The Sweetener Erythritol May Increase the Risk of Blood Clots

Aug. 8, 0224 –There’s more evidence that the artificial sweetener erythritol is linked to an increased risk of blood clots, which can lead to problems with your heart and blood vessels, like heart attacks or strokes.

Erythritol is often used in keto diet products and others seeking to limit calories and carbohydrates. It is considered a sugar alcohol that can be produced by fermenting corn. And while it can occur naturally in fruits and vegetables or be made in small amounts by our own bodies, the artificial additions to foods and drinks can be significantly greater than amounts naturally found in produce.

The new findings, published Thursday in the journal Arteriosclerosis, Thrombosis, and Vascular Biology, showed that when healthy people consumed 30 grams of erythritol, scientists could detect changes in their blood afterward that showed a higher blood clot risk. They described 30 grams as “a typical quantity.” People who consumed 30 grams of sugar did not experience the same effect. The study included 10 people in the erythritol group and 10 people in the sugar group.

In many cases, manufacturers aren’t required to list the amount of sugar alcohols on a product label, although they may voluntarily do so, according to the FDA, which advises that consumers look for them to be listed on package ingredient lists. The federal agency says sugar alcohols are found in many sugar-free and reduced-sugar products, including baked goods, chewing gum, jams and jellies, frosting, candy, ice cream, and other frozen desserts.

These latest findings build upon previous research from many of the same Cleveland Clinic team members that was published last year in Nature Medicine. That research linked increased erythritol blood levels to a higher risk of problems with the heart and blood vessels in a group of 4,000 people. The earlier study also demonstrated a link between erythritol and blood clotting, and showed that when people drank a beverage artificially sweetened with a common amount of erythritol, changes in their blood could persist for days afterward that could increase the risk of blood clots.

“Many professional societies and clinicians routinely recommend that people at high cardiovascular risk – those with obesity, diabetes or metabolic syndrome – consume foods that contain sugar substitutes rather than sugar,” researcher Stanley Hazen, MD, PhD, a Cleveland Clinic cardiologist, said in a statement. “These findings underscore the importance of further long-term clinical studies to assess the cardiovascular safety of erythritol and other sugar substitutes.”

Sugar alcohols are currently considered safe by the FDA, but the agency cautions that “some people may have a particular sensitivity or adverse reaction to any food substance. Talk with your health care professional if you are concerned about a negative food reaction.”

The president of the industry group Calorie Control Council said that these findings should be interpreted with caution due to the way the study was designed, including involving a small number of people researched and how much erythritol was used.

“Consumers need to rely on science, and for 30 years, science has shown that erythritol is a proven safe and effective choice for sugar and calorie reduction,” the council’s president, Carla Saunders, told CBS News.

The Cleveland Clinic team wrote that their “findings suggest that discussion of whether erythritol should be reevaluated as a food additive with the Generally Recognized as Safe designation is warranted.”