Artificial sweeteners, such as erythritol, are common replacements for table sugar in lowcalorie,
low-carbohydrate and ‘keto’ products
Consumption of popular artificial sweetener, erythritol, is associated with an increased risk of
heart attack and stroke, according to a study which calls for further safety research to examine
the long-term effects of such products.
Researchers at Cleveland Clinic studied over 4,000 people in the US and Europe and found
those with higher blood erythritol levels were at elevated risk of experiencing a major adverse
cardiac event such as heart attack, stroke or death.
They also examined the effects of adding erythritol to either whole blood or isolated platelets,
which are cell fragments that clump together to stop bleeding and contribute to blood clots.
The study, published in the journal Nature Medicine, found that erythritol made platelets easier
to activate and form a clot. Pre-clinical studies confirmed ingestion of erythritol heightened
clot formation.
Artificial sweeteners are present in thousands of food and beverage brands worldwide, however
they remain a controversial topic and are currently being re-evaluated by the European Food
Safety Authority, the World Health Organization, and other health agencies.
The findings from a large-scale study published in the British Medical Journal in September
last year found a potential direct association between higher artificial sweetener consumption,
especially aspartame, acesulfame potassium, and sucralose, and increased cardiovascular
disease risk.
“Sweeteners like erythritol have rapidly increased in popularity in recent years but there needs
to be more in-depth research into their long-term effects,” said senior study author Stanley
Hazen, co-section head of Preventive Cardiology at Cleveland Clinic.
“Cardiovascular disease builds over time, and heart disease is the leading cause of death
globally. We need to make sure the foods we eat aren’t hidden contributors,” Hazen said in a
statement.
Artificial sweeteners, such as erythritol, are common replacements for table sugar in lowcalorie,
low-carbohydrate and “keto” products. Sugar-free products containing erythritol are
often recommended for people who have obesity, diabetes or metabolic syndrome and are
looking for options to help manage their sugar or calorie intake.
People with these conditions also are at higher risk for adverse cardiovascular events like heart
attack and stroke.
The researchers noted that erythritol is about 70 per cent as sweet as sugar and is produced
through fermenting corn. After ingestion, erythritol is poorly metabolised by the body.
Instead, it goes into the bloodstream and leaves the body mainly through urine. The human
body creates low amounts of erythritol naturally, so any additional consumption can
accumulate.
Measuring artificial sweeteners is difficult and labelling requirements are minimal and often
do not list individual compounds.
Erythritol is “Generally Recognised As Safe (GRAS)” by the US FDA, which means there is
no requirement for long-term safety studies. The authors of the latest study note the importance
of follow-up research to confirm their findings in the general population.
The study had several limitations, including that clinical observation studies demonstrate
association and not causation.
“Our study shows that when participants consumed an artificially sweetened beverage with an
amount of erythritol found in many processed foods, markedly elevated levels in the blood are
observed for days—levels well above those observed to enhance clotting risks,” said Hazen.
“It is important that further safety studies are conducted to examine the long-term effects of
artificial sweeteners in general, and erythritol specifically, on risks for heart attack and stroke,
particularly in people at higher risk for cardiovascular disease,” Hazen added.
https://www.tribuneindia.com/news/health/common-artificial-sweetener-linked-to-increasedheart-
attack-stroke-risk-study-484177
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