Erythritol has been in the news a lot these past few weeks because of its possible link to heart attack and stroke. Erythritol is a sugar alcohol that is used to add bulk to sugar substitutes like stevia and monkfruit sweetener. It is also used to reduce sugar in Keto products. Is all the media attention cause for alarm? Let’s look at the facts.
Study Published in Nature Medicine
The scientific research study that started the media buzz was published in the peer reviewed journal, Nature Medicine, in February 2023, led by Dr. Stanley Hazen (1). The study showed a possible link between erythritol and increased cardiovascular risk, especially stroke. Note that this is an observational study which helps explain a connection between erythritol and stroke, but not causation (which requires a randomized clinical trial). The study mentions 30g of erythritol a day, which is the equivalent to eating an entire pint of Keto ice cream. In contrast, a packet of stevia, which you might use to sweeten a latte, has about 1-2g of erythritol. In addition, study participants were all over 60 and had pre-existing cardiovascular disease or were at risk for it. So, headlines proclaiming “Erythritol Causes Strokes” are overstated.
Rethinking Artificial Sweeteners In General
Beyond this study which is getting a lot of media attention, it’s important to think about why we turned to artificial sweeteners in the first place. Artificial sweeteners in diet sodas have been promoted to reduce sugar consumption, reduce obesity, and even lower blood glucose levels. However, they haven’t lived up to their promise. Studies that followed the patterns of diet soda consumers over the course of a day found they engaged in compensatory behaviors—e.g. they just ate more sugary foods later. Additionally, a meta-analysis of 36 clinical trials published last month in Nutrients showed that beverages with artificial sweeteners had no effect on glucose levels and were similar to water.
Top Takeaway
The general guideline from health professionals is to cut down on sugar consumption vs. adding artificial sweeteners as a substitute.
In my opinion, reducing the intake of sweets is safer and more effective than using a sugar substitute. — Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute (lead author of the erythritol study)