Sugar substitute erythritol linked to blood clots
The favored sugar substitute erythritol present in keto merchandise, sweets and low- or no-calorie eating regimen drinks may enhance the danger of coronary heart assault and stroke, in response to new analysis.
A research led by the Cleveland Clinic printed Thursday within the medical journal Arteriosclerosis, Thrombosis and Vascular Biology discovered the sweetener made blood platelets extra energetic, growing the danger of blood clots, whereas meals sweetened with sugar didn’t have the identical impact.
The research was tiny – it checked out simply 20 sufferers – and researchers who weren’t concerned in it say individuals ought to be cautious when decoding its outcomes.
Erythritol is a zero-calorie sugar substitute used to sweeten a whole bunch of merchandise, together with protein bars, yogurt, cookies and ice cream. It’s a thickening agent resembling sugar and the first sweetener within the low-carb, high-fat keto eating regimen. In 2001, the Meals and Drug Administration decided that erythritol was “usually acknowledged as secure.”
Nonetheless, researchers stated individuals within the Nationwide Institutes of Well being-funded research who consumed water sweetened with erythritol confirmed indicators that their blood platelets had been activated, whereas individuals who drank glucose-sweetened water did not expertise the same impact.
“After consuming an erythritol-sweetened drink, you are at heightened threat for clotting, and your platelet perform adjustments – and this was seen in each topic who was examined,” stated Dr. Stanley Hazen, a heart specialist and chair of cardiovascular and metabolic sciences in Cleveland Clinic’s Lerner Analysis Institute.
The findings comply with a bigger 2023 research additionally led by Hazen, which linked the favored sugar substitute to cardiovascular issues. Final yr’s research examined blood samples from greater than 1,100 individuals who underwent coronary heart threat evaluation over three years and adopted up with one other group of greater than 2,100 non-emergency sufferers. The research linked erythritol to an elevated threat of coronary heart assault, stroke and demise. The research additionally discovered the sweetener led to blood clots in mice who had eaten it.
Sweetener vs. sugar
After his 2023 research, Hazen stated individuals started asking his analysis workforce which forms of sweeteners they need to eat or drink in lieu of erythritol. His workforce wished to check the clotting threat of customers who drank a liquid sweetened with erythritol or sugar.
The research recruited 20 nonsmokers with regular kidney well being and no historical past of coronary heart illness, hypertension or diabetes. After an evening of fasting, individuals had their blood examined earlier than and half-hour after they drank water sweetened with 30 grams of glucose or erythritol. That dosage is about how a lot is in an erythritol-sweetened soda or a muffin and equal to day by day consumption based mostly on a 2014 nationwide survey and Meals and Drug Administration filings, researchers stated.
The research individuals who drank the sweetened water had common erythritol ranges enhance greater than 1,000 instances in comparison with their pre-consumption ranges. The research additionally reported individuals confirmed a big enhance in blood clot formation after consuming erythritol. No such change was noticed within the group members who drank glucose.
The brand new research doesn’t specify how lengthy customers may face a heightened threat for clotting after consuming meals or consuming drinks with the sugar substitute.
Quite than erythritol, Hazen suggested customers to go for reasonable quantities of pure sweeteners containing sugar, glucose, honey or fruit. Pure sweeteners do not put customers at heightened threat for clotting, “whereas we expect that can occur within the days following erythritol ingestion” he stated.
Analysis ‘shouldn’t alarm customers’
Researchers not concerned within the research stated customers shouldn’t be alarmed by the findings of this research.
Alice H. Lichtenstein is a professor and director of the cardiovascular diet laboratory at Tufts College in Boston. She stated the research ought to be interpreted throughout the context of different studies on the subject as a result of no single research dictates coverage.
“We have no idea sufficient concerning the general impact of non-nutritive sweeteners vs. sugar to precisely assess their relative results on well being outcomes,” Lichtenstein stated.
Lichtenstein stated there is a want to higher consider how a lot sweetener individuals can safely eat. She stated dangers and advantages ought to be analyzed by evaluating “non-nutritive” sweeteners to sugar for components equivalent to physique weight, dental well being and coronary heart threat.
She suggested individuals to drink water and seltzer and restrict consumption of meals or drinks filled with sugar or sweeteners.
“As a lot as doable, select entire meals of their pure state and use widespread sense,” Lichtenstein stated.
Joanne Slavin, a professor within the division of meals science and diet on the College of Minnesota-Twin Cities, stated customers ought to contemplate the dangers and advantages in selecting different sweeteners.
“This research provides one other piece to the puzzle, however shouldn’t alarm customers that they’re risking their well being,” Slavin stated. “It’s straightforward to keep away from different sweeteners, however they’re helpful instruments for diabetics and others who have to keep away from digestible carbohydrates.”
Meals business defends erythritol
Meals business teams criticized the Cleveland Clinic research, citing the restricted variety of individuals and the quantity of erythritol individuals consumed.
The ten analysis individuals got an erythritol dosage two to a few instances the quantity that’s sometimes present in an 8- or 16-ounce beverage bought in the US, stated Carla Saunders, president of the Calorie Management Council, a bunch that represents the low- and reduced-calorie meals and beverage business.
Saunders famous that researchers measured erythritol ranges simply as soon as after individuals consumed the sweetened drinks and the research didn’t management for way of life components which may have affected outcomes.
As a result of erythritol ranges have been measured earlier than and half-hour after consumption, “there isn’t a method to display any lasting impact of extreme consumption on any well being final result,” Saunders stated.
The Calorie Management Council stated greater than 250 meals and beverage producers use erythritol as a sweetener in alcoholic drinks, snacks, pet meals and dietary supplements.
“Shoppers have to depend on science, and for 30 years, science has proven that erythritol is a confirmed secure and efficient selection for sugar and calorie discount,” Saunders stated.
However Hazen stated his most up-to-date research just isn’t “standing in isolation” and stated there’s rising proof of potential harms.
“I am hoping this shall be a name to arms for extra analysis on this matter, particularly given how prevalent and ubiquitous erythritol is as a man-made sweetener,” Hazen stated.
