Erythritol and the Link to Increased Blood Clotting
Emerging research has identified the sugar alcohol erythritol as a sweetener that can cause blood clots. A prominent 2023 study from the Cleveland Clinic, and a subsequent 2024 study, revealed a significant connection between higher blood erythritol levels and an increased risk of major adverse cardiovascular events like heart attack and stroke. The findings are particularly concerning because erythritol is a widely used ingredient in many processed foods marketed as low-calorie, zero-sugar, or 'keto-friendly'.
The Mechanism Behind Erythritol's Effect
Studies showed that when erythritol is added to blood samples, it increases the likelihood of clotting by enhancing the reactivity of platelets. Platelets are small, disc-shaped blood cells that play a critical role in forming blood clots. In controlled human studies, volunteers who consumed a beverage sweetened with erythritol experienced a rapid and dramatic spike in blood erythritol levels, which remained significantly elevated for several days. During this time, their platelets showed increased sensitivity to clotting signals, suggesting a heightened risk of blood clot formation.
Comparison of Sweeteners: Erythritol vs. Others
To provide clarity, here is a comparison table outlining the potential risks and characteristics of erythritol against other common sweeteners.
| Feature | Erythritol | Xylitol | Sucralose | Aspartame |
|---|---|---|---|---|
| Associated Risk of Blood Clots | Increased Risk (supported by multiple recent studies) | Potential Risk (similar but less studied mechanism to erythritol) | Controversial (studies link to overall cardiovascular risk, not direct clotting) | Controversial (potential link to vascular inflammation, not direct clotting) |
| Type | Sugar alcohol | Sugar alcohol | Artificial Sweetener | Artificial Sweetener |
| Primary Use | "Keto" foods, beverages, sugar substitutes | Sugar-free gums, mints, foods | Diet sodas, baked goods, sugar packets | Diet sodas, light yogurts, tabletop sweeteners |
| Effect on Blood Sugar | Does not raise blood sugar | Does not raise blood sugar | Does not raise blood sugar | Does not raise blood sugar |
| Safety Profile | Re-evaluation of long-term safety is warranted | Long-term cardiovascular risks under scrutiny | WHO advises against for weight control | Decades of controversy; WHO classifies as possibly carcinogenic |
The Wider Context: Overall Cardiovascular Health
While the link between erythritol and blood clotting is specific, it is part of a broader conversation about artificial sweeteners and cardiovascular health. For instance, separate research has also flagged concerns about other sweeteners like xylitol, which was found to enhance blood clotting in laboratory and animal studies, similar to erythritol. Other sweeteners, including sucralose and aspartame, have been associated with increased cardiovascular disease risk in observational studies, though the mechanism is less clear and not directly linked to heightened platelet activity.
Furthermore, the long-term consumption of artificial sweeteners has been linked to other negative health outcomes, including weight gain, metabolic syndrome, and Type 2 diabetes, which are themselves major risk factors for heart disease and blood clots. The World Health Organization (WHO) has advised against using non-sugar sweeteners for weight control due to a lack of evidence for long-term benefit and potential risks. The issue is compounded by the fact that many consumers who opt for these sweeteners, such as those with obesity or diabetes, are already in high-risk categories for cardiovascular problems.
Natural Alternatives and Moderation
As the scientific community continues to investigate these potential risks, health experts suggest exercising caution. A general recommendation for consumers is to reduce overall intake of both added sugars and artificial sweeteners. When a sweet taste is desired, opting for small, moderate amounts of natural alternatives can be a safer choice. Examples include honey, maple syrup, or using whole fruits to add sweetness to food.
Ultimately, understanding that artificial sweeteners are not a universally 'safe' or 'healthy' alternative is crucial. The health impacts, particularly in relation to complex cardiovascular processes like blood clotting, are still being uncovered. Consumers, especially those with pre-existing cardiovascular risk factors, should consult with a healthcare professional or registered dietitian for personalized advice regarding their dietary choices. A balanced diet focusing on whole, unprocessed foods remains the most reliable strategy for promoting long-term health.
Conclusion
Recent studies, most notably from the Cleveland Clinic, have established a direct link between the sugar alcohol erythritol and an increased risk of blood clots. This effect is believed to be caused by erythritol's ability to enhance platelet activity, potentially increasing the risk of heart attacks and strokes. Similar concerns have also been raised about xylitol, while other artificial sweeteners like aspartame and sucralose have broader, though less direct, associations with cardiovascular risk. Given the mounting evidence, it is prudent for consumers to approach artificial sweeteners with caution. Reducing reliance on all sweeteners and focusing on whole foods is the safest approach, especially for individuals already at high risk for cardiovascular events. The science is still evolving, but the initial findings provide a strong signal for consumers to reassess their intake of these common additives.
