Study: Zero-Calorie Sweetener Raises Clot Risk

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Erythritol, a zero-calorie sweetener most notably found in Truvia® and other reduced-sugar products, has links to stroke, heart attack, and death, according to a new study published in Nature Medicine.

Premier Health Now asked vascular neurologist John Terry, MD, what the study means and whether to avoid the sweetener.

“The study looked at people with high risk of vascular disease – heart attack and stroke risk,” Dr. Terry says. “Patients who had the highest levels of erythritol, compared with those who had the lowest levels, were two times more likely to have a stroke, heart attack, or death over the three years the study followed patients.”

He explains that vascular disease leads to serious events such as heart attack or stroke when platelets in the blood form clots that block blood flow to critical organs. Researchers noted that when people with vascular disease had high levels of erythritol, their platelets tended to form more clots.

Erythritol is found naturally in many fruits and vegetables. It looks and tastes like sugar and is added to stevia, monk fruit, keto diet foods, and other low-carb products.

Dr. Terry emphasizes, “The study didn’t fully answer the question of whether to stop using erythritol. The FDA approved this substance back in the early 2000s, based on studies that showed it to be safe. This study looks at a very specific population and a specific way of causing health problems.”

He concludes, “If you already have high risk – you have had a heart attack or stroke or you are overweight, have diabetes, smoke, have high blood pressure, or a family history of heart attack or stroke – you might want to think about scaling back or avoiding this type of sweetener. We can’t tell for sure the danger of the exposure. We just know in terms of the population looked at, the people with more exposure tended not to do as well as those with less exposure.”

Dr. Terry and other experts agree that further studies are needed to determine if erythritol definitively raises clotting risk. 

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