Erythritol and Heart Disease

We’ve talked a few times about artificial sweeteners in our blog and how they affect our bodies. In today’s article, we want to dive further and focus on Erythritol and the bad press around this sweetener. In the past few days, a study has been published linking Erythritol and heart disease but it’s not as black and white as it sounds. Newspaper articles and social media videos might have scared a few, however, we want to breat it down for you to understand what the paper was actually about.

What’s Erythritol

Erythritol is part of the class of compounds called sugar alcohols. They are hybrids of sugar molecules and alcohol molecules. Most of the sugar alcohols that many companies use to sweeten foods are produced industrially in a variety of ways. However, some sugar alcohols, such as erythritol, occur naturally in foods like mushrooms, watermelon, and even cheese!

They’re all low-calorie sweeteners created as a healthier alternative to sugar about 3 decades ago. People are trying to replace sugar since we learned that sugar has a disastrous effect on every organ in our body. All sweeteners tend to be as sweet as sugar since they were created to replace sugar. Erythritol specifically, is 70-80% as sweet as sugar, however, it’s has 0 calories and doesn't have the negative effects on your organs sugar does. Erythritol, unlike other sweeteners, has a 0GI which means it doesn’t raise blood sugar levels.

All of this combined with the fact that people wanted a replacement to sugar, led to an increased consumption of sweeteners. An increased consumption of anything that should be taken in small dosis might indeed lead to health issues. Salt is one great example of that, too much salt can lead to high blood pressure, heart disease, and stroke. That doesn’t mean we all need to stop using salt or that if you use it one day you’ll be at risk. Dr. Berg makes great points in his video, “replacing sugar is not bad but the degree in which you do might be [...] the dose makes the poison.”

With this we want to clarify that there is no proof of causation in the paper, meaning, there is nothing there that says Erythritol consumption can or will lead to heart disease or stroke. We’ll dive into the details of this study.

First of all, it’s important to mention that it’s scientifically proven that there’s a causation between high glucose levels and heart disease. This study shows that there’s in fact a correlation between high glucose levels and heart disease. However, it does not show any causation between high Erythritol consumption and heart disease. The study was a case of a cohort of very sick people who showed reverse causality, meaning the state of their disease created the overproduction of some metabolites, in this case, Erythritol.

There was one in-vitro study where Erythritol was added to blood platelets in a Petri dish and it impaired blood platelet function. However, it’s not an in-vivo study, which means metabolic health, diet, lifestyle, etc. does not play a role, which they should, and is therefore not good evidence of Erythritol consumption causing heart disease or heart attacks. In fact, many other studies have shown Erythritol (taken exogenously) reduces blood sugar levels and improves insulin sensitivity (see footnotes).

Erythritol and heart disease

The first point to keep in mind is that this study affirms that people with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of Erythritol in their blood. This doesn’t mean they were consuming it, this along with other reasons is why it’s a purely observational study.

Many people have jumped to conclusions and believe what the paper says is applied to the general population, however, they did not consider some important facts about the study, how it was done, or the population

Participants

The first and most important is that all the participants in the study were already at increased risk of cardiovascular events. They either suffered from obesity, high blood pressure, or other cardiovascular issues that were already affecting their health and putting them at a higher risk of suffering from a stroke or heart attack.

Health issues preceding the study 

Some of the participants of the study also suffered from diabetes, high blood pressure, or other issues that were already affecting their health and put them at higher risk of cardiovascular disease.

Participant's Diet

They only took into consideration the Erythritol found in the blood of the participants. What the study doesn’t tell, however, is that Erythritol is naturally produced by the body when you metabolize glucose and from oxidative stress in the body, which is a result of diabetes, belly fat, liver, or kidney disease. Remember, it is also naturally present in foods such as beer, wine, or even cheese! They simply compared blood markers and compared them with the data about stroke, heart attack, etc., but at no point is it mentioned whether the participants consumed it or not in any type of form.

TO SUM UP:

1. The body ALREADY produces erythritol when you are metabolically unhealthy or at risk of cardiovascular disease already.
2. The study NEVER looked at actual erythritol consumption.
3. The study is PURELY OBSERVATIONAL - there was 0 information regarding their metabolic state or diet of the patients.
4. Over 70% of the patients had hypertension and high levels of diabetes type 2 meaning their bodies were most likely already producing erythritol from being metabolically unhealthy.

Looking globally, there are not that much amount of people following a keto diet or a low-carb lifestyle which are the ones that mainly use Erythritol as their main sweetener, and there is a good chance that the people in the study were not following a keto or a low-carb diet, and probably they’ve never used an Erythritol sweetener. 

What doctors and health professionals are saying

Benefits of Erythritol

But enough of bringing Erythritol down, let’s talk about its benefits and why we recommend and use this sweetener in our Funky Fat Chocs.

1- Does not spike blood sugar or insulin

One thing we must keep in mind about Erythritol is that we humans don’t have the enzymes needed to break it down. As a result, it’s absorbed into the bloodstream and then excreted unchanged in the urine.

It is also a great alternative to sugar since its Glycemic Index (GI) is 0. That means that it does not give your body sugar spikes or spike blood sugar and insulin, which is great for people who have diabetes or are overweight. As we already know, eating a lot of high-GI foods can be detrimental to your health because it pushes your body to extremes. Following a low-carb diet and using low-GI foods on a daily basis will keep your energy levels balanced since the glucose will be slowly trickled into your bloodstream, causing no spikes.

2- May reduce the risk of heart disease

On the opposite side of the study mentioned in an earlier opinion, studies in rats with diabetes have found that Erythritol acts as an antioxidant and it may reduce blood vessel damage caused by high blood sugar levels. It does the same for people with type 2 diabetes. These benefits may potentially reduce the risk of heart disease. However, more studies are needed.

3- Helps with weight loss

We already know how sugar affects your heart health and the adverse effect it has on your weight and adiposity build-up. This is why when trying to lose weight or to stay healthy people change sugar with Erythritol if they cannot go completely sugarless. As we’ve mentioned, this sugar alcohol has a 0 GI, so using it instead of sugar, will reduce the blood glucose build-up that triggers weight gain. It’s also easily digested in your gut and it gets digested slowly and almost completely due to its low glycemic index.

4 - May benefit dental health

One common adverse effect of excessive sugar intake is poor dental health, cavities, and tooth decay. The harmful bacteria in the mouth use sugar for energy and growth. In the process, they release acids that erode tooth enamel.

Erythritol nonetheless suppresses the growth of oral bacteria, such as Streptococcus, which form a biofilm on your teeth and cause tooth decay. Inhibition of microbial growth leads to a reduction in the acid produced by your gut. This way, the teeth don’t develop caries and plaques.

Conclusion

With all the overload of information that’s been released about Erythritol, our goal with this article is to provide you with another, scientific-based, point of view and for you to hear from other health professionals. We do stand for Erythritol as a healthier alternative to sugar all the way, and for the reasons we just mentioned above, it’s our sweetener of choice for our chocolate bars. Feel free to leave comments/questions below and we will gladly help you out.