Popular artificial sweetener linked to blood clots and risk of heart disease: Study

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Consuming foods containing erythritol, a popular artificial sweetener that’s also used in keto diet products, increases the risk of heart attack and stroke, according to a new study.

Researchers at the Cleveland Clinic found that erythritol made platelets in the blood of healthy people more active, which can raise the risk of blood clots.

“This research raises some concerns that a standard serving of an erythritol-sweetened food or beverage may acutely stimulate a direct clot-forming effect,” said study co-author W. H. Wilson Tang, research director for Heart Failure and Cardiac Transplantation Medicine at Cleveland Clinic.

“Erythritol and other sugar alcohols that are commonly used as sugar substitutes should be evaluated for potential long-term health effects especially when such effects are not seen with glucose itself,” Tang added.

Erythritol is a popular low-calorie replacement for table sugar and is added to sugar substitutes marketed as “natural” alternatives to sugar in stevia and monk fruit sweeteners.

It’s about 70% as sweet as sugar and is produced through fermenting corn.

However, erythritol is poorly metabolized by the body and can accumulate.

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The sweetener is among Health Canada’s list of permitted sweeteners. Last year, the agency authorized an expanded use of erythritol in granola and other ready-to-eat breakfast cereals and coatings.

The study was published in the journal Arteriosclerosis, Thrombosis and Vascular Biology and was part of series of investigations on the physiological effects of common sugar substitutes at the Cleveland Clinic.

“Many professional societies and clinicians routinely recommend that people at high cardiovascular risk — those with obesity, diabetes or metabolic syndrome — consume foods that contain sugar substitutes rather than sugar,” said lead study author Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.

“These findings underscore the importance of further long-term clinical studies to assess the cardiovascular safety of erythritol and other sugar substitutes,” Hazen said.

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The study was conducted on healthy adults and compared those who consumed an erythritol dose to those who those who consumed sugar.

“What is remarkable is that in every single subject, every measure of platelet responsiveness (clotting) went up following the erythritol ingestion,” Hazen told CNN.

Comparatively, another group of 10 people who consumed a drink with an equal amount of glucose, or sugar, did not affect blood platelet activity in their bodies, Hazen said.

A previous study by the clinic looked at the sugar substitute xylitol, which is a sugar alcohol like erythritol, and found that it produced similar increases in plasma levels and affected platelet aggregation in healthy volunteers.

The study’s authors say further clinical studies assessing the long-term cardiovascular safety of erythritol are warranted.

“I feel that choosing sugar-sweetened treats occasionally and in small amounts would be preferable to consuming drinks and foods sweetened with these sugar alcohols, especially for people at elevated risk of thrombosis such as those with heart disease, diabetes or metabolic syndrome,” Hazen said.

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