New study finds sugar substitute erythritol may increase risk for cardiovascular issues

Erythritol, a sugar substitute often used in keto-friendly and reduced-sugar products, may raise the risk of negative cardiovascular events such as heart attacks and strokes, according to new research from the Cleveland Clinic.

Researchers from the Cleveland Clinic compared erythritol to typical sugar and found only erythritol caused worrisome cardiovascular effects.

An interventional study, published in ‘Arteriosclerosis, Thrombosis and Vascular Biology’ on Thursday, found that consuming a “standard serving” of 30 grams of erythritol — a dose typically found in a sugar-free soda or muffin — increased platelet activity in healthy participants, which could elevate the risk of blood clots. This effect was not observed with sugar.

Erythritol is commonly included in sugar-free products recommended for individuals with obesity, diabetes, or metabolic syndrome to help manage sugar and calorie intake. For example, it is an ingredient in the popular calorie-free stevia sweetener Truvia. People with these conditions are already at a higher risk for adverse cardiovascular events like stroke.

“Cardiovascular disease develops over time, and heart disease is the leading cause of death worldwide. It’s crucial to ensure that the foods we consume are not hidden contributors,” said Dr. Stanley Hazen, the study’s senior author. “These findings highlight the need for further long-term clinical studies to evaluate the cardiovascular safety of erythritol and other sugar substitutes.”

Currently, erythritol is classified by the U.S. Food and Drug Administration as GRAS — “generally recognized as safe” — permitting its unrestricted use in food products. However, this study adds to growing evidence suggesting that erythritol and other sweeteners may not be as safe as previously believed.

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