Non-Nutritive Sweetener Erythritol Increases Platelet Reactivity and Thrombosis Risk, Study Finds

Although artificial and non-nutritive sweeteners are widely used and generally recognized as safe, there have been no clinical trials to assess either long-term cardiovascular disease risks or short-term cardiovascular disease–relevant phenotypes.

Therefore, using a prospective interventional study design, the authors tested the impact of erythritol or glucose consumption on multiple indices of stimulus-dependent platelet responsiveness in healthy volunteers. Erythritol plasma levels were quantified with liquid chromatography tandem mass spectrometry. Platelet function at baseline and following erythritol or glucose ingestion was assessed via both aggregometry and analysis of granule markers released. It was found that dietary erythritol lead to a more that 1000-fold increase in erythritol plasma concentration and exhibited acute enhancement of stimulus-dependent aggregation responses in all subjects, agonists, and doses examined. Erythritol ingestion also enhanced stimulus-dependent release of the platelet dense granule marker serotonin and the platelet α-granule marker CXCL4. In contrast, glucose ingestion triggered no significant increases in stimulus-dependent release of either serotonin or CXCL4.

Hence, it was concluded that ingestion of a typical quantity of the non-nutritive sweetener erythritol, but not glucose, enhances platelet reactivity in healthy volunteers, raising concerns that erythritol consumption may enhance thrombosis potential.

Ref: Marco Witkowski, Jennifer Wilcox et al. Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers; Arteriosclerosis, Thrombosis, and Vascular Biology;

https://doi.org/10.1161/ATVBAHA.124.32101