Cleveland Clinic Research Slams Erythritol

March 29, 2023
Large study finds it increases clotting and raises the risk of heart attack and stroke.

Cleveland Clinic on Feb. 27 published results of a study of more than 4,000 people in the U.S. and Europe that found people who had more erythritol in their blood were at elevated risk for major heart problems.

“We were looking for compounds in blood that predict risk for experiencing a future heart attack or stroke. The top candidate that kept showing up was erythritol,” says Stanley Hazen, MD, PhD, a specialist in preventive cardiovascular medicine who was the senior author of the study.

Reports on the research did not quantify how much more likely erythritol consumers are for heart attack or stroke.

Erythritol, a sugar alcohol typically manufactured by fermenting corn, is one of the most common sweeteners. It’s used in many foods and beverages, especially those marketed for weight loss and diabetes management because it contains just 5% of the calories of sugar -- about 0.2 calories per gram. It’s about 60–80% as sweet as regular sugar and has a very similar taste.

It’s also used as a bulking agent. Erythritol is added to many sugar substitutes, including stevia and monk fruit sweeteners. It is Generally Recognized as Safe (GRAS) by the FDA.

In addition to the human studies, the Cleveland Clinic researchers gave erythritol to animal models. They saw enhanced clot formation in models of arterial disease. They added it to blood outside of the body and found that adding erythritol made the blood “clump up,” or form a blood clot by activating platelets.

“A serving of erythritol in common ‘keto-friendly’ processed food products made blood levels of erythritol go up 1,000-fold, well above the levels linked to enhanced clotting risks,” Hazen said. “We found that the risk for clotting can be increased for several days after consumption of just one serving of artificially sweetened food containing erythritol.

“The very people who are being targeted for foods that contain erythritol are the same people who already are at increased risk for cardiovascular events, so this is very concerning,” he continued. Plus, sugar alcohols in general have been known to cause digestive issues for some people.

Hazen said more studies will be needed to confirm these findings and to prove if high erythritol in blood was the actual cause of the increased heart attacks and strokes.

About the Author

Dave Fusaro | Editor in Chief

Dave Fusaro has served as editor in chief of Food Processing magazine since 2003. Dave has 30 years experience in food & beverage industry journalism and has won several national ASBPE writing awards for his Food Processing stories. Dave has been interviewed on CNN, quoted in national newspapers and he authored a 200-page market research report on the milk industry. Formerly an award-winning newspaper reporter who specialized in business writing, he holds a BA in journalism from Marquette University. Prior to joining Food Processing, Dave was Editor-In-Chief of Dairy Foods and was Managing Editor of Prepared Foods.

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