Erythritol May Pose Cardiovascular Risks: Study Finds Link to Heart Attack, Stroke and Death

As people increasingly look for options to manage their sugar or calorie intake, artificial sweeteners such as erythritol are becoming increasingly popular in low-calorie, low-carbohydrate and “keto” products. However, a recent research paper published in Nature Medicine has found that erythritol use could be linked with an elevated risk of experiencing heart attack, stroke or death.

Erythritol is about 70% as sweet as sugar while containing just 6% of the calories, making it a popular choice for diet products. It is “generally recognized as safe” or GRAS by the U.S. Food and Drug Administration, meaning no long-term safety studies are required and food companies don’t have to list erythritol on their nutrition labels.^[0]

The study, led by Dr. Stanley Hazen of the Cleveland Clinic, found that people with higher levels of erythritol in their blood had a notably higher risk of cardiovascular problems. ‘The top 25% had twice the risk of heart attack, stroke and death compared to the bottom 25%,’ said Dr. Hazen.^[1] “That places it on par with the strongest other cardiovascular risk factors, such as diabetes.”^[2]

The researchers also looked into the influence of introducing erythritol to either entire blood or individual platelets, which are components that aggregate to impede bleeding and are part of the clotting process. The findings demonstrated that erythritol increases the activation of platelets and the formation of clots, which was further corroborated by preclinical studies that showed that taking erythritol is associated with increased clot formation.

Robert Rankin, executive director of the Calorie Control Council, an association representing the low- and reduced-calorie food and beverage industry, cautioned that the results of this study should not be extrapolated to the general population.^[3]

The researchers also gave a group of eight healthy volunteers a drink containing erythritol and saw strikingly high levels of erythritol in their bodies for two days afterwards.^[4] This has raised questions about the safety of erythritol and the potential of long-term health risks.

0. “A New Study Connected an Artificial Sweetener with Higher Heart Attack Risk—Here's What to Know” EatingWell, 1 Mar. 2023, https://www.eatingwell.com/article/8032368/new-study-artificial-sweetener-heart-attack-risk/

1. “What Cleveland Clinic finds in artificial sweetener study” WJW FOX 8 News Cleveland, 5 Mar. 2023, https://fox8.com/news/what-cleveland-clinic-finds-in-artificial-sweetener-study/

2. “Sweetener erythritol linked to heart problems | Research” Chemistry World, 6 Mar. 2023, https://www.chemistryworld.com/news/sweetener-erythritol-linked-to-heart-problems/4017092.article

3. “Sweetener erythritol may increase risk for stroke, blood clot, death” USA TODAY, 27 Feb. 2023, https://www.usatoday.com/story/news/health/2023/02/27/sugar-substitute-erythritol-increase-risk-stroke/11330213002

4. “Artificial low-calorie sweetener in brands such as Halo Top may raise heart attack and stroke risk” Daily Mail, 1 Mar. 2023, https://www.dailymail.co.uk/health/article-11798339/Artificial-low-calorie-sweetener-raise-heart-attack-stroke-risk.html