Study links Erythritol, a common sugar substitute, with cardiovascular risks

A recent groundbreaking research published in Nature Medicine, suggests that erythritol, a commonly used sugar substitute, is associated with an increased risk of major adverse cardiovascular events (MACE) and promotes heightened platelet reactivity and thrombosis formation.

The study began with untargeted metabolomics studies involving 1,157 patients undergoing cardiac risk assessment, referred to as the discovery cohort. The findings revealed a noteworthy association between circulating levels of multiple polyol sweeteners, particularly erythritol, and the risk of major adverse cardiovascular events (MACE). These events encompassed serious outcomes such as death, nonfatal myocardial infarction (heart attack), or stroke and occurred within a three-year period.

Subsequent targeted metabolomics analyses were conducted in independent validation cohorts from both the United States (2,149 patients) and Europe (833 patients) undergoing elective cardiac evaluation. The results consistently supported the initial discovery, showing that individuals with higher erythritol levels faced a significantly increased risk of MACE compared to those with lower levels.

A prospective pilot intervention study involving healthy volunteers further highlighted the concerns. After erythritol ingestion, plasma erythritol levels in participants increased significantly and remained elevated for over two days. These elevated levels were associated with heightened platelet reactivity and a greater potential for thrombosis in laboratory experiments.

Reference: Marco Witkowski et al, The artificial sweetener erythritol and cardiovascular event risk, Nature Medicine