Consumption of erythritol keto, which is present in many keto-friendly foods (including the sweetener Truvia), has been linked to an elevated risk of cardiovascular disease, according to early research. A new study released today in Nature Medicine suggests that erythritol, the sugar substitute used in Truvia and other no-sugar and keto-friendly products, may be associated with an increased risk of heart attack and stroke.
The risk of death, heart attack, and stroke was found to be double in those whose blood erythritol levels were greatest compared to those whose levels were lowest.
I was astonished by these findings. That’s on level with having diabetes, one of the strongest cardiac risk factors. In fact, it’s “arguably stronger than the risk of high cholesterol or blood pressure,” as stated by the study’s senior author, Stanley Hazen, MD, PhD, chairman of the department of cardiovascular and metabolic sciences at the Lerner Research Institute, and co-section head of preventive cardiology at the Cleveland Clinic in Ohio.
According to Mandeep Kainth, MD, associate director of preventive cardiology at the Stony Brook Heart Institute in Stony Brook, New York, “this is an incredibly important study that provides significant evidence for how the use of artificial sweeteners, in particular the sugar substitute erythritol, may also increase the risk of cardiovascular disease.” Dr. Kainth was not a part of this study in any way.
It’s possible that having a high erythritol level in your body would increase your risk of developing heart disease by a factor of 2.
Dr. Hazen claims that erythritol research wasn’t conducted with that goal in mind. Researchers looking to see if any of the naturally occurring compounds in the blood could predict future heart attack or stroke found that those with high levels of erythritol, a byproduct of metabolism, looked to be at greater risk.
The study’s authors shifted their attention to erythritol and conducted tests on data from nearly 3,000 people in the United States and Europe. A study revealed that the risk of cardiovascular disease, stroke, and death was two times higher in the top 25 percent of erythritol producers compared to those who produced the least of the compound.
Researchers also looked at what happened when erythritol was added to either whole blood or isolated platelets, which are tiny pieces of cells that clump together to prevent bleeding and aid in the formation of blood clots. Scientists discovered that erythritol facilitated the activation and clotting of platelets. Clots in the blood have the potential to break loose and move to the heart, causing a heart attack, or to the brain, causing a stroke.
When consumed in processed foods, erythritol can cause a one-thousand-percent increase in plasma levels of the compound. The fermentation of maize results in erythritol. It can be offered on its own, or as an additive to other sweeteners like stevia and monk fruit. It’s about 70% as sweet as sugar, making it a suitable alternative.
Erythritol is weakly metabolised after ingestion. To the contrary, it is absorbed into the circulation and excreted primarily through the urine. In light of the dangers of erythritol and its effect on blood clotting, Hazen and coworkers investigated the possibility of erythritol accumulation in individuals who ate a lot of processed foods. One to two servings of erythritol were given to healthy volunteers in the form of sweetened ice cream and lemonade in a preliminary trial.
According to Hazen, “the plasma levels of erythritol went about 1,000-fold higher and then stayed above the levels that were noted,” to enhance clotting risks in previous experiments, for days. The results support prior worries about the link between sugar substitutes and cardiovascular disease.
According to Kainth, in 2018, the American Heart Association (AHA) recommended a reasonable strategy for calorie reduction and weight loss: the temporary substitution of sugar-sweetened beverages with beverages containing low-calorie sweeteners, including artificially sweetened beverages.
He claims that many people with preexisting cardiac risk factors have been misguidedly ingesting erythritol-sweetened products in the mistaken belief that doing so would mitigate those dangers. “This research suggests that those products are increasing people’s risk of cardiovascular disease,” the authors write.
Drawing on previous research from the Women’s Health Initiative, this study found that women who drank at least 24 ounces per day on average of artificially sweetened beverages had a significantly higher chance of cardiovascular disease.
“Since the long-term effects of using sugar replacements have not been investigated, I think there should be more discussion about the health effects of artificial sweeteners. “This article raises some compelling questions that need to be addressed,” adds Kainth.
The Possible Dangers of Erythritol Need to Be Confirmed in Further Research.
The authors acknowledged the need for further research to verify these results among the broader public. One flaw was that observational studies can only prove a correlation, not a cause and effect, which severely limited the usefulness of the results.
Although these results do not prove a causal relationship between erythritol and cardiovascular disease, they do add to the increasing body of literature on the subject, as Kainth points out. erythritol keto
The results need to be bolstered, he says, by more robust scientific evidence in the form of randomised controlled trials with larger population sizes so that the direct impact of these products on cardiovascular disease can be assessed.
Further studies on the impacts of artificial sweeteners in general and erythritol in particular are necessary, according to Hazen. He recommends that researchers examine the possibility of an elevated risk for heart attack and stroke in high-risk populations. For substances like erythritol, the Food and Drug Administration does not mandate information on their long-term safety.
The FDA has determined that erythritol is “Generally Recognized As Safe” (GRAS), so there is no need for any kind of long-term safety research. Hazen claims that erythritol’s widespread use in processed goods came without extensive testing, in part because of the sugar alcohol’s perceived safety and naturalness. And to be honest, no one could have seen this coming. Not us; we literally just happened upon it. But now that we know, he adds, “some cautionary alarms need to go up, and we need to study it to evaluate its safety. It’s hard to get accurate readings on artificial sugars, and labels rarely break down ingredients.
It is now evident, according to Hazen, that erythritol is something about which people need to be educated in order to make healthy decisions. In order to allow consumers to make educated decisions, he argues that mandatory labelling is necessary from a public health perspective. erythritol keto
Should You Continue Consuming Erythritol-Sweetened Foods?
The dearth of research into the long-term effects of artificial sweeteners is what makes Kainth wary of recommending them. According to him, the results of this study indicate that erythritol may cause more harm than good when used internally.
This would “further strengthen my support for choosing lifestyle changes and reducing sugar intake over using artificial sugar substitutes for an overall reduced chance of cardiovascular events,” he adds.
The same can be said by Hazen, who says, “I’m going to tell my patients that it’s better to use a modest amount of sugar or honey — in moderation — rather than reach for the thing that has an enormous amount of artificial sweetener in it that has not been well studied in terms of long-term health effects.”
Kainth encourages his patients to be gentle and patient with themselves as they make dietary adjustments, and he emphasises the importance of starting slowly and building momentum.
One strategy for doing so is to switch to water or decaf tea in place of sugary drinks like soda. He recommends paying attention to the sugar content of the food we consume by reading labels. erythritol keto
