A recent study from Cleveland Clinic researchers suggests that consuming a 30-gram serving of erythritol, a widely used artificial sweetener, may significantly elevate the risk of blood clots. The findings were published on August 8 in Arteriosclerosis, Thrombosis, and Vascular Biology.
Erythritol, commonly found in diet, low-calorie, and sugar-free products—especially those marketed for ketogenic diets—is often mixed with other sweeteners like stevia and monk fruit to enhance flavor and bulk.
The study assessed the impact of erythritol and regular sugar on blood platelets, which are crucial for blood clotting. The researchers observed that erythritol notably increased platelet activity, potentially heightening the risk of clot formation. In contrast, sugar did not affect platelet function in the same way.
Blood clots can be dangerous, leading to conditions such as heart attacks, strokes, or pulmonary embolisms if they travel to the heart, brain, or lungs, respectively.
These results build on earlier research from the same team, which linked erythritol to a higher risk of heart attack and stroke. This raises questions about the safety of erythritol as a food additive.
Products like Truvia and certain Splenda varieties contain erythritol. Both companies declined to comment on the new study.
The Calorie Control Council (CCC), which represents the low- and reduced-calorie food industry, criticized the study’s findings as “misleading.” The CCC emphasized that global authorities have long confirmed the safety of erythritol and similar sweeteners.
Study Details
The study involved 20 healthy volunteers with normal kidney function, averaging about 30 years old. After an overnight fast, participants consumed either a 30-gram serving of glucose or erythritol mixed with water. Blood samples were taken before and 30 minutes after consumption.
Participants who ingested erythritol experienced a dramatic increase in blood levels of the sweetener—over 1,000 times higher than baseline levels. These individuals also showed increased platelet aggregation and higher levels of platelet markers. No such changes were observed in those who consumed glucose.
Though the study’s small scale and single-dose approach limit its scope, it suggests that erythritol may pose a risk of blood clot formation when consumed regularly. This follows similar findings about xylitol, another artificial sweetener, and underscores the need for further research into the long-term health impacts of sugar alcohols like erythritol and xylitol.
Is Erythritol Safe?
Erythritol is marketed as a natural and calorie-free alternative to sugar, occurring naturally in some fruits and vegetables. However, it is commercially produced through fermentation and used in larger quantities as a food additive.
Common sources of erythritol include sugar-free gum, energy bars, diet sodas, and protein shakes. The study’s dosage of 30 grams reflects typical daily intake estimates from past surveys, though actual consumption may have increased.
Erythritol is not metabolized by the body and is excreted unchanged in the urine. Despite its “generally recognized as safe” (GRAS) status by the FDA, growing concerns about its safety prompt caution.
Should You Avoid Erythritol?
While erythritol has been recommended for individuals with conditions like obesity and diabetes, experts now advise caution. Thomas M. Holland, MD, a physician-scientist not involved in the study, suggests that the GRAS designation may not fully account for long-term risks. He recommends consumers be cautious, particularly those with cardiovascular issues.
Kiran Campbell, a registered dietitian, also advises avoiding erythritol until more is known. She points to WHO guidelines discouraging the use of non-nutritive sweeteners for weight loss or chronic disease prevention.
Alternative Sweeteners
For those looking to reduce artificial sweeteners, natural alternatives may be safer. These include:
Pure honey
Pure maple syrup
Dates
Coconut sugar
100% stevia extract
100% monk fruit extract
While natural sugars should be consumed in moderation to avoid long-term health issues, they may present a safer option compared to artificial sweeteners like erythritol.
Conclusion
The Cleveland Clinic study indicates that a 30-gram serving of erythritol could significantly increase the risk of blood clots. This highlights the need for continued scrutiny of artificial sweeteners and consideration of natural alternatives for those concerned about cardiovascular health.