Until last week, the non-caloric sweetener erythritol was not on anyone’s radar screen. But recent research reports linked high levels of erythritol in blood to increased risk for heart attacks and stroke. Valid concern? Or a nothing burger?
Erythritol 101
Erythritol is a sugar alcohol sweetener that occurs naturally in small amounts in some foods, like watermelon and pears. The erythritol used to sweeten processed foods is manufactured from corn. The FDA classifies it as GRAS (Generally Recognized as Safe). Most of the erythritol you consume is absorbed in the blood and then excreted. It does not impact blood sugar.
You can find it in processed foods like:
- sweetened coffee and tea drinks
- juice drinks
- flavored waters
- soft drinks
- bakery products/frosting
- cookies
- frozen desserts/ice cream
- sugar-free gum
- sugar substitutes. Some Monk fruit sweeteners are high in erythritol
Don’t rely on food labels for information about erythritol content. The ingredients list can simply say “natural sweetener” instead of “erythritol”, so you may not realize you’re consuming it. Most of it is absorbed into the blood. The more erythritol you consume, the higher your blood levels will be, until your kidneys excrete it.
What’s all the fuss about?
The erythritol-heart disease link came to light in a set of studies comparing blood levels of this sweetener to incidence of heart attack and stroke. In brief, the studies found that higher blood levels of erythritol were associated with higher incidence of major adverse cardiovascular events, such as heart attack. Additional research found that erythritol increases risk for blood clots.
Is this Cause-and-Effect? Or just a coincidence? Or perhaps there’s something else about people who consume higher amounts of erythritol-sweetened foods. Such as, they are using artificial sweeteners to control their weight, or because they have Type 2 diabetes and are avoiding sugar. Obesity and diabetes also raise heart disease risk. One of the studies focused on people who already had risk factors for heart disease. Perhaps high risk people are more susceptible to adverse effects of this sweetener, but other healthier people will be unaffected.
More research will hopefully shed light on those questions. The link between erythritol and blood clots is more concerning and perhaps the most straightforward to investigate — compare concentration of erythritol to blood clotting activity.
What should you do?
I’m never a fan of artificially sweetened food, so my Big Picture solution is to stop using so many artificially sweetened processed foods. Just look at the list above. If you depend on artificially sweetened coffee drinks, flavored water and low carb sweets every day, you need to rethink your choices. Result: you’d automatically consume fewer sweeteners. You’d also give your taste buds a chance to learn how unprocessed whole foods taste.
I’m not convinced — yet — that erythritol all by itself impacts heart disease risk. There are too many other variables in some of these studies. The effect on blood clotting is most concerning, but I’m waiting for more data. If you’re worried about this, and you have risk factors for heart disease and stroke, you can certainly make an effort to avoid erythritol. Bakery foods, candy, frozen desserts, sweeteners and beverages aimed at the keto market are especially likely to be sweetened with erythritol.
