2023-10-07 08:18:37
Dubai, United Arab Emirates (CNN) – A new study has shown that there is a link between a sugar substitute called erythritol, used as a sweetener from the stevia plant or monk fruit and in low-sugar keto diet products, with blood clotting, stroke, heart attacks and death.
“The degree of risk was not slight,” said lead study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnosis and Prevention at the Cleveland Clinic Lerner Research Institute.
According to the study published in the journal Nature Medicine on February 27, people with risk factors for heart disease, such as diabetes, were twice as likely to suffer a heart attack or stroke, as they had the highest levels of erythritol in their blood.
“If your blood erythritol level is 25 percent higher than the lowest 25 percent, your risk of heart attacks and strokes is doubled,” Hazen said. “It’s on par with the strongest heart risk factors, such as diabetes.”
Additional laboratory and animal research included in the paper revealed that erythritol appears to cause platelets to clot more easily. The clots may break off and travel to the heart, causing a heart attack, or to the brain, causing a stroke.
“This certainly raises alarm bells,” said Dr. Andrew Freeman, director of cardiovascular disease prevention and wellness at National Jewish Health Hospital in Denver, who was not involved in the research.
“There appears to be a risk of clotting from the use of erythritol,” Freeman noted. He continued: “Clearly more research is needed, but with an abundance of caution, it may make sense to limit erythritol in your diet for the time being.”
In response to the study, Robert Rankin, a member of the Calorie Control Council, an industry association, told CNN, “The results of this study contradict decades of scientific research that have shown that low-calorie sweeteners like erythritol are safe, as evidenced by global regulatory approvals for their use in foods and beverages.” “.
Rankin added that the results “should not be generalized to the general population, because intervention participants were already at increased risk of developing cardiovascular disease.”
The European Polyol Producers Association declined to comment because it had not reviewed the study.
What is erythritol?
Like sorbitol and xylitol, erythritol is a sugar alcohol, a carbohydrate found naturally in many fruits and vegetables. Its sweetness is about 70% of the sweetness of sugar, and it is considered calorie-free, according to experts.
Erythritol is synthetically manufactured in large quantities, has no lingering aftertaste, does not spike blood sugar, and has a less laxative effect than some other sugar alcohols.
“Erythritol looks like sugar, it tastes like sugar, and you can bake it,” said Hazen, who also directs the Center for the Microbiome and Human Health at the Cleveland Clinic.
He added: “It has become a favorite in the food industry, and is a very popular additive in the keto diet and other low-carb products and foods marketed to people with diabetes. Some of the diabetes-labeled foods we looked at contained more erythritol than any other ingredient.” Another by weight.
The relationship between erythritol and cardiovascular disease
Hazen said the discovery of the link between erythritol and cardiovascular problems was purely serendipitous: “We never expected this. We weren’t even looking for this.”
Hazen’s research had a simple goal: to find unknown chemicals or compounds in a person’s blood that might predict the risk of a heart attack, stroke, or death in the next three years. To do this, the team began by analyzing 1,157 blood samples from people at high risk of heart disease, collected between 2004 and 2011.
“We found this substance that seemed to play a big role, but we didn’t know what it was,” Hazen explained. “Then we discovered it was erythritol, the sweetener.”
He said that the human body produces erythritol naturally, but in low quantities that do not explain the levels that were measured.
To confirm the findings, Hazen’s team tested another set of blood samples from more than 2,100 people in the United States, and an additional 833 samples collected by colleagues in Europe through 2018. About three-quarters of the participants in the three populations had coronary artery disease and high blood pressure. About a fifth of them have diabetes. More than half were males in their 60s and 70s.
In all three populations, the researchers found that higher levels of erythritol were associated with an increased risk of heart attack, stroke, or death within three years.
but why? To find out, the researchers conducted more animal and laboratory tests and discovered that erythritol “causes coagulation,” or blood clotting, according to Hazen.
Clotting is essential in the human body, otherwise we would bleed to death from cuts and injuries. The same process is constantly happening internally as well.
Fields of the Stevia plant from which the sweetener, an alternative to sugar, is extractedCredit: NORBERTO DUARTE/AFP via Getty Images
“Our blood vessels are always under pressure, we’re leaking, and platelets are constantly plugging these holes all the time,” Hazen explained.
However, the size of the clot made by platelets depends on the size of the stimulus that stimulates the cells.
“But what we see with erythritol is that the platelets become super responsive: just 10 percent of the activator produces 90 to 100 percent of the clot formation,” Hazen continued.
“For people who are at risk for clots, heart attacks, and strokes, like people with existing heart disease or people with diabetes, I think there’s enough data here to say they should stay away from erythritol until more studies are done,” Hazen explained.
Track blood tests for erythritol levels and clotting risks
In the final part of the study, eight healthy volunteers drank a drink containing 30 grams of erythritol, the amount consumed by many people in the United States, according to Hazen, according to the National Health and Nutrition Examination Survey, which examines American nutrition annually.
Blood tests over the next three days tracked erythritol levels and clotting risks.
“Thirty grams was enough to raise blood erythritol levels a thousandfold,” Hazen said. “It remained elevated above the threshold needed to stimulate and increase the risk of clotting for the next two or three days.”
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