Erythritol appears to gum up your blood, posing a clotting risk.
Some days it feels like you just canât win in the health game.
Thereâs no sugar (substitute)-coating this one. You canât have your cake and eat it (without cardiovascular consequences). Thereâs no such thing as a (calorie-)free lunch.
With sugar-sweetened beverages on every public health sh*tlist, low-calorie alternatives should be the smart way to go.
But of course it canât be that easy.
Thereâs been an annoying, paradoxical but persistent association observed over the years between artificially sweetened drinks and obesity and cardiometabolic disease. Itâs been poorly understood and often chalked up to confounding, but the overall picture that emerges is that thereâs no way to indulge a sweet tooth without paying some sort of price.
One recent paper showed an increased risk of atrial fibrillation in adults who drank 2L of artificially sweetened drinks per week.
Now a specific class of non-sugar sweeteners look likely to raise consumersâ risk of blood clots.
Erythritol, a naturally occurring sugar alcohol or polyol derived industrially through fermentation usually of corn, is found wherever sugar is â cakes, sweets, chewing gum, drinks and in bulk in the baking aisle. Itâs promoted as great for diabetics, with no effects on blood sugar or insulin.
Itâs about 70% as sweet as sucrose but with virtually no per cent of the calories, and has the extra marketing benefit of being able to be sold as âAll Natural!â and âOrganicâ and sometimes âNon-GMOâ.
Erythritol doesnât come with the uncomfortable gastrointestinal effects of some other polyols, as it is better absorbed, and has carried a âgenerally recognised as safeâ label in the US for about 25 years. However, safety assessments have generally involved testing for toxicity, mutagenicity and carcinogenicity.
The latest in a series of studies from the Cleveland Clinic on causes of residual cardiovascular risk has confirmed erythritolâs nasty little secret: consuming it enhances platelet reactivity, a red flag for thrombosis.
The study, using healthy volunteers who drank water sweetened either with glucose or erythritol, found the latter significantly increased release of the platelet dense granule marker serotonin and platelet alpha-granule marker CXCL4 compared with glucose.
A study published in June by the same team showed the same prothrombotic effect was caused by xylitol, another polyol.
Lead author Dr Stanley Hazen told Healio: âI am recommending to all of my patients, if your loved one has heart disease especially, I strongly recommend you advise them to avoid erythritol, xylitol and other sugar alcohols.â
Itâs another piece of the puzzle showing the rather depressing image of a species that evolved to love and crave sweet-tasting things and is being slowly killed by them.
Times like this the Back Page is happy not to be a sweet tooth. Pass the salt substitute, please.
Send anticoagulant story tips to penny@medicalrepublic.com.au.
