New research from the Cleveland Clinic found an association between consuming erythritol, a sugar substitute found in many baked goods and other sweets, and a potentially increased risk for cardiovascular events like stroke or heart attack. Published in the journal Arteriosclerosis, Thrombosis and Vascular Biology this month, researchers found that erythritol had a blood-clotting effect while glucose (found in “real” sugar) didn’t. Erythritol is a sugar alcohol used as a low-calorie substitute to sugar. It’s found naturally in foods such as fruits, but added to others as a sweetener in much higher levels than what occurs naturally. It’s a different type of sweetener than other sugar substitutes, like aspartame or sucralose.
While the study was small and does not prove causation, its findings are important because of how commonly artificial sweeteners and low-calorie sugar substitutes are touted as the healthier option — particularly to people and who may already be at a higher risk for heart disease. It’s also gained some popularity as a keto-friendly option. It adds to similar existing research on erythritol and cardiovascular risk done by the Clinic and published in Nature Medicine last year. It also follows 2023 advice from the World Health Organization to not use sugar substitutes as a means for long-term weight control or management, as it doesn’t tend to work.
Many professional societies and clinicians routinely recommend that people at high cardiovascular risk – those with obesity, diabetes or metabolic syndrome – consume foods that contain sugar substitutes rather than sugar,” Dr. Stanley Hazen, senior and corresponding author of the newer erythritol study and chair of Cardiovascular and Metabolic Sciences in Cleveland Clinic’s Lerner Research Institute, said in Cleveland Clinic news release. “These findings underscore the importance of further long-term clinical studies to assess the cardiovascular safety of erythritol and other sugar substitutes.” The Centers for Disease Control and Prevention advises people to approach sugar substitutes the same way they should approach real sugar: with moderation.
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