Artificial Sugar Erythritol May Not Be as Safe as Once Thought 

by | Mar 20, 2023 | Nutrition

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A recent clinical study of erythritol reveals previously unknown risk factors that can increase the possibilities of blood clots or cardiovascular events. 

Because of concerns about health risks associated with sugar consumption, erythritol, along with other sugar substitutes, has become very popular over the years.  

The concern about sugar is not misplaced, considering the international epidemics of obesity, diabetes and other metabolic conditions that sugar consumption is associated with. As a result, many medical and nutritional professionals advise the use of sugar substitutes. 

Erythritol is popular because it has about 70% of the sweetness of sugar, tastes like sugar and bakes like sugar—all desirable qualities for a sugar substitute.  However, a recently published study reveals that erythritol may also be a previously unsuspected risk factor for certain life-threatening cardiac events.  

The study, funded by the National Institutes of Health, headed by Dr. Stanley Hazen of the Cleveland Clinic and published in Nature, begins by pointing out that, despite their widespread presence in food products, long-term use of artificial sweeteners has never been proven to be safe: 

There is growing epidemiological evidence linking the consumption of artificial sweeteners to … weight gain, insulin resistance, type 2 diabetes and cardiovascular disease (CVD), including atherothrombotic complications and cardiovascular mortality. Randomized clinical trials examining the long-term safety of consuming artificial sweeteners have not been performed (even for more early adopted forms such as aspartame and sucralose). Indeed, despite the growing incorporation of artificial sweeteners into the food chain, their cardiovascular risks have seldom been investigated.  

A release from the Cleveland Clinic provided this summary of the study’s findings:  

Researchers studied over 4,000 people in the U.S. and Europe and found those with higher blood erythritol levels were at elevated risk of experiencing a major adverse cardiac event such as heart attack, stroke or death. They also examined the effects of adding erythritol to either whole blood or isolated platelets, which are cell fragments that clump together to stop bleeding and contribute to blood clots. Results revealed that erythritol made platelets easier to activate and form a clot. Pre-clinical studies confirmed ingestion of erythritol heightened clot formation. 

Additionally, according to Dr. Hazen,  

Our study shows that when participants consumed an artificially sweetened beverage with an amount of erythritol found in many processed foods, markedly elevated levels in the blood are observed for days—levels well above those observed to enhance clotting risks. 

The presence of erythritol in sugar substitute blends has become almost ubiquitous. A rapid survey of commercially available sugar substitutes products found that many include erythritol in addition to the advertised compound. This included sweeteners advertised as stevia, monk fruit, xylitol and others.  

The eSavvyHealth Real Food article Are Alternative Sugars Healthy And Safe offers more information and recommendations for those who wish to reduce or eliminate sugar substitutes. 

Fundamentals of Health Alliance

Fundamentals of Health Alliance


The Fundamentals of Health Alliance works to publish useful and reliable information about nutrition and health. Their mission is to empower readers to be informed with honest, non-biased information about food, nutrition and the vital components of health.

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