The artificial sweetener erythritol and cardiovascular event risk

M Witkowski, I Nemet, H Alamri, J Wilcox, N Gupta, N Nimer, A Haghikia, XS Li, Y Wu, PP Saha, I Demuth, M König, E Steinhagen-Thiessen, T Cajka, O Fiehn, U Landmesser, WHW Tang, SL Hazen

Published: 27 February 2023

This study is an aggregate of several different clinical studies on the association between erythritol, a zero-calorie sweetener, and cardiovascular risk and included prospective and retrospective cohort studies and experiments assessing plasma levels of erythritol after consumption as well as the effects of erythritol on platelet aggregation. The studies showed an association of erythritol blood levels with MACE, with a hazard ratio as high as 4.48 for those in the highest quartile of erythritol levels in one of the Europe-based studies. This risk remained significant when controlled for pre-existing coronary artery disease. The other reported studies suggest a prothrombotic effect of erythritol on platelets in vitro and that post-consumption plasma erythritol levels are above the threshold when these effects are induced in healthy volunteers, suggesting a possible mechanism of action. Read more