Erythritol, a zero-calorie artificial sweetener found in many keto-friendly food products, may be correlated with blood clots, heart attack, and stroke, according to a new study in Nature Medicine.
The initial study found that those with risk factors for heart disease who had the most erythritol in their blood had double the risk of heart attack or stroke compared to the bottom 25 percent of participants. Researchers then looked at a smaller group of individuals without risk factors and found that erythritol still increases risk.
"The study basically showed that erythritol provokes blood clotting more than just your body's natural ability to just clot," said Dan LeMoine, holistic nutritionist, author of Fear No Food, and CEO of Revitalized Weight Loss & Wellness.
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Blood clotting is a healthy thing, he said. For example, if you cut yourself, you want the platelets in your body to clot to stop bleeding. But too much blood clotting isn't such a good thing, especially if you already have risk factors.
"So what was most concerning about the study was that if you do have a comorbidity or an existing risk factor like heart disease or diabetes, it looks as if a higher intake of erythritol could potentially be correlated to increased risk of heart attack or stroke," LeMoine said in an interview with Delish.
But over the years, the research on erythritol seems to have provided different results. The executive director of the Calorie Control Council, Robert Rankin, told CNN that “the results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages.”
Rankin added that these results “should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events.”
But LeMoine is skeptical about the United States' approval process for food. "The way the FDA and the different regulatory bodies allow different foods and chemicals to get into our foods seems to be a lot different than other parts of the world," he said. "In America, we have this innocent-until-proven-guilty-type mentality, even when it comes to chemicals and food ingredients and things like that. Whereas other parts of the world, like Europe, for example, you have to prove that you're going to do no harm before you even get to be in a in a food or in the general public's use."
What Is Erythritol?
"Erythritol is like a lot of these other non-nutritive sweeteners in that it's low-calorie or no-calorie," said LeMoine. Erythritol doesn't spike blood sugar, which is important for anyone with diabetes or following a keto diet. It also tastes like sugar and is heat stable, making it good for baking.
Are Foods With Erythritol Safe To Eat?
Until there's more broad-based studies, LeMoine said that it would probably be advisable to pull back or steer clear of erythritol if you eat a lot foods with it or have existing risk factors.
But keep in mind, the individuals in the study who had high levels of erythritol in their blood were eating a lot of foods with erythritol. "I don't think the folks who were at the highest risk were the 'every once in a while I had a couple packets of erythritol in my coffee' [erythritol consumer]," he said.
When advising his clients, he said, "A lot of these non-nutritive sweeteners can be really good in a pinch when you're just really craving something, but generally speaking, it's still highly processed and probably good to just eat as close to nature as possible."
"Treat treats as treats, is what we like to say," said LeMoine. "So whether you're sweetening those treats with erythritol or sugar, treat it like a treat."
He added that even things like stevia have been shown to mess up the gut microbiome. "They're not the silver bullet that I think sometimes they're allotted."
He likes to think about this as a spectrum of risk, where you look at your overall health, diet, and existing risk factors. And at the end of the day, he thinks that more research on erythritol is needed.
Allison Arnold is the Associate SEO Editor at Delish, where she writes about kitchen gadgets and food and culture. She likes exercising almost as much as eating, and has a thorough Google Maps ranking system for her favorite restaurants and bars. You can find her spewing hot takes on the food world and planning her next trip, all with multiple cans of seltzer open at a time.
