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Erythritol, a sugar substitute, associated with increased risk of blood clots

A recent study has raised concerns about the popular sugar substitute erythritol, commonly found in keto products, sweets, and low- or no-calorie diet drinks. The study, led by the Cleveland Clinic and published in the medical journal Arteriosclerosis, Thrombosis and Vascular Biology, suggests that erythritol may increase the risk of heart attack and stroke by making blood platelets more active, thus increasing the risk of blood clots. This finding is particularly alarming as food sweetened with sugar did not have the same effect.

Erythritol is a zero-calorie sugar substitute that is used in a wide range of products, including protein bars, yogurt, cookies, and ice cream. It is a thickening agent that resembles sugar and is a primary sweetener in the low-carb, high-fat keto diet. Despite being deemed „generally recognized as safe“ by the Food and Drug Administration in 2001, the recent study has raised concerns about its potential health risks.

The study, which looked at just 20 patients, found that participants who consumed water sweetened with erythritol showed signs that their blood platelets had been activated, while those who drank glucose-sweetened water did not experience a similar effect. Dr. Stanley Hazen, a cardiologist and chair of cardiovascular and metabolic sciences at the Cleveland Clinic’s Lerner Research Institute, noted that after consuming an erythritol-sweetened drink, individuals were at a heightened risk for clotting, with changes in platelet function observed in all subjects tested.

This study builds upon previous research led by Hazen, which linked erythritol to cardiovascular problems. The earlier study, conducted in 2023, tested blood samples from over 1,100 individuals and found an increased risk of heart attack, stroke, and death associated with erythritol consumption. Additionally, the study found that erythritol led to blood clots in mice that had ingested it.

In response to these findings, Hazen advised consumers to opt for natural sweeteners containing sugar, glucose, honey, or fruit, rather than erythritol. He emphasized that natural sweeteners do not pose the same heightened risk for clotting that erythritol does.

While the recent study has raised concerns about the potential dangers of erythritol, researchers not involved in the study caution against alarm. Alice H. Lichtenstein, a professor at Tufts University, emphasized the need to interpret the study within the context of other research on the topic. She highlighted the importance of evaluating the overall effects of non-nutritive sweeteners versus sugar on health outcomes.

Joanne Slavin, a professor at the University of Minnesota-Twin Cities, suggested that consumers weigh the risks and benefits when choosing alternative sweeteners. She noted that while the study adds valuable information to the discussion, consumers should not be unduly alarmed about the potential health risks associated with erythritol.

In response to the study, the food industry has defended erythritol, citing the limited number of participants in the research and the amount of erythritol consumed by participants. The Calorie Control Council, a group representing the low- and reduced-calorie food and beverage industry, pointed out that the dosage of erythritol given to participants was higher than what is typically found in beverages sold in the United States.

Despite the pushback from the food industry, Hazen emphasized the need for further research on the potential harms of erythritol, given its widespread use as an artificial sweetener. He hopes that the study will prompt more research on the topic to better understand the risks associated with erythritol consumption.

In conclusion, while the recent study raises concerns about the potential dangers of erythritol, it is essential for consumers to consider the findings within the context of existing research and to make informed choices about their sweetener consumption. As more studies are conducted on the topic, it is crucial to stay informed about the potential risks and benefits of different sweeteners to make healthy choices for overall well-being.

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