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Jul 04, 2023

Sweetener Erythritol Linked to Higher Heart Attack, Stroke Risk

By Quinn Phillips | March 23, 2023 The zero-calorie sweetener erythritol —

By Quinn Phillips | March 23, 2023

The zero-calorie sweetener erythritol — which is found as a component in many products at a typical grocery store, including items labeled as stevia or monkfruit sweeteners — is linked to an elevated risk for cardiovascular events like a heart attacks or stroke, according to a new study published in the journal Nature Medicine.

There has long been controversy in the diabetes community about the risks and benefits of using zero-calorie or low-calorie sweeteners (sugar substitutes). Some of these sweeteners have been linked to an elevated risk for certain kinds of cancer — but other sugar substitutes have not been linked to cancer. While there is some evidence that using low-calorie sweeteners may help with weight loss, other studies have found no weight-loss benefit from using them. Past research has also shown that using certain artificial sweeteners — such as aspartame, sucralose, and acesulfame potassium — is linked to a higher risk for serious cardiovascular events.

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For the latest study, researchers measured blood levels of erythritol in a group of 2,149 American and 833 European participants with an elevated risk for cardiovascular disease (due to factors such as diabetes or high blood pressure). Over a period of three years, participants with blood levels of erythritol that put them in the top quarter were 1.8 times as likely to have a cardiovascular event like a heart attack or stroke as those in the bottom quarter in the American group, and 2.2 times as likely to have a cardiovascular event in the European group. The decision to look at ethythritol in this way wasn't randomly chosen — the researchers previously looked for a wide range of substances in blood samples from 1,157 participants that were linked to a higher risk for cardiovascular events, and found that erythritol was one of these substances. Another analysis of erythritol in participants found that it enhanced blood clot formation — which would easily explain why it's linked to a higher risk for heart attacks and strokes.

In an article on the study at CNN, the researches noted that erythritol — which belongs to a group of sweeteners called sugar alcohols, and is about 70% as sweet as sugar but without any calories or direct effect on blood glucose — is found in a variety of products marketed as having a reduced sugar content or being sugar-free, including some sweeteners that aren't called erythritol on the front package label. That's because erythritol is often used as the base for other sweeteners, such as stevia or monk fruit, allowing them to be used a a granulated form that can be directly substituted for sugar in baking and other uses. Since stevia and monk fruit are hundreds of times as sweet as sugar and don't have sugar's physical properties, they can't be used by themselves as a sugar substitute in baking.

The researchers concluded that due to the higher risk for cardiovascular events linked to erythritol consumption — and the fact that products containing erythritol as a sugar substitute are often used by people with diabetes, who already have an elevated risk for cardiovascular disease — "studies assessing the long-term safety of erythritol are warranted."

Want to learn more about protecting your heart? Read "Be Heart Smart: Know Your Numbers," "Does Diabetes Hurt Your Heart?" "Fight Off Heart Disease With These Five Heart-Healthy Foods" and "Lower Your Risk of Heart Disease."

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

Disclaimer of Medical Advice: Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information, which comes from qualified medical writers, does not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs.

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