Erythritol is a sugar alcohol often used to sweeten low-sugar, reduced-calorie drinks and foods, especially in low-carb or "keto" diets. Researchers found that erythritol could cause a rise in blood platelets and promote blood clot formation.
These findings were published in the journal *Arteriosclerosis, Thrombosis, and Vascular Biology*.
In a previous study published in *Nature Medicine*, the same research team discovered that heart patients with high levels of erythritol in their blood had double the risk of experiencing a major cardiac event within three years.
"In this study, we directly compared drinking a sweetened drink with either 30 grams of glucose, which is sugar, or 30 grams of erythritol," explained Dr. Stanley Hazen, the senior author and co-section head of preventive cardiology at Cleveland Clinic, in a video shared with Fox News Digital.
The study involved 20 healthy volunteers, around 30 years old on average, who had their blood tested after an overnight fast. The participants drank water mixed with either 30 grams of erythritol (similar to the amount found in an artificially sweetened soda or baked good) or 30 grams of glucose.
After 30 minutes, their blood was tested again to measure erythritol levels and platelet function. The results showed that those who consumed the artificial sweetener had erythritol levels more than 1,000 times higher than those who consumed glucose.
"There is every reason to believe that after drinking erythritol, there is a heightened risk of clotting, or thrombosis, which could increase the chances of heart attack or stroke," said Dr. Hazen.
"Based on the current data, it looks like it’s safer to drink a glucose-sweetened drink rather than an erythritol-sweetened drink," he continued. "I recommend my patients avoid artificial sweeteners and sugar substitutes, try to eat whole foods, avoid processed foods, and shop in the produce section."
Dr. Hazen also suggested using natural sweeteners like honey or fruit instead of artificial ones.
The same risk has been observed with other sugar alcohols, Dr. Hazen noted.
The U.S. Food and Drug Administration (FDA) and the European Food Safety Authority classify erythritol as GRAS ("generally recognized as safe"). However, Dr. Hazen pointed out that there's no strong mandate for testing its safety. "I would like to see regulatory bodies reevaluate the safety of using sugar alcohols," he said.
The researchers believe more clinical studies are needed to understand the long-term cardiovascular safety of erythritol.
Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution in Cincinnati, Ohio, was not involved in the study but shared his concerns with Fox News Digital. "Many artificial sweeteners have been studied and historically have been sold as healthy alternatives to sugar, but they have often been found to have significant side effects," he said.
"There have been other studies showing that erythritol increases platelet activity, which leads to abnormal blood clot formation."
Other sugar substitutes, like xylitol, have also been linked to negative health effects, according to Dr. Serwer.
"In addition to increasing the risk of cardiovascular events, these artificial sugars often trick the body into producing more insulin," he explained. "Insulin increases sweet cravings, so people crave more sugar after eating artificial sweeteners, which can lead to metabolic syndrome."
Dr. Serwer mentioned that many of his cardiology patients are looking for healthier alternatives to sugary, high-calorie foods. "It is important to inform them that it may be better to avoid these sugar alcohols altogether," he said.
He hopes that "this data will cause the FDA to reevaluate the safety of erythritol."
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