Erythritol, A sweetener widely used as an alternative to common sugar, it would not be entirely safe for health. According to the results of a study published in Nature Medicine, erythritol is associated with the risk of adverse cardiovascular events independently of traditional risk factors.Not only that: a high plasma level seems to favor the formation of thrombi. Results that suggest the need for studies examining the long-term effects of artificial sweeteners, and in particular the one examined, on the risk of heart attack and stroke especially in patients at higher risk of cardiovascular disease.
Although artificial sweeteners are used to reduce sugar and calorie intake and are considered safe by several regulatory agencies including the Food and Drug Administration and the European Union, in reality little is known about their long-term effects, according to the authors of the research. There is a lack of randomised clinical trials and risks have rarely been analysed over time, despite being increasingly introduced into the food chain. Among the various sweeteners, erythritol quickly achieved great popularity. Naturally present in fruits and vegetables in small quantities, when ingested it is mostly eliminated through the urine.
The researchers conducted four clinical trials.In the first, which involved non-targeted metabolomic analysis of plasma samples from more than 1,100 adults undergoing cardiac risk assessment, circulating levels of multiple polyol sweeteners, many of which were used in food, were associated with an incident risk of major adverse cardiovascular events (MACEs) of 3 years, including death or nonfatal myocardial infarction or stroke. The association was then confirmed by targeted metabolomic analyses performed in two validation cohorts, one US (second study) and one European (third study), which included patients undergoing cardiac evaluation. Higher plasma levels of erythritol were found in people with cardiovascular disease present and among those who experienced a major cardiovascular event in the 3 years of follow-up. The association with incident MACE risk remained significant even after adjusting for cardiovascular risk factors. In addition, in vitro erythritol increased platelet reactivity, a confirmed finding in laboratory animals, in which the sweetener increased thrombus formation.
Finally, with a fourth study (Erythritol Intervention Study) the researchers wanted to examine the postprandial levels of the sweetener and the trend of its elimination.It was found that the intake of a drink sweetened with erythritol (30 g) by healthy volunteers, exposure comparable to that given for example a can of artificially sweetened beverage, increased plasma levels for over 2 days to a value above the thresholds associated with increased platelet reactivity.
«Following exposure to dietary erythritol, a prolonged period of potentially elevated thrombotic risk may occur. This is worrying given that the same subjects for whom artificial sweeteners are marketed (patients with diabetes, obesity, history of CVD and renal impairment) are typically at higher risk of future cardiovascular events.
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