently classifies erythritol and other artificial sweeteners as “generally recognized as safe”
While the Food and Drug Administration (FDA) currently classifies erythritol and other artificial sweeteners as “generally recognized as safe” (GRAS), Hazen hopes that emerging evidence will prompt the FDA to reevaluate these classifications. Internationally, concerns over erythritol have also caught the attention of regulators. Last year, the European Food Safety Authority recommended that the European Commission gather more data on erythritol content in foods to better assess its risks.
The study’s findings have sparked debate about whether erythritol is more dangerous than traditional high-calorie sugar. Valisa Hedrick, a registered dietitian at Virginia Tech, pointed out that diets high in sugary foods can also elevate blood glucose levels, contributing to stroke and clotting risks. Hedrick was not involved in the Cleveland Clinic study but highlighted the importance of balancing overall diet and health considerations when evaluating sweetener choices.
