Clots can break loose from blood vessels and travel to the heart, causing a heart attack or to the brain, causing a stroke. Previous studies have associated erythritol with an increased risk of stroke, heart attack, and mortality.

“What is remarkable is that in every single subject, every measure of platelet responsiveness (clotting) went up following the erythritol ingestion,” said lead study author Dr. Stanley Hazen, director of the Centre for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.

Hazen, who holds the Jan Bleeksma Chair in Vascular Cell Biology and Atherosclerosis at the Cleveland Clinic, stated that consuming a drink containing an equal amount of glucose or sugar did not affect blood platelet activity in another group of ten people.

“This is the first direct head-to-head comparison of the effects of ingesting glucose versus ingesting erythritol on multiple different measures of platelet function,” Hazen said. “Glucose doesn’t impact clotting, but erythritol does.”

Hazen said that the 30 grams of erythritol used in each drink in the study were the equivalent of what is included in typical sugar-free sodas, ice creams, or muffins, of which people often eat more than one.

Study co-author Dr Wai Hong Wilson Tang, research director for heart failure and cardiac transplantation at the Cleveland Clinic, said in a statement: "This research raises some concerns that a standard serving of an erythritol-sweetened food or beverage may acutely stimulate a direct clot-forming effect."

Like sorbitol and xylitol, erythritol is a sugar alcohol, a carbohydrate found naturally in many fruits and vegetables. The human body also produces erythritol as a byproduct of glucose metabolism, but only in small quantities.

Hazen said, "Erythritol is the largest ingredient by weight in many 'natural' stevia and monk fruit products. It looks and tastes like sugar and can be used for baking. It is also a key ingredient in many keto-friendly products, including ice cream."

in an earlier interview, Hazen said that if you look at nutrition labels on many keto ice creams, you’ll see "reducing sugar" or "sugar alcohol," which are terms for erythritol. "You’ll find a typical pint of ice cream has somewhere between 26 and 45 grams in it."

The new study, published on 08 Aug 2024 in Arteriosclerosis, Thrombosis, and Vascular Biology, asked 20 participants to fast overnight in preparation for a morning blood test. Next, they were given a drink with either 30 grams of erythritol or 30 grams of sugar. After 30 minutes, blood was tested again.

Levels of erythritol in the blood rose by a thousandfold after consuming the drink containing that substance. In contrast, blood sugars rose only a small amount after consuming the drink containing glucose. However, Hazen said that the change in platelet activity was the startling thing.

"We saw enhanced clotting, using measures of how quickly clots will occlude a vessel or stop blood flow, which is like a model of a heart attack or a stroke,” he said.

Similar results appeared in a 2023 study by Hazen and his colleagues in which eight healthy volunteers also consumed the same amount of erythritol and saw a thousandfold spike of the substance in their blood.

"(Erythritol) remained elevated above the threshold necessary to trigger and heighten clotting risk for the following two to three days," Hazen said at the time.

That study also analysed the blood of more than 4,000 people in the United States and Europe and found that those with the highest levels of erythritol were twice as likely to experience a heart attack or stroke.

"What we’re seeing with erythritol is the platelets become super responsive: A mere 10% stimulant produces 90% to 100% of a clot formation,” Hazen said.

The studies were done on healthy people without chronic disease; however, Hazen said the findings still apply to the future.

"However, if you look at middle-aged America, the average person has two to three risk factors for heart disease, and 70% of us are going to develop heart disease in our lifetime, so maybe we should all be considering action," he said.

When it comes to the risk of cardiovascular disease, occasional sugar-sweetened treats in small amounts may be preferable to consuming drinks and foods sweetened with sugar alcohols, he said. That’s especially true for anyone at highest risk for clotting, heart attack and stroke — such as those with existing cardiac disease or diabetes.

"Cardiovascular disease builds over time, and heart disease is the leading cause of death globally," he said. “We need to ensure the foods we eat aren’t hidden contributors."

Source:

https://edition.cnn.com/2024/08/08/health/erythritol-blood-clotting-wellness/index.html