• Erythritol, the sweetener widely used in the food and beverage industry, has come to the attention of researchers for its long-term disease risk.
According to studies carried out in Europe and in the United States of America on a sample of more than 4.000 people, the popular artificial sweetener is associated with an increased risk of heart attack and stroke.
In the conclusions published in Nature Medicine, researchers showed that people with higher levels of erythritol in their blood had a higher risk of suffering a major cardiac event, such as heart attack, stroke, or death.
Stanley Hazen, chair of the Department of Cardiovascular and Metabolic Sciences at Lerner Research Institute explain: "Sweeteners such as erythritol have grown rapidly in popularity in recent years, but more research is needed into their long-term effects.
Cardiovascular disease builds up over time, and heart disease is the leading cause of death worldwide. We need to make sure that the food we eat is not contributing to this phenomenon."
Erythritol, found naturally in a variety of foods such as pears and watermelons, has in recent years become a common ingredient in low-calorie foods as an alternative to conventional sugar.
Additional consumption is possible accumulates
Erythritol is obtained from the fermentation of corn and is 70% as sweet as sugar. After ingestion, erythritol is poorly metabolized by the body, entering the bloodstream and then being eliminated. Because the human body naturally creates low amounts of erythritol, studies confirm that any additional consumption can build up.
This conclusion is based on a 2017 study that identified erythritol as a biomarker for increased fat mass. Contrary to previous hypotheses and research, this study demonstrated that erythritol can be metabolized and even produced by the human body.
The scientists found that subjects who gained weight and accumulated abdominal fat within a year had fifteen times higher blood erythritol levels at the beginning of the year compared to subjects in the reference group who had kept the weight stable or even lost weight. However, this being a clinical observational study, it demonstrates association and not causation.
People with obesity, diabetes, or metabolic syndrome looking for options to help manage their sugar or calorie intake choose sugar-free products that contain erythritol. But this specific group is initially at higher risk of adverse cardiovascular events, such as heart attack and stroke.
In vitro studies cannot mimic the physiological process
This fact was noticed by Calorie Control Council (CCC), the international association representing the low-calorie and reduced-calorie food and beverage industry, in response to the latest research on erythritol.
"The results of this study run counter to decades of scientific research showing that low-calorie sweeteners like erythritol are safe, as evidenced by worldwide regulatory approvals for their use in food and beverages, and should not be extrapolated to the general population because intervention participants were already at increased risk of cardiovascular events”, says CCC executive director Robert Rankin.
The CCC representative argues that in vitro studies cannot mimic the complex physiological process of the human body, which includes absorption, metabolism and elimination. And since most commercial erythritol products usually contain a small amount mixed with other sweeteners, the study in which subjects were asked to consume 30g of erythritol dissolved in 300ml of water over two minutes did not reflect the usual amount of the substance ingested from food .
Studies supporting the safety of erythritol
For over 30 years, erythritol has been commercially produced and added to foods and beverages to sweeten them, as well as to improve their taste and texture. In addition to providing zero calories, erythritol is well tolerated, does not affect blood glucose or insulin levels, and does not cause tooth decay.
The safety of erythritol as a food ingredient is supported by a number of human and animal safety studies. WHO/FAO Joint Expert Committee on Food Additives (JECFA) reviewed the safety of erythritol in 1999 and established a DZA (Acceptable Daily Intake).
Its use in food has already been approved in more than 50 countries, including Canada, the US, Brazil, Mexico, Australia and the European Union, and other government agencies around the world have been petitioned to expand the use of erythritol.
"Erythritol is a proven safe and effective choice for reducing sugar and calories and has been used in low-sugar foods and beverages for over 30 years to sweeten, improve taste and texture," Rankin added.
"Along with exercise and a healthy diet, low-calorie sweeteners are an essential tool that can help consumers manage body weight and reduce the risk of diseases such as cardiovascular disease."
Further studies still required
However, the authors of the Cleveland Clinic Safety Study of erythritol noted that it has several limitations. They insisted that despite its approval as safe for use in food in the EU and the US, long-term safety studies of erythritol are still needed.
"It is important that further safety studies be conducted to examine the long-term effects of artificial sweeteners in general, and erythritol in particular, on the risks of heart attack and stroke, especially in people at higher risk of cardiovascular diseases."
Article written by Gabriela Dan, Editor of Arta Albă
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