Try This: Erythritol and Heart Disease, Is There a Link?

If you’ve ever munched on a low-carb or keto food, snack bar, or beverage, chances are you’ve probably heard of erythritol.

I’ve written about erythritol before as a zero-calorie alternative to sugar with research-backed benefits for weight loss and balancing blood sugar.

So you can imagine my surprise when the media blasted headlines from a new study linking it to heart attacks and strokes!

After consulting with my go-to nutrition experts, I saw that this was another case of a poorly designed study twisted into fear-mongering headlines.

Let’s unwrap this controversial research and see if your erythritol-sweetened treats will break your heart (literally).

Is Erythritol Linked to Heart Attack, Stroke?

Here’s a summary of the study and what it found:

Researchers measured blood erythritol levels in a cohort of 3,000 people and found that those with the highest levels had double the risk of heart attack and stroke compared to those with the lowest levels. Alright, cool… We have an association, but does that equal causation?

To test this further, they introduced erythritol to blood cells and found that it caused clotting (which is not saying much—almost any substance introduced in vitro will cause cells to aggregate). And finally, researchers gave eight healthy subjects dietary erythritol and saw it raised their levels beyond the threshold of what would cause blood clots.

The researchers concluded that dietary erythritol can increase the risk of blood clots, heart attack, and stroke. But based on what was tested and measured, is this a reasonable conclusion? Let’s find out!

3 Major Flaws with This Study’s Design

Dr. Layne Norton, Thomas DeLauer, and Chris Kresser took the liberty of clapping back in these videos and blog posts, expressing their thoughts on why this study is inherently flawed and misleading for those likely benefiting from replacing added sugar with erythritol in their diet.

Flaw #1: The Cohort Was Already Metabolically Sick 

The 3,000-strong cohort was already metabolically unwell, with a history of heart problems, hypertension, and diabetes. But guess what? This tidbit was missing from the study abstract (where most media outlets find their headlines)!

Flaw #2: The Body Naturally Produces Erythritol

Plot twist: our bodies make erythritol naturally during sugar metabolism! Folks with high-sugar diets and metabolic dysfunction tend to have higher erythritol levels. So maybe it’s not erythritol that’s the heartbreaker, but rather existing health issues?

Flaw #3: Dietary Erythritol Wasn’t Measured

The researchers did not measure how much erythritol participants consumed 🤯. How can you link dietary erythritol to heart issues without measuring it?!

Should You Steer Clear of Erythritol?

A recent Nutrients journal review says that erythritol was likely a safe and effective sugar alternative that may help with weight loss and satiety, which is good news for people looking to cut down on their sugar intake without foregoing sweets entirely. While more research is needed to understand long-term effects, don’t be afraid to indulge in moderation.

There are instances where erythritol can cause GI issues. Personally, if I have a snack bar or drink that’s sweetened with erythritol, I can feel some bloating and discomfort afterward. That’s because I have a more sensitive gut. : )

For the vast majority of people looking to improve their metabolic health, however, erythritol is going to be a better choice than sugar. Based on this study, there’s no reason to write off erythritol for your heart’s sake.

As new studies come out, I’ll be sure to let you know if that changes.

Here’s to your health,
Dhru Purohit

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