A study conducted by the Cleveland Clinic has found that eating foods containing erythritol can enhance the risk of adverse cardiovascular events.
The sweetener — which naturally occurs in a number of fruits and vegetables — is often used in low-sugar food products such as baked goods and fizzy drinks, but is used to sweeten foods at a greatly elevated level to when the ingredient is naturally found.
The clinic’s intervention study, which was published in Arteriosclerosis, Thrombosis and Vascular Biology, found that healthy volunteers who consumed the sweetener had more active platelets, which are commonly associated with clotting.
To further this, it was also found that the addition of erythritol to the blood could significantly increase blood clot formation.
This could be concerning as the volunteers who consumed food-grade levels of the sweetener had a blood erythritol levels 1000x higher than normal.
The researchers also found that sugar did not sustain this effect on the body.
Researchers call for a rethink on erythritol
According to Cleveland, there is a growing body of evidence to suggest that erythritol may not be as safe for use in food and beverage products as originally assumed, and it may need re-evaluating.
“Many professional societies and clinicians routinely recommend that people at high cardiovascular risk – those with obesity, diabetes or metabolic syndrome – consume foods that contain sugar substitutes rather than sugar,” said senior and corresponding author Stanley Hazen, Chair of Cardiovascular and Metabolic Sciences in Cleveland Clinic’s Lerner Research Institute and co-section head of Preventive Cardiology. “These findings underscore the importance of further long-term clinical studies to assess the cardiovascular safety of erythritol and other sugar substitutes.”
Erythritol is currently classified by the US Food and Drug Administration (FDA) and the European Food Safety Authority (EFSA) as GRAS.
“This research raises some concerns that a standard serving of an erythritol-sweetened food or beverage may acutely stimulate a direct clot-forming effect,” said study co-author W. H. Wilson Tang, research director for Heart Failure and Cardiac Transplantation Medicine at Cleveland Clinic. “Erythritol and other sugar alcohols that are commonly used as sugar substitutes should be evaluated for potential long-term health effects especially when such effects are not seen with glucose itself.”
The results are also concerning owing to the results of another recent study, which found that xylitol, a common artificial sweetener, can also affect platelet aggregation and induce adverse cardiovascular events.
Dr Hazen concluded: “Cardiovascular disease builds over time, and heart disease is the leading cause of death globally. We need to make sure the foods we eat aren’t hidden contributors.”