Common Low-Calorie Sweeteners May Increase Thrombus Risk

A recent study has provided evidence suggesting that the common artificial sweetener erythritol may increase the risk of thrombus formation. This finding has garnered widespread attention from the medical community and the public, as erythritol is widely used in various low-calorie and sugar-free foods.

Study Finds Erythritol Associated with Increased Thrombus Risk

Researchers from the Cleveland Clinic recently conducted a study showing that after consuming 30 grams of erythritol, participants exhibited a significant increase in platelet activity, indicating a higher likelihood of thrombus formation. The results of this study were published on August 8, 2023, in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.

Key findings of the study include:

1. After consuming erythritol, participants' blood levels of erythritol surged to over 1000 times their baseline levels.

2. Participants in the erythritol group showed a significant increase in platelet aggregation when exposed to specific triggering factors.

3. The erythritol group also exhibited an increase in specific markers of platelet release.

4. In contrast, the control group consuming regular sugar (glucose) did not show these changes.

These findings echo earlier results published by the research team in 2023, which linked erythritol to higher risks of heart disease and stroke. These concerning data suggest that the safety of erythritol as a food additive may need to be re-evaluated.

Widespread Use of Erythritol

Erythritol is a common artificial sweetener found in dietary, low-calorie, and sugar-free food and beverage products, particularly those targeting the ketogenic diet market. It is often mixed with stevia and monk fruit sweeteners to enhance volume and improve taste.

Popular sweetener brands, such as Truvia and certain Splenda products, use erythritol as a primary ingredient. In addition to specialized sweetener products, erythritol is also added to many other processed foods and beverages, including:

• Sugar-free gum
• Energy bars
• Certain sugar-free sodas
• Protein shakes
• Low-calorie desserts and baked goods

According to data from the National Health and Nutrition Examination Survey (2013-2014) and calculations by the FDA in 2001, the amount of erythritol used in this study (30 grams) reflects a typical daily intake from food and beverages. However, considering the steady increase in the use of artificial sweeteners, current daily intake may have exceeded these earlier estimates.

Metabolic Process of Erythritol in the Body

Understanding the metabolic process of erythritol in the human body is crucial for assessing its potential risks:

1. Not digested after intake: Unlike other sugar alcohols, erythritol is almost not absorbed in the small intestine.

2. Enters the bloodstream: It enters the circulatory system through the intestines.

3. Excreted unchanged: It is primarily excreted through urine without undergoing chemical changes in the body.

4. Naturally produced in the body: The human body naturally produces small amounts of erythritol, but additional erythritol from dietary sources may accumulate in the bloodstream.

5. Possible accumulation effects: As shown in this study, levels of erythritol in the blood may surge sharply after intake, raising concerns about the safety of long-term use.

Safety Assessment of Erythritol

Despite increasing evidence questioning its safety, the U.S. Food and Drug Administration (FDA) still classifies erythritol as a "Generally Recognized as Safe" (GRAS) substance. This means that erythritol is considered safe for the general population when consumed in typical daily amounts in food and beverage products.

However, Dr. Thomas M. Holland, an assistant professor at the Rush University Institute for Healthy Aging, points out: "The GRAS designation relies on safety assumptions based on existing research and historical use, but this approach may not always account for long-term or cumulative risks."

Dr. Holland advises that individuals, especially those at risk for cardiovascular issues or diseases associated with increased thrombus risk, should "exercise caution" and avoid using artificial sweeteners like erythritol.

Registered dietitian Kiran Campbell echoed this view, urging the FDA to reconsider the safety of erythritol. She emphasized that consumers should cautiously avoid erythritol until more is known, especially since nearly half of the adult population "has some form of heart disease, including stroke, and may be taking antiplatelet medications."

Latest Recommendations from the World Health Organization

Notably, the World Health Organization (WHO) updated its guidelines in 2023, recommending against the use of non-nutritive (zero-calorie) sweeteners for weight loss or chronic disease prevention. This recommendation further emphasizes concerns about the safety of artificial sweeteners and supports experts' calls for caution in using erythritol.

Alternatives to Erythritol

In light of the current research findings, experts recommend considering safer alternatives to replace erythritol. Here are some possible options:

1. Pure natural honey (Grade A)
2. Pure maple syrup
3. Coconut sugar
4. 100% stevia extract (calorie-free)
5. 100% monk fruit extract (calorie-free)
6. Natural fruits (such as dates) as a source of sweetness

Dr. Holland emphasizes: "While a diet low in added sugars is ideal, given the current evidence, occasionally consuming natural sugars may be safer than relying on artificial substitutes."

However, he also warns that even natural sugars should be consumed in moderation to prevent long-term negative effects, such as metabolic disorders.

Conclusion

This new study from the Cleveland Clinic indicates that 30 grams of erythritol (a common artificial sweetener) may significantly increase the risk of thrombus formation. This study highlights that even substances deemed safe by regulatory agencies may pose potential risks, especially for individuals with existing health issues.

As more evidence questions the safety of erythritol and other artificial sweeteners, experts recommend that consumers cautiously avoid using these products and consider moderate choices of natural sugars and sweetener alternatives.

Finally, it is important to emphasize that while this study provides significant insights, more research is needed to fully understand the long-term health effects of erythritol. In the meantime, consumers should remain vigilant, stay informed about the latest research findings, and adjust their dietary choices as necessary.

The content of this article is based on publicly available information at the time of writing. If there are any inaccuracies, readers are welcome to point them out, and we will correct them promptly.