Erythritol Linked with Increased Clotting Risk

Many adults are making efforts to cut back on their consumption of added sugars to drop some weight, prevent or control Type 2 diabetes, or protect heart health for greater longevity and vigour.  Certain sugar replacements may warrant caution, however, as new evidence surfaces linking erythritol with blood clotting, stroke, heart attack, and death. 

According to a recent CNN Health report, erythritol is used to add bulk or sweeten stevia, monk fruit, and keto reduced-sugar products.  A new study from the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute found people with existing risk factors for heart disease, including diabetes, were at twice the risk of having a heart attack or stroke if they had the highest levels of erythritol in their blood. 

The research, published in the journal Nature Medicine, found that if blood levels of erythritol were in the top 25 percent compared to the bottom 25 percent, the risk for heart attack and stroke doubled.  This increased risk for a heart attack or stroke is equivalent to one of the strongest cardiac risk factors – diabetes.  

The initial research analyzed blood samples of 1,157 people collected between 2004 and 2011 who were at risk for heart disease.  The sweetener, erythritol, was found to have a connection with cardiovascular issues as researchers were investigating unknown chemicals or compounds found in the blood that might predict the risk for a heart attack, stroke or death in the following three years. 

Subsequent testing of blood samples from more than 2,100 people in the United States and an additional 833 samples collected in Europe through 2018, helped to confirm the findings.  In participants with coronary artery disease or high blood pressure, diabetes, or who were men in their 60s and 70s, higher levels of erythritol were linked with an increased risk for heart attack, stroke or death within three years. 

Researchers found that erythritol appears to cause blood platelets to clot more readily.  These clots can break off and travel to the heart, triggering a heart attack or to the brain, leading to a stroke.  The Calorie Control Council told CNN the results of the study should not be “extrapolated to the general public” because participants in the research were already at increased risk for cardiovascular events.   

Additional research is needed to learn more about the zero-calorie sweetener, but to be cautious, some experts advise limiting erythritol in your diet until more is known about its safety.  Erythritol is a sugar alcohol found naturally in many fruits and vegetables which has about 70 percent the sweetness of sugar but is considered zero-calorie.  The carb is artificially manufactured in large quantities and has no aftertaste, does not spike blood sugar and has less of a laxative effect than some other sugar alcohols. 

Although there is no firmly accepted daily intake of erythritol, the US Food and Drug Administration considers the “reducing sugar” or “sugar alcohol” to be generally recognized as safe.  In a third and final component of the study, 8 healthy volunteers drank a beverage containing 30 grams of erythritol – about the equivalent of that found in a pint of keto ice cream.  Blood tests found this amount was enough to spike blood levels of erythritol and keep it elevated above the threshold to trigger and increase the risk of clotting for the following two to three days.