New Cleveland Clinic Study Highlights Growing Concerns Over Erythritol's Cardiovascular Risks

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There's no sugar coating this, a new Cleveland Clinic study has brought back into the spotlight the potential cardiovascular risks associated with erythritol, a popular sugar substitute. This new research echoes the alarming concerns raised by a similar study conducted by the Cleveland Clinic just a year ago, suggesting a growing body of evidence that erythritol may not be as heart-friendly as once thought.

What is Erythritol?

Erythritol is a sugar alcohol commonly used as a low-calorie sweetener in various foods and beverages. It is about 70% as sweet as sugar but contains only a fraction of the calories, making it a popular choice among those looking to reduce sugar intake and manage weight. It is naturally found in some fruits and fermented foods, but the commercial erythritol used in products is typically produced from corn through a fermentation process.

What Was The Effect Of The Previous Study?

A Year-Old Concern

Last year, the Cleveland Clinic released a study that raised eyebrows within the health community. The research suggested that erythritol could potentially increase the risk of cardiovascular events, such as heart attacks and strokes. This study found that high levels of erythritol in the blood were linked to an increased risk of these events, prompting further investigation into the safety of this widely used sugar substitute.

What Does The New Study Tell Us?

Reinforcing the Alarm

The latest Cleveland Clinic study delves deeper into the potential dangers of erythritol, reinforcing the concerns highlighted in the previous research. This new study involved a larger cohort and utilized advanced analytical methods to measure erythritol levels and their association with cardiovascular risks.

What Are The Key Findings?

1. Elevated Erythritol Levels and Cardiovascular Events: The study confirmed that individuals with higher levels of erythritol in their blood had a significantly increased risk of major cardiovascular events, including heart attacks and strokes.

2. Mechanistic Insights: Researchers explored the mechanisms behind this association and found that erythritol could potentially enhance platelet reactivity. This means that erythritol might make blood platelets more likely to form clots, which can block blood vessels and lead to heart attacks or strokes.

3. Comparison with Other Sweeteners: The study also compared erythritol with other sugar substitutes and found that the cardiovascular risks were notably higher with erythritol. This suggests that not all sugar substitutes carry the same level of risk, emphasizing the need for careful consideration when choosing sugar alternatives.

4. Dose-Response Relationship: The findings indicated a dose-response relationship, meaning that higher erythritol consumption was associated with a greater risk of cardiovascular events. This points to the importance of moderating intake levels of erythritol in daily diets.

What Are Implications for Consumers?

For many people, especially those managing diabetes or seeking weight loss, sugar substitutes like erythritol have been seen as a healthier alternative to sugar. However, the accumulating evidence from these studies suggests that consumers should be cautious about their erythritol intake. Here are some practical takeaways:

• Read Labels Carefully: Check the ingredient lists on food and beverage packaging to identify the presence of erythritol.
• Moderation is Key: While occasional consumption may not pose significant risks, frequent and high intake of erythritol could be problematic.
• Consider Alternatives: Explore other low-calorie sweeteners that might have a safer profile, such as stevia or monk fruit extract, though these too should be used in moderation.

What Is The Broader Context?

Sugar Substitutes and Health

This growing concern over erythritol adds to the broader debate about the safety of sugar substitutes. Over the years, various studies have scrutinized artificial and natural sweeteners, with mixed findings. Some substitutes have been linked to negative health outcomes, while others are considered relatively safe.

Artificial Sweeteners: Aspartame, sucralose, and saccharin have long been used as sugar alternatives. While they are generally regarded as safe by regulatory agencies, some studies have suggested potential links to metabolic disorders, gut health issues, and even cancer risks, though evidence is not conclusive.

Natural Sweeteners: Stevia and monk fruit extract are often touted as healthier alternatives due to their natural origins. However, their long-term health impacts are still under investigation.

Looking Ahead: What Needs to Be Done?

The Cleveland Clinic's findings underscore the need for further research to fully understand the health impacts of erythritol and other sugar substitutes. Here are some steps that researchers, regulators, and consumers can take:

• Long-Term Studies: More extensive, long-term studies are needed to track the health outcomes of erythritol consumption over time.
• Regulatory Review: Regulatory bodies like the FDA and EFSA should review existing safety guidelines for erythritol in light of new evidence.
• Public Awareness: Increased efforts to educate the public about the potential risks associated with sugar substitutes can help consumers make informed choices.

The recent Cleveland Clinic study provides a stark reminder that not all sugar substitutes are created equal. While erythritol offers the appeal of sweetness without the calories, its potential cardiovascular risks cannot be ignored. As we await further research, it is prudent to approach erythritol and other sugar substitutes with caution, prioritizing moderation and a balanced diet for better heart health.

What Products Contain Erythritol?

1. Sugar-Free and Low-Calorie Sweeteners

Erythritol-based sweeteners

• Swerve: Swerve is a well-known erythritol-based sweetener available in granular, powdered, and brown sugar forms.
• Lakanto: This brand offers a monk fruit sweetener that is blended with erythritol.
• Truvia: While Truvia primarily markets itself as a stevia-based sweetener, it actually contains a blend of stevia and erythritol.
• Pyure Organic: This product is a blend of stevia and erythritol.

2. Baked Goods

Sugar-free cookies,  Low-calorie muffins, Keto bread and pastries, Sugar-free cakes and brownies

• HighKey: HighKey products like cookies and brownie bites often contain erythritol as a sweetener.
• Quest Nutrition: Many of their protein cookies, bars, and other snacks contain erythritol.
• Kiss My Keto: Their cookies and other baked goods use erythritol.
• Good Dee’s: Baking mixes for low-carb cookies, brownies, and cakes often contain erythritol.

3. Candy and Confectionery

Sugar-free candies (e.g., hard candies, gummies),  Chocolate bars (especially keto-friendly), Mints and chewing gum, Sugar-free chocolates

• Lily’s Sweets: Their chocolate bars, chocolate chips, and other chocolate products are sweetened with a blend of erythritol and stevia.
• SmartSweets: These low-sugar gummy candies often use erythritol as a sweetener.
• Russell Stover: Their sugar-free chocolates and candies contain erythritol.
• ChocZero: This brand offers sugar-free chocolate products, all sweetened with erythritol.

4. Beverages

Diet sodas and soft drinks, Flavored waters. Low-calorie energy drinks, Sugar-free iced teas, Keto coffee creamers and syrups

     1. Flavored Waters and Drinks:

• Bai: Bai Antioxidant Infusions and Bai Bubbles beverages are sweetened with a combination of erythritol and stevia.
• VitaminWater Zero: Some varieties of VitaminWater Zero include erythritol as a sweetener.
• SoBe Water: Certain SoBe Lifewater products contain erythritol.

     2. Energy Drinks:

• G Fuel: This energy drink mix contains erythritol as one of its sweeteners.
• Bang Keto Coffee: Bang’s Keto Coffee beverages include erythritol.
• Monster Energy Ultra: Some of the "Ultra" line of Monster Energy drinks are sweetened with a mix of erythritol and other sugar alcohols

5. Desserts

Sugar-free ice creams and frozen desserts, Low-calorie pudding, Keto-friendly mousses, Gelato and sorbet

• Talenti: New line of gelato sweetened with monk fruit juice concentrate, sugar and erythritol
• Rebel Creamery: Their keto-friendly ice creams are sweetened with erythritol and other low-carb sweeteners.
• Enlightened: Many of their low-calorie ice creams and desserts contain erythritol.
• So Delicious: Some of their dairy-free, low-sugar ice cream alternatives contain erythritol.

6. Processed Foods:

• Keto Chow: This meal replacement shake mix contains erythritol.
• Real Good Foods: Their frozen meals and snacks, which are marketed as low-carb, sometimes include erythritol.
• SlimFast Keto: Their meal bars, shakes, and snacks in the keto line often contain erythritol.

7. Snack Foods

Keto-friendly snack bars, Protein bars, Sugar-free granola, Low-carb cookies

• Keto and Co: Products like granola and baking mixes often contain erythritol.
• Love Good Fats: Their snack bars are sweetened with erythritol.
• Atkins: Many of their protein bars, shakes, and snack products include erythritol.

8. Supplements:

• Orgain: Some of their protein powders and shakes contain erythritol.
• Garden of Life: Their protein and meal replacement powders include erythritol.
• KetoLogic: Their BHB exogenous ketones and meal replacement shakes often contain erythritol.

9. Specialty Diet Products

Keto, paleo, and diabetic-friendly products, Low-carb meal prep kits

• Perfect Keto: Keto bars, snacks, and supplements with erythritol.
• Primal Kitchen: Keto-friendly pantry staples.
• Know Brainer: Keto creamer and beverages.

This list includes some of the most popular brands, but there are many more products that use erythritol, especially in the health and wellness space. Always check the ingredient labels to confirm the presence of erythritol.

Sources

1. Cleveland Clinic. (2024). New Study on Erythritol and Cardiovascular Risks.
2. Cleveland Clinic. (2023). Previous Study on Erythritol.
3. American Heart Association. (2023). Understanding Sugar Substitutes and Heart Health.
4. National Institutes of Health. (2022). The Impact of Artificial Sweeteners on Metabolic Health.
5. What Sugar?: Erythritol Guide

Author

Dr. Mark L. Meyer Dr. Meyer graduated from Haverford College with a Bachelor of Science, High Honors, in cellular and molecular biology, Phi Beta Kappa, Magna Cum Laude. He attended the Yale University School of Medicine, where he also completed a categorical residency in Internal Medicine, served for one year as an Emergency Department attending physician, and held the title of Clinical Instructor in the Department of Surgery. During this time, Dr. Meyer obtained a J.D. from the Yale Law School, concentrating on medical ethics, scientific research law, and FDA law. He then completed a fellowship in Cardiovascular Diseases at the Hospital of the University of Pennsylvania, where he obtained Level 3 Nuclear Cardiology training.