A study published recently by the US-based Cleveland Clinic has suggested that the popular sugar substitute erythritol significantly increases the risk of stroke and heart attack.

Erythritol is one of many sweeteners that have gained increased traction in recent years, being trumpeted as a healthier alternative to sugar.

Erythritol was first discovered in the mid-19th century by a Scottish scientist. It occurs naturally within fermented fruit and in the human body.

The compound erythritol, and another named xylitol, have much of the same contents as normal sugar and are just as sweet. However, the key difference is that both have fewer calories. While erythritol works as a sweetener for foods and drinks, xylitol is chiefly used for gum, mouthwash, and toothpaste. However, in both substances, the same concern has been identified.

Apart from the study that was published earlier this month, a study by the Cleveland Clinic in 2023 found that there was a potential link between erythritol, strokes, and heart attacks. Based on these findings, a hypothesis was made, which suggested that Erythritol and xylitol, as sugar alternatives, may have been enabling the blood cells in the body to become thicker, and thus more likely to form blood clots.

Blood clots serve as a double-edged sword, having the potential to be both useful and disastrous. When a person is bruised, the clotting of blood at the site of the wound plays a major role in preventing additional blood loss and the prospect of bleeding to death.

However, internally, blood clots can prevent the flow of blood to and through crucial veins and arteries, which in turn can prove fateful with the onset of a stroke and heart attacks.

With this in mind, the Cleveland Clinic organised a new study to compare and analyse the effects of erythritol and regular sugar on the body, gathering two groups of 10 able-bodied male and female volunteers. The first set of 10 were to be those that consumed strictly regular sugar, and the second set to be individuals that used only erythritol.

To start this project, both groups spent the previous night fasting, before drinking half glasses of water. The first set of ten had 30 grams of sugar-based glucose mixed in their drinks, and the second half 30 grams of erythritol-based glucose.

According to Dr Stanley Hazen, who works at the Cleveland Clinic, 30 grams of erythritol is roughly equivalent to the normal erythritol content in meals or drinks containing the compound.

According to this study, while the group of 10 that drank normal sugar water showed no notable change in their blood that could encourage clotting, the set that had erythritol mixed into their drinks underwent a 1,000 per cent increase in the erythritol levels in their blood, which in time and after continued building up risked significant clotting. According to Hazen, these findings are noteworthy as such an increase in erythritol levels far exceeds the average amount found in the human blood.

“The amount in sugar substitutes is thousands of folds higher than what is made in our bodies, so to call it ‘natural,’ it’s not,” he declared. “Your best recommendation is to avoid the sugar substitutes, and sugar alcohols in particular because there’s an acute increase in the likelihood of clotting events once you ingest them.”

Despite Hazen’s most recent findings, many agencies responsible for ensuring safe and proper food is served to people, have been slow to act. The United States’ Food and Drug Administration (FDA), still considers erythritol, xylitol, and other artificial sweeteners as “safe”.

In Europe, however, the European Food Security Authority has suggested that further studies be done to ascertain the risks involved. Erythritol is a major ingredient in the ‘Keto diet’, a popular weight loss programme. According to the International Food Information Council, in 2023, 23 million people — roughly seven per cent of the US population — practised the Keto diet alone, with the numbers being much bigger worldwide.