Insights from a pilot study

A recent pilot study revealed that the consumption of a beverage containing erythritol—an artificial sweetener used to bulk up stevia and monk fruit and to sweeten low-carb keto products—more than doubled the risk of blood clotting in 10 healthy individuals.

Blood clots can dislodge from blood vessels and travel to the heart, triggering a heart attack, or to the brain, causing a stroke. Previous research has linked erythritol to an increased risk of stroke, heart attacks, and death.

Dr. Stanley Hazen, the lead author of the study and director of the Cardiovascular Diagnostic and Prevention Center at the Cleveland Clinic Lerner Research Institute, noted that “surprisingly, in all subjects, all measures of platelet response (blood clotting) increased after erythritol ingestion.”

Taxing sugary drinks could prevent 2 million cases of diabetes and cardiovascular diseases, a study suggests. Consumption of a beverage with the same amount of glucose, or sugar, did not affect platelet activity in another group of 10 individuals, as indicated by Hazen, who also holds the Jan Bleeksma Chair of Vascular Cell Biology and Atherosclerosis at the Cleveland Clinic.

“This is the first direct comparison of the effects of glucose versus erythritol ingestion on multiple distinct measures of platelet function,” said Hazen. “Glucose does not influence coagulation, but erythritol does.”

While small, the study was described as “very intriguing and interesting” by Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.

“I am not saying we have to stop using these sugar alcohols immediately, but this line of research certainly raises the question: Are they safe or not?” stated Freeman, who was not involved in the research.

In response to the study, the Calorie Control Council, an industry association, told CNN that 30 years of science have demonstrated that erythritol is a “safe and effective option” for reducing sugar and calories.

“Consumers should interpret the results of this pilot study with extreme caution. The limited number of participants, a total of 10, received an excessive amount of erythritol, almost four times the maximum amount approved in any beverage in the United States,” said council president Carla Saunders in an email.

However, the amount of erythritol used in each drink in the study—30 grams—equated to what is found in typical sugar-free sodas, ice cream, or muffins that people often consume more than one of, Hazen pointed out.

“This research raises some concerns about the possibility that a standard serving of a food or beverage sweetened with erythritol could acutely stimulate a direct clot-forming effect,” noted study co-author Dr. Wai Hong Wilson Tang, director of heart failure and transplant research at the Cleveland Clinic.