erythritol may cause serious issues

zebasschick

https://newsroom.clevelandclinic.org/2023/02/27/cleveland-clinic-study-finds-common-artificial-sweetener-linked-to-higher-rates-of-heart-attack-and-stroke/

"Researchers studied over 4,000 people in the U.S. and Europe and found those with higher blood erythritol levels were at elevated risk of experiencing a major adverse cardiac event such as heart attack, stroke or death. They also examined the effects of adding erythritol to either whole blood or isolated platelets, which are cell fragments that clump together to stop bleeding and contribute to blood clots. Results revealed that erythritol made platelets easier to activate and form a clot. Pre-clinical studies confirmed ingestion of erythritol heightened clot formation.:

neanderthin

That's a confirmed, maybe. Cheers

paperpudding

that seems a reputable source reporting on an interesting study.
it is a report about the study, not the study itself.

As they said: "Sugar-free products containing erythritol are often recommended for people who have obesity, diabetes or metabolic syndrome and are looking for options to help manage their sugar or calorie intake. People with these conditions also are at higher risk for adverse cardiovascular events like heart attack and stroke."

So more people who are obese and/or diabetic turn to artificial sweeteners - it would seem expected to me that such group has higher risk because of their conditions rather than their artificial sweetener use.

I hope the study accounted for this.

on an individual level one would want to assess risk (if any) vs benifit and the risk of not using it if that meant one used sugar instead and did not lose weight or get good BSL control. - ie kept the cardiovascular risk of obesity/poor BSL control

I realise it isnt either /or - ie one could lose weight without sugar or sweeteners - but most people using sweeteners do so in place of sugar, not suddenly start sweetening things they didnt like sweet before.

kchapmanma

I saw a report on this on CNN, too. Since I am diabetic, I already have an elevated risk with heart disease, so this was enough for me to decide to stop eating artificial sweeteners with erythritol in them. This certainly needs to be studied in much more depth, but for me, I'd prefer to go without than wait for the results of further studies. Erythritol is used in a lot of artificial sweeteners, so going without means learning to enjoy things without additional sweeteners (I'm looking at you, coffee), substituting in small amounts of sweeteners like Tupelo honey instead, and no longer eating "sugar-free" or "keto-friendly" foods that include erythritol. On the plus side, though, it seems erythritol is also the substance that gives a lot of people (including me) stomach issues if they eat too much of it - so I won't miss that, at least.

paints5555

For anyone trying to avoid erythritol - it occurs naturally in some fruits and fermented foods.

VegjoyP

kchapmanma wrote: »

I saw a report on this on CNN, too. Since I am diabetic, I already have an elevated risk with heart disease, so this was enough for me to decide to stop eating artificial sweeteners with erythritol in them. This certainly needs to be studied in much more depth, but for me, I'd prefer to go without than wait for the results of further studies. Erythritol is used in a lot of artificial sweeteners, so going without means learning to enjoy things without additional sweeteners (I'm looking at you, coffee), substituting in small amounts of sweeteners like Tupelo honey instead, and no longer eating "sugar-free" or "keto-friendly" foods that include erythritol. On the plus side, though, it seems erythritol is also the substance that gives a lot of people (including me) stomach issues if they eat too much of it - so I won't miss that, at least.

Sugar in ant form is all sugar. Maybe try monk fruit, vegetable glycerine or without any sweeteners

VegjoyP

paperpudding wrote: »

that seems a reputable source reporting on an interesting study.
it is a report about the study, not the study itself.

As they said: "Sugar-free products containing erythritol are often recommended for people who have obesity, diabetes or metabolic syndrome and are looking for options to help manage their sugar or calorie intake. People with these conditions also are at higher risk for adverse cardiovascular events like heart attack and stroke."

So more people who are obese and/or diabetic turn to artificial sweeteners - it would seem expected to me that such group has higher risk because of their conditions rather than their artificial sweetener use.

I hope the study accounted for this.

on an individual level one would want to assess risk (if any) vs benifit and the risk of not using it if that meant one used sugar instead and did not lose weight or get good BSL control. - ie kept the cardiovascular risk of obesity/poor BSL control

I realise it isnt either /or - ie one could lose weight without sugar or sweeteners - but most people using sweeteners do so in place of sugar, not suddenly start sweetening things they didnt like sweet before.

This was much of my thoughts too

kchapmanma

VegjoyP wrote: »

kchapmanma wrote: »

I saw a report on this on CNN, too. Since I am diabetic, I already have an elevated risk with heart disease, so this was enough for me to decide to stop eating artificial sweeteners with erythritol in them. This certainly needs to be studied in much more depth, but for me, I'd prefer to go without than wait for the results of further studies. Erythritol is used in a lot of artificial sweeteners, so going without means learning to enjoy things without additional sweeteners (I'm looking at you, coffee), substituting in small amounts of sweeteners like Tupelo honey instead, and no longer eating "sugar-free" or "keto-friendly" foods that include erythritol. On the plus side, though, it seems erythritol is also the substance that gives a lot of people (including me) stomach issues if they eat too much of it - so I won't miss that, at least.

Sugar in ant form is all sugar. Maybe try monk fruit, vegetable glycerine or without any sweeteners

Thanks - and yup, my main plan is to just cut down on using sweeteners. I should have explained this in further detail, but the reason I mentioned Tupelo honey is because it specifically doesn't raise my blood sugar levels the way other sugars do (I have a continuous glucose meter so I can watch that type of thing). You're right, though, that sugar is sugar. When I asked my doctors about why I had different reactions then, they basically said that it's because a person's body chemistry is personal, so they can have different reactions to different substances (or combinations of substances). All of which is to say that just because Tupelo honey is a better sweetener for me, doesn't mean it's actually a better sweetener than anything else. It's just a sweetener that, in moderation, works better for me personally.

Also, I should have said that I'm not trying to never eat erythritol, because it isn't just in artificial sweeteners. What I'm trying to do is cut down on how much of it I'm eating via the easiest route of cutting out the artificial sweeteners.

neanderthin

Observational studies like this make good headlines and never show causality, only causation. What happens in a petri dish allowing for real world dosages and how that translates into human trials would need to be tested with a double or triple blinded randomized controlled trial. There's many observations that are associated with increased heart related events, now we have another one.

westrich20940

paperpudding wrote: »

that seems a reputable source reporting on an interesting study.
it is a report about the study, not the study itself.

As they said: "Sugar-free products containing erythritol are often recommended for people who have obesity, diabetes or metabolic syndrome and are looking for options to help manage their sugar or calorie intake. People with these conditions also are at higher risk for adverse cardiovascular events like heart attack and stroke."

So more people who are obese and/or diabetic turn to artificial sweeteners - it would seem expected to me that such group has higher risk because of their conditions rather than their artificial sweetener use.

I hope the study accounted for this.

on an individual level one would want to assess risk (if any) vs benifit and the risk of not using it if that meant one used sugar instead and did not lose weight or get good BSL control. - ie kept the cardiovascular risk of obesity/poor BSL control

I realise it isnt either /or - ie one could lose weight without sugar or sweeteners - but most people using sweeteners do so in place of sugar, not suddenly start sweetening things they didnt like sweet before.

The study did NOT account for this and this is actually posed by one of the researchers as a possible explanation for their finding...
https://www.pbs.org/newshour/show/popular-artificial-sweetener-erythritol-linked-to-higher-risk-for-blood-clots

They interview them here. They specifically ask about this. And it seems that all of the authors agree that (as in most cases with BOMBASTIC results that get reported to the public)...more research is warranted.

EDIT: just to say that there is no problem with this study. They set out and did what they intended to do and found unexpected results. Worth publishing. The issue comes with then how those things are reported, especially by news outlets (or consumers) who read the abstract instead of the actual article....and that's even if those reading it can actually understand the methodology or possible short-comings of such a study.

neanderthin

westrich20940 wrote: »

paperpudding wrote: »

that seems a reputable source reporting on an interesting study.
it is a report about the study, not the study itself.

As they said: "Sugar-free products containing erythritol are often recommended for people who have obesity, diabetes or metabolic syndrome and are looking for options to help manage their sugar or calorie intake. People with these conditions also are at higher risk for adverse cardiovascular events like heart attack and stroke."

So more people who are obese and/or diabetic turn to artificial sweeteners - it would seem expected to me that such group has higher risk because of their conditions rather than their artificial sweetener use.

I hope the study accounted for this.

on an individual level one would want to assess risk (if any) vs benifit and the risk of not using it if that meant one used sugar instead and did not lose weight or get good BSL control. - ie kept the cardiovascular risk of obesity/poor BSL control

I realise it isnt either /or - ie one could lose weight without sugar or sweeteners - but most people using sweeteners do so in place of sugar, not suddenly start sweetening things they didnt like sweet before.

The study did NOT account for this and this is actually posed by one of the researchers as a possible explanation for their finding...
https://www.pbs.org/newshour/show/popular-artificial-sweetener-erythritol-linked-to-higher-risk-for-blood-clots

They interview them here. They specifically ask about this. And it seems that all of the authors agree that (as in most cases with BOMBASTIC results that get reported to the public)...more research is warranted.

EDIT: just to say that there is no problem with this study. They set out and did what they intended to do and found unexpected results. Worth publishing. The issue comes with then how those things are reported, especially by news outlets (or consumers) who read the abstract instead of the actual article....and that's even if those reading it can actually understand the methodology or possible short-comings of such a study.

Exactly. Erythritol is made endogenously by the body and the study doesn't tell us much about us eating it. Some people may produce more erythritol than others and this study didn't actually measure any consumption of erythritol, so this is just a prospective announcement that people with higher levels are at more risk and that person could potentially have never consumed any ever. the media had a field day because they're stupid, but we knew that, right.

zebasschick

but the amount made by the body and in many foods is a small amount. those who use it as a sugar substitute are using many times more. and after looking stuff up, because erythritol is made by the body and small amounts appear in foods, the FDA considers it as generally regarded as safe, which basically means it hasn't been tested or studied for safely even though it's been in use in large amounts for a bit over 20 years...

Healthtimes51520

So does this mean not more using Trivia?

refactored

I don't understand how people can so easily discount this NIH funded study. Yes it is not a double blind randomised controlled study but conducting one on people would probably be unethical. They even exposed human platelets to erythritol in the same amounts they measured in the human blood stream and it caused clotting. It has also been shown that it sped up artery blockages in mice. Yes more evidence is always needed but isn't it wise to avoid it until the weight of evidence is enough to show whether it is or isn't dangerous?

paperpudding

What I think is wise is to balance the possible maybe risk of this vs the known risk of the alternative- ie of using sugar instead and not getting good BSL control/not losing weight.

Yes of course you could use neither or reduce both - but as I pointed out in my last post - most people using artificial sweeteners are doing so in place of sugar - not suddenly using a product to create sweetness that they didnt like before.

sollyn23l2

Erythritol is naturally produced by the body. This study didn't test, differentiate, or even speculate on the effects of consuming erythritol, but rather, erythritol that is in the body. That's why people are hesitant about saying that this study means erythritol is dangerous. It is connected to and indicative of cardiovascular disease. But not necessarily causative.

refactored

They measured a 1000-fold increase in erythritol in the blood after consumption though so well above what naturally occurs in the body. They said that after consumption, erythritol is poorly metabolized by the body so makes its way into the blood stream. The elevated level was enough to cause clotting in human platelets in a test tube and mouse studies (which are more easily controllable) it was shown to be associated with an increase in blockages in mice.

Of course it doesn't show causation. What single medical study does? It is the weight of evidence that is needed and even then showing causation is not possible. So who will pay for further follow up studies that must disclose the results no matter what the outcome? And anyway even if there is a lot of evidence to show it associated with stroke and cardiovascular events, they can only ever say it associated with an increased risk in much the way we say smoking is associated with an increased risk of cancer.

paperpudding

No I don't think this is ' much the same' as smoking link to cancer, cardiovascular risk etc.

Far from it.