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Study Review: Erythritol Sugar Substitute and Stroke Risk

A recent study looking at what causes increased stroke and heart disease risk has found a strong association with erythritol and increased risk. Erythritol is a sugar alcohol that is found in many diet or low/no sugar foods and drinks. These products are often advertised to people with obesity, diabetes, and metabolic syndrome because they are lower in sugar and calories. However, these diseases already put people at a higher risk for heart disease and stroke. The lead researcher stated, Stanley Hazen, M.D., Ph.D., “The very people who are being targeted for foods that contain erythritol are the same people who already are at increased risk for cardiovascular events, so this is very concerning,”.


Sugar alcohols are not quite as sweet as sugar and not nearly as sweet as artificial sweeteners. The body naturally produces erythritol in small amounts, it is when the substance is eaten in high doses that problems arise. Erythritol is often added to "natural" sweeteners such as stevia or monk fruit because it has a similar look and texture to sugar that makes it more appealing.


The study began as analyzing blood samples for components that may be increasing stroke and heart disease risk. They found very early that erythritol at higher than normal levels was very common in these blood samples. The researchers then began to look more closely at erythritol in over 4,000 human blood samples. They found that erythritol increased blood clotting by activating platelets. Platelets are the part of blood that forms together to stop bleeding, for example the scab that forms after a cut. In a study on mice they found that the increased blood clotting occurs both when the blood is inside the body (to help stop internal bleeding) and outside of the body.


After finding all of this information the researchers were concerned about how erythritol was impacting stroke and heart disease risks in the general population as well as those already at a higher risk. They found that when humans consumed 30 grams of erythritol, which is about the amount found in 1 pint of "keto-friendly" ice-cream, blood clotting increased by 1,000-fold and stayed elevated for several days! Many foods and beverages contain more than 30 grams of erythritol because it is not a regulated at this time.


The research brings up some very alarming questions on whether erythritol is safe for people to be consuming at such high levels, or at all. It was stated very clearly by the researchers that this study did not establish erythritol as a cause for heart disease and stroke, but as a strong correlation. This research is enough to establish the need for studies on the long-term effects of erythritol and other sugar alcohols. It is recommended to keep an eye on how many sugar alcohols you are consuming, especially if you are already at a higher risk for stroke and heart disease.



Written by: Meghan Hawley, Ellen Bryon and Associates


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