Is the sweetener erythritol bad for the heart?

What does observational study mean? This means that it only aims to evaluate whether there may be an association between two elements, but not a direct causal relationship. This clarification is necessary, and the journal itself points out this feature, in front of the research that appears on nature medicine (first name Marco Witkowski) and was coordinated by Stanley Hazen of the New Cleveland Clinic. According to reports, a widely used sweetener like erythritol could be associated with an increased risk of developing a heart attack or stroke. Not only that: in other studies conducted on blood samples from healthy volunteers, there seems to be a possible impact on the coagulation processes in the short term. All of these observations are reported in the publication. However, there are many points to understand: for example, there are no specific indications on the diet of the subjects and their lifestyles (just to mention a few aspects) as well as on the quantity of sweeteners taken over time. Also for this reason, the same scholars point out that further research is needed to define the situation, considering that what emerges from the main study was obtained on people who already had other cardiovascular risk factors.

A complex search

Scholars, as they point out in their work, have examined the possible association between sweetener intake and risk of pathology in different situations using metabolomics (a technique which allows us to observe how the body “digests” a given molecule). In the first non-specific studies on patients (therefore already suffering from cardiovascular diseases) undergoing cardiac risk assessment, they followed up more than 1150 patients monitored for cardiovascular risk: in the following three years they saw that those with higher blood levels of sweeteners, and in particular of erythritol, had a higher risk of developing major adverse cardiovascular events such as heart attack or stroke. Then specific analyzes were carried out on two populations, for a total of about 300 people, to validate this hypothesis. These investigations also confirmed the first observations as well as showing a potential activity of the compound on coagulation processes. Finally, further possible confirmation of this specific action of erythritol in the blood came from an analysis on a very small population of healthy volunteers.

Further evaluations needed

To date, prospective data on polyols, such as erythritol or xylitol, are not available. And there is a lack of information on the possible levels of these components in the blood as well as on the possible metabolic changes that these compounds could theoretically induce over time. Moreover, it is not the first time that the attention of scholars has focused on erythritol in relation to cardiac health. In 2014, a pilot study published on Acta Diabetologica (first name Nir Flint) conducted by Boston University scholars highlighted a protective association between the consumption of this compound and the function of the endothelium (the innermost layer of the arterial wall) as well as the improved elasticity of the aorta in people with type 2. It should also be mentioned that this zero calorie sweetener, classified as a food additive, is considered safe by regulatory bodies. It is obtained through the fermentation of corn, so it can also be taken by vegans. It is only minimally metabolized by the body, then enters the blood and is then eliminated through the kidneys. According to the authors of the research, in the future it will be important to conduct monitoring surveys for a possible confirmation of the results in the general population.