News

Jan 21, 2024

Food for Thought: Erythritol Ever After?

Something for nothing. More bang for our buck. It’s human nature to seek value

Something for nothing. More bang for our buck. It's human nature to seek value in things, even in food. We’ve seemingly found freebies in low calorie, diet products like artificial sweeteners and sugar alcohols. Something for nothing – all the taste and fewer calories – but what's the catch? Are they too good to be true?

A recent study in Nature Medicine suggests that, yes, one in particular may be exactly that. Erythritol, a popular sugar alcohol, is used in products from protein powders, toothpaste and ice cream to a host of other foods, particularly keto friendly products. Our bodies produce low levels of erythritol during glucose metabolism, but much of the sweetener used today is commercially produced using corn or wheat starch, making it an ultra-processed food. Because low levels of erythritol also exist in foods like grapes, peaches, mushrooms, cheese and even beer and wine, it's thought to be ‘natural’.

Erythritol took off as another ‘something for nothing’ sweetener. It's even used to sweeten monk fruit to make it taste more like sugar. Many things with this sugar alcohol remain unclear, but it is reported to be excreted by our bodies unchanged, which is why it has close to zero calories and doesn't spike our blood sugar. It's almost as if it's sugar incognito!

The study spurred much conversation because of its subjects. A group of about 4,000 people who were undergoing cardiac assessment, all of whom were nearly age 60 or over, made up the participants. The study linked use of erythritol to cardiac arrest, stroke and ultimately death. According to the Cleveland Clinic, the results seem to show that erythritol made platelets easier to activate and form clots. Additionally, sugar alcohols were shown to remain in eight people's blood streams for days after they had eaten ice cream containing erythritol. (Naysayers rightfully call that number to issue).

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None of us like bad news, especially those of us who may use this sweetener, but I got so much blowback from social media regarding my discussion of the study, that I decided to go to the source. Dr. Rigved Tadwalkar, a cardiologist in Santa Monica, has been named an ‘emerging voice in the field’ and was quoted in articles discussing the study on Healthline.com and in Prevention Magazine. I came across his name while researching the study and decided to contact him for an interview. Dr. Tadwalkar is as charismatic during our meeting as he is in the news clips in which he's featured. He discusses the study in a digestible manner and is cautious in telling his patients to adopt artificial sweeteners in any capacity other than sparingly.

"It makes sense that anything we can do early on, from a preventative standpoint to try to reduce our cardiovascular risk factors, is always of value. So just because you’re younger, it doesn't put you in a category where you should potentially think of it as safe. Consume it sparingly."

Implications.

The study's outcomes beg the question: "Should we ingest erythritol?" European countries demand studies to show that a substance is not harmful before they add it to their food sources. In America, we do the opposite. We use it until it is proven, beyond a doubt, that it is not only harmful, but deadly.

"It's honestly probably better to have the real thing," Dr. Tadwalkar says. "There is some evidence that, for many people, real sugar can satiate the palate better than artificial sweeteners. Sugar activates the brains reward centers and releases dopamine which is a neurotransmitter that is associated with satisfaction and pleasure, satiation, things like this. This can create a feeling of fullness and contentment that can lead to a decrease in cravings for even more sweet foods. Artificial sweeteners don't really activate the same brain reward centers and, as a result, they don't really quite release the dopamine in the same way or to the same extent."

Given the fact that older people with chronic health conditions, like heart disease, diabetes and a predisposition to stroke, may seek to lower their sugar, thereby using erythritol or other sugar alcohols, the findings of this study may have deeper real-world implications.

My question is, what foods containing erythritol are we so attached to that we would risk our health to eat them? What is more important than health?

"Obviously we’re not going to eliminate sweet foods, it's a daily part of life, it's a part of living and it's a source of contentment, we just have to do it the right way," Tadwalkar says.

Try this recipe to curb a sweet tooth…the right way.

DIY Fruit Roll Ups

Ingredients

1 pound strawberries (fresh or frozen, thawed)

2 tablespoons lemon juice

2 teaspoons sugar

Method

Trim and purée berries in a food processor.

Transfer mixture to a saucepan.

Add lemon juice and sugar.

Cook over medium heat for 20 minutes, until the mixture thickens, stirring often

Preheat oven to 170° F.

Spread over parchment lined baking sheet until it's about 1/8" thick.

Bake for 3-4 hours or until the mixture lifts easily and is no longer soft.

Cut with pizza cutter, roll up & enjoy!

Katharine A. Jameson

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