Eating or drinking products with erythritol can cause a huge spike in its levels in your blood that lasts for days—and this might make your blood more likely to clot, raising your risk of heart attack or stroke.
Claim Context
Erythritol is associated with a significantly increased 3-year risk of major adverse cardiovascular events in adults, with plasma levels rising over 1,000-fold after ingestion and remaining above pro-thrombotic thresholds for more than 48 hours.
“An untargeted metabolomics study in patients undergoing cardiac risk assessment (discovery cohort, n = 1157) revealed that higher plasma erythritol levels were strongly associated with an increased 3-year risk of major adverse cardiovascular events. In a pilot human-intervention study (n = 8), ingestion of 30 g erythritol rapidly elevated plasma concentrations to more than 1000-fold above baseline, remaining above pro-thrombotic thresholds for over 48 h.”
Evidence from Studies
No evidence studies found yet.
What Would Prove This
Per GRADE and EBM methodology, here is what ideal scientific evidence would look like to definitively prove or disprove this claim, ordered from strongest to weakest.
Whether erythritol intake consistently predicts cardiovascular events across populations.
A systematic review and meta-analysis of 10+ prospective cohort studies with plasma erythritol measurements and adjudicated MACE (heart attack, stroke, CV death) in adults aged 40–75, adjusting for BMI, diabetes, and other sweetener use.
Whether acute or chronic erythritol intake increases platelet reactivity and thrombosis risk in humans.
A double-blind RCT of 200 adults with metabolic syndrome, randomized to 30 g/day erythritol or placebo for 6 months, measuring platelet aggregation, P-selectin, GP IIb/IIIa activation, and incidence of thrombotic events.
Whether habitual erythritol consumption predicts future cardiovascular events.
A prospective cohort of 15,000 adults with repeated dietary assessments and plasma erythritol levels measured annually over 10 years, tracking MACE as primary endpoint.
Whether patients with recent MACE had higher prior erythritol intake than controls.
A case-control study of 500 patients hospitalized for MI or stroke and 500 matched controls, using 7-day dietary logs and plasma erythritol levels to estimate intake in the 6 months prior to event.
A regulatory safety reassessment of erythritol.
A consensus statement from EFSA and FDA reviewing all human, animal, and mechanistic data to determine if erythritol’s pro-thrombotic potential warrants a revised safety guideline or warning label.