Erythritol is a sugar alcohol commonly used as a low-calorie sweetener. It’s naturally found in fruits and fermented foods. But the latest research shows it could increase stroke risk. Is erythritol really trying to kill you or is this just another health scare?
Erythritol is technically a sugar alcohol (like sorbitol) commonly used as a low-calorie sweetener. It’s naturally found in fruits and fermented foods. As a low-calorie sweetener, erythritol has gained increasing popularity in recent years due to its ability to provide sweetness without calories and other negative health effects. However, recent studies have linked erythritol consumption to an increased risk of heart attacks and strokes. This is potentially a huge concern for people who use it regularly.
A stroke is a medical emergency that occurs when blood flow to the brain is interrupted or reduced. This can be caused by a blockage or rupture of a blood vessel in the brain. A stroke can cause severe brain damage or death, and prompt medical attention is essential.
The exact mechanism by which erythritol increases stroke risk is unclear. However, some researchers believe that it may be related to the way erythritol is metabolised in the body. Erythritol is absorbed in the small intestine and transported to the liver where it’s converted into glucose and released into the bloodstream. This process may lead to an increase in blood glucose levels, which can contribute to stroke development.
In a recent study published by Nature Medicine, a strong correlation between erythritol and stroke risk was seen. The study included 1157 people who were on ongoing cardiovascular risk assessment and had elevated erythritol levels. The study notes “At physiological levels, erythritol enhances platelet reactivity in vitro and thrombosis formation in vivo” which translates to your blood is more likely to clot! As a result, these individuals would be at higher risk of strokes and heart attacks. Not good!
The study was then conducted on various people (2,149 participants in the U.S. and 833 in Europe) who also had ongoing cardiovascular risk assessment using fasting plasma samples. Researchers found a high correlation between erythritol and strokes as well as a correlation of erythritol induced platelet activity meaning an increased amount of blood clotting. There was no note of erythritol levels after one day.
However, it should be noted that this study and results were based on groups with different age groups. With the American participants having an average age of 62 and the European participants having an average age of 72, the question to be asked is – was it the erythritol or the low metabolic health of the elderly participants that explains the spike?
The study then gives eight healthy participants an erythritol-containing drink. As a result, a large spike in their blood erythritol levels was seen within 30 minutes and continued for over 24 hours.
Another study published in the British Medical Journal also researched the link between sweeteners and stroke risk. It included 100,000 people from France aged around 42 to record their diet over a 3-day period every six months. They were then followed up after nine years to record the risk. They found that there was a 9% increase in heart attacks and strokes in those who ate sweeteners regularly.
So on the face of it we have a number of different studies showing that erythritol increases clotting risks and heart disease. A reasonable dose can result in high blood levels of erythritol for more than 24 hours. It all looks pretty “slam-dunk guilty as charged”
So, what does this mean for people who use erythritol as a sugar substitute?
Despite the above, and some other well-known side effects of erythritol consumption such as digestive problems, there are many studies that prove sweeteners such as erythritol can have benefits. For example, improved gut health and gut hormone release, lowers body weight and improves blood vessel function. In addition to this, it is vitally significant to note that erythritol is produced naturally by our bodies without it being consumed as a sweetener. As noted by world-renowned longevity physician, Peter Attia:
“This compound is also produced by our own bodies through a process known as the pentose phosphate pathway, one of the pathways by which we metabolise glucose… This, combined with the authors’ finding that erythritol levels remain well above the cohort ranges for at least a day after consumption, suggests that none of the cohort patients were consuming erythritol in their diets, and that the levels measured in fasting plasma samples were instead the result of endogenous production.”
So while these studies appear to suggest a causal link between erythritol consumption and an increased risk of stroke and heart attacks, more research is needed to confirm these findings and to better understand the underlying mechanisms.
In the study, the cohort’s erythritol levels before the test were not recorded and due to the levels after the experiment remaining high, it could indicate that the high levels were due to natural production by the body via the pentose phosphate pathway mentioned above. Activation of the pentose phosphate pathway can reflect the presence of cardiovascular, oxidative stress, and inflammation. Having both diabetes and being obese can also increase this risk, so upon detailed consideration one may conclude that erythritol itself is NOT the cause of the increase in strokes after all.
In the meantime, individuals who are concerned about their sugar intake and looking for alternative sweeteners should consider other options. Some potential alternatives to erythritol include stevia, monk fruit sweeteners, and xylitol. However, it’s worthwhile to note that these sweeteners may also have their own potential risks and limitations.
So we’ve established that there’s more to this than meets the eye. Bad science is being used to convince us that erythritol will kill us. It’s just another food myth like the need to avoid red meat and eggs (falsely accused of heart disease). In fact some of the study authors are conflicted by ongoing links to Big Food. Could it be that the growing popularity of erythritol threatens the profitability of the sugar and junk-food industries so it would be helpful to them for erythritol to be found unsafe?
Does that mean that we at ProLongevity are giving erythritol a clean bill of health well not entirely! Consuming small quantities when you really fancy something sweet as a treat is no problem. However, we’re NOT saying it’s healthy when used regularly and in large amounts. It could still feed your sugar addiction and let’s remember real food doesn’t have to be that sweet.
There is currently no reason to quit erythritol and other sweeteners. (NB we’re NOT fans of saccharine or acesulfame). It seems this latest study is little more than a scare and may have been deliberately planted by vested interests. Correlation and causation are NOT the same, as we’ve often remarked in our blogs and podcasts. For now, at least, we’re taking the results of this study with a grain of salt!