Fascinating, I'm a heavy consumer of this stuff and I would love to know how valid this research is. If it's solid work, I guess it's bye bye to a lot of products that felt guilt-free.
They think that erythritol increases platelet activity which may cause thrombosis. They have proven that erythritol does affect platelet reactivity. However the study doesn't prove it adequately to say that it definitively causes thrombosis. That would require a follow up study. They have some correlation in data from people with cardiac disease, but it's not surprising to see erythritol there because a lot of cardiac disease is caused by type 2 diabetes.
Without further study there is no way to say if there is an increased risk of thrombosis from this data alone. Just enough to say they should perform further studies to make a determination. In most cases with these studies, the increased risk of thrombosis would so low that you could offset it by taking a walk once a week.
I personally won't stop my consumption of erythritol on this data alone, but there ARE other sweeteners. I mostly use Stevia myself.
Most "monk fruit" sweetener I've seen actually has erythritol as the main ingredient, which just a small amount of monk fruit. Presumably this is to get away with calling it "monk fruit sweetener" which appeals to the idea that it's somehow a more "natural" product.
Monkfruit is "300x sweeter than sugar." I have no idea how they measure this. I've never tasted monkfruit or an undiluted extract. They mix it in with erythritol to try and match the sweetness and appearance of sugar.
Allulose is about 70% as sweet as sugar but tastes much more like sugar than the other sugar alcohols. Allulose caramelizes (tho you should not try to make caramel with allulose. (you've been warned.)) It dissolves much better than erythritol. Allulose has a consistency more like dextrose than table sugar. More like a powder. It behaves more like sugar in baked goods.
Erythritol has a kinda minty aftertaste.. like on the exhale that can be unpleasant if it's not overpowered by something else.
All that said, I still prefer an erythritol + monkfruit sweetener in beverages. Erythritol is easier on my stomach in larger quantities.
I wouldn't worry about it, from what I gather the validity (of the claim erythritol: bad) of the study is questionable. Mainly because the study participants were very ill with hypertension, diabetes, CVD, and they didn't look at erythritol intake, just blood levels.
Layne Norton did a quick video explaining the shortcomings of the study.
The problem with studies like this is the reporting on them. I'm fairly sure most people reporting on this study did not actually read it (and you can't read it without paying). And it just plays into the confirmation bias that any non-nutritive sweetener is bad, despite them all being wildly different chemical compounds that all get metabolised in very different ways.
Oh? Who is that 'known' by? Certainly not any of the over 100 regulatory agencies around the world who have made aspartame one of the most studied compounds on earth. Unless you have PKU or migraines there is literally no widely accepted science that says otherwise.
“Now, a large study has found a potential link between artificial sweeteners and an increased risk of strokes, heart attacks, and related cardiovascular problems (see "Fake sugars and heart health").”
There's plenty of issues with the 'widely accepted' aspartame safety. There's indeed a lot of research that says aspartame is safe, but not as many if you exclude those that are not financed directly or indirectly by the industry. I will not even get into the circumstances around the Bressler report and the fact that it took a change of FDA leadership to get it approved.
I feel like this is a fallacy. For most of us, the choice isn't between artificial sweeteners and never consuming anything sweet ever, it's between artificial sweeteners and sugar.
Given the glut of well-documented harmful effects of sugar, I'll take the "kinda sorta maybe" of aspartame any day, because I'm not about to give up every pleasure in life just because they all seem to kill me.
Thing is, if by 'they' you mean processed foods, you are basically right.
A little bit of sugar that you add to a coffee or whatever won't kill you. The problem is that just about all the processed food available has been spiked with sugar.
A little bit of a thing that has documented harmful effects won't kill me, but a little bit that we studied a ton and still aren't sure if it's harmful will? Why?
I can attest to this. You don’t even have to avoid all carbs. Just cut out sweet sugary stuff and things will start tasting sweeter. It works with salt too.
It is either that or stuff is loaded with butter. I can't think of a single restaurant that I've been to in the last two years that I crave going to again. I keep thinking it is the area I live in or the places I've been, but at the end of the day, I think I'm just spoiled by cooking at home.
I can't eat out. We've learned to cook at home a lot of our favorite foods and they taste so much better at home now. Not in any way saying we're chefs, but just the over salting and too much butter that restaurants use is not good.
You're right. The reason I switched to using artificial is because I'm borderline hypoglycemic so I have abstained at periods in my life and yeah it's better. But then you really just want something sweet and down you go.
Back when I still used sugar I found Xylitol pretty neat. It has about 1/2 of the calories of normal sugar but mostly tastes the same (I actually prefer it to 'real' sugar by taste). There are some claims about health benefits but I remain skeptical about them.
All in all, I decided pretty early on that eating stuff that tastes extremely sweet but does not cause the associated glucose spike is a weird way of fooling one's body, and it just doesn't seem like a great idea to me...
Reducing sugar/overly sweet stuff intake has this nice by-effect that everything else starts tasting much, much more intense. I'm very much into savory stuff nowadays, and when I sometimes let someone trick me into trying something sweet, I usually regret it - purely based on the disappointing taste.
I assume you make oatmeal with water, right? Try to make it with milk (2% is fine) instead of water.
Probably not the healthiest alternative but I think better than sugar or sweetener.
The holy grail of sweetners is left handed sugar. Basically a regular glucose molecule but flipped. Tastes identical to sugar but cannot be metabolized.
The catch is that no one has found a way to synthesize it cheaply.
First ingredient (after water), wow. I guess that is not shocking, a lot of foods have been doing the same thing for years with sugar.
One thing I would like to see on labels is concentrations of the various ingredients. I suppose that gets into proprietary recipe information that no manufacturer will be keen on releasing, but it would be nice to know what % of a given concoction is made up by a given ingredient.
Weird. It has no effect on survival in rats and the doses were large.
> One chronic (78-weeks) study in rats with dietary levels of 0, 1, 3, or 10% erythritol (equal to
> 0.46, 1.4 and 5 g/kg bw/day for males and 0, 0.54, 1.7 and 5.7 g/kg bw/day for females) (Til
> and van Nesserooij, 1994) and another 2-year chronic toxicity/carcinogenicity study in rats
> with dietary levels of erythritol of 0, 2, 5, or 10% (equal to 0, 0.9, 22, and 4.6 g/kg bw/day for
> males and 0, 1.0, 2.6, and 5.4 g/kg bw/day) (Lina et al., 1994; 1996) demonstrated that
> erythritol did not affect survival and had no carcinogenic effect.
> In a population-based prospective cohort study with repeated dietary records, ingestion of multiple artificial sweeteners (for example, aspartame, acesulfame potassium and sucralose) was associated with CVD risk.
Ok, let's look at that reference.
> Results Total artificial sweetener intake was associated with increased risk of cardiovascular diseases (1502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03); absolute incidence rate in higher consumers (above the sex specific median) and non-consumers was 346 and 314 per 100 000 person years, respectively. Artificial sweeteners were more particularly associated with cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100 000 person years in higher and non-consumers, respectively). Aspartame intake was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100 000 person years in higher and non-consumers, respectively), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (730 events; acesulfame potassium: 1.40, 1.06 to 1.84, P=0.02; incidence rates 167 and 164; sucralose: 1.31, 1.00 to 1.71, P=0.05; incidence rates 271 and 161).
This study shows the same thing with _all_ artificial sweeteners, and has way more people (n=103,388) than the present Nature study (n=1,157). And we know that erythritol is often used by type 2 diabetics due to its low effect on insulin levels. That population is predisposed to cardiac events to begin with.
When adjusting the US/EU cohorts for cardiovascular risk factors, the observed effect with erythritol are smaller and closer to this study of other artificial sweeteners.
> Consistent with the results observed within the discovery cohort (adjusted HR = 2.95 (1.70–5.12) P < 0.001; Fig. 1 and Supplementary Table 4), the association between erythritol levels (fourth quartile versus first quartile) and incident MACE risk remained significant in both US and European validation cohorts following adjustments for cardiovascular risk factors (adjusted HR (95% CI) = 1.80 (1.18–2.77) and 2.21 (1.20–4.07), P = 0.007 and P = 0.010, respectively
I'm not convinced of the validity of this study. They ignored the rat chronic toxicity data and proposed a mechanism for what they saw in a small cohort of humans, but it should be reproducible in mammals.
I just avoid artificial sweetener as a category. They all taste like chemicals to me anyway. I used to drink a lot of Diet Coke but have hardly touched it for years. It tastes like weed killer to me now.
Oh boy, so now the promising erythritol is also under suspicion. A while ago I read about its benefits for dental health, which seemed to exceed xylitol's, so I even bought a bag (which also included the stevia-class sweetener Reb M).
I've read 2022 studies on various non-sugar sweeteners, and statistically, sucralose seems to have a slight advantage over aspartame and acesulfame-k in regards to cancer risk correlation.[1] Whereas aspartame and stevia didn't significantly impair glycemic response / glucose tolerance over a 2-week trial, but sucralose and saccharin did.[2] So each sweetener probably has different downsides. In the end, I think they seem safe enough to have occasionally in place of sugar, though I wouldn't go wild with them.
(It's also interesting that this new study comes from Stanley Hazen's lab. He's also published research about the potential cardiovascular risk impact of choline through its metabolite TMAO.)
73 comments
[ 3.0 ms ] story [ 82.7 ms ] threadWithout further study there is no way to say if there is an increased risk of thrombosis from this data alone. Just enough to say they should perform further studies to make a determination. In most cases with these studies, the increased risk of thrombosis would so low that you could offset it by taking a walk once a week.
I personally won't stop my consumption of erythritol on this data alone, but there ARE other sweeteners. I mostly use Stevia myself.
Erythritol has a kinda minty aftertaste.. like on the exhale that can be unpleasant if it's not overpowered by something else.
All that said, I still prefer an erythritol + monkfruit sweetener in beverages. Erythritol is easier on my stomach in larger quantities.
Also, here is a thread from a week ago that also discussed allulose: https://news.ycombinator.com/item?id=34879059
Layne Norton did a quick video explaining the shortcomings of the study.
https://www.youtube.com/watch?v=Ad8_scQtHFM
The problem with studies like this is the reporting on them. I'm fairly sure most people reporting on this study did not actually read it (and you can't read it without paying). And it just plays into the confirmation bias that any non-nutritive sweetener is bad, despite them all being wildly different chemical compounds that all get metabolised in very different ways.
Is there an artificial sweetener left that doesn't cause issues? Splenda was associated with CVD so that's why I switched.
https://www.health.harvard.edu/heart-health/sugar-substitute...
There's a good list here: https://www.efsa.europa.eu/sites/default/files/event/documen...
Given the glut of well-documented harmful effects of sugar, I'll take the "kinda sorta maybe" of aspartame any day, because I'm not about to give up every pleasure in life just because they all seem to kill me.
Thing is, if by 'they' you mean processed foods, you are basically right.
A little bit of sugar that you add to a coffee or whatever won't kill you. The problem is that just about all the processed food available has been spiked with sugar.
Hear me out.
I have never had such sweet bread as I had after being on Keto for a year. As in actual Ketosis, doctor verified.
When I started eating "normal" again, lots of things tasted way sweeter than I remembered. But like saltiness and other things you get used to it.
All in all, I decided pretty early on that eating stuff that tastes extremely sweet but does not cause the associated glucose spike is a weird way of fooling one's body, and it just doesn't seem like a great idea to me...
Reducing sugar/overly sweet stuff intake has this nice by-effect that everything else starts tasting much, much more intense. I'm very much into savory stuff nowadays, and when I sometimes let someone trick me into trying something sweet, I usually regret it - purely based on the disappointing taste.
The catch is that no one has found a way to synthesize it cheaply.
It seems everything that gratifies the tongue is bad in some way.
The actual politically sensitive possibility is sugar (and even more so, high fructose corn syrup). There's a lot of money involved there.
Gave me hives all over my face for a few hours. Intensely itchy.
Now whenever I drink something new, I always look out for it.
Like this one.
https://www.safeway.com/shop/product-details.960552358.html
One thing I would like to see on labels is concentrations of the various ingredients. I suppose that gets into proprietary recipe information that no manufacturer will be keen on releasing, but it would be nice to know what % of a given concoction is made up by a given ingredient.
> One chronic (78-weeks) study in rats with dietary levels of 0, 1, 3, or 10% erythritol (equal to > 0.46, 1.4 and 5 g/kg bw/day for males and 0, 0.54, 1.7 and 5.7 g/kg bw/day for females) (Til > and van Nesserooij, 1994) and another 2-year chronic toxicity/carcinogenicity study in rats > with dietary levels of erythritol of 0, 2, 5, or 10% (equal to 0, 0.9, 22, and 4.6 g/kg bw/day for > males and 0, 1.0, 2.6, and 5.4 g/kg bw/day) (Lina et al., 1994; 1996) demonstrated that > erythritol did not affect survival and had no carcinogenic effect.
https://ec.europa.eu/food/fs/sc/scf/out175_en.pdf
From this paper:
> In a population-based prospective cohort study with repeated dietary records, ingestion of multiple artificial sweeteners (for example, aspartame, acesulfame potassium and sucralose) was associated with CVD risk.
Ok, let's look at that reference.
> Results Total artificial sweetener intake was associated with increased risk of cardiovascular diseases (1502 events, hazard ratio 1.09, 95% confidence interval 1.01 to 1.18, P=0.03); absolute incidence rate in higher consumers (above the sex specific median) and non-consumers was 346 and 314 per 100 000 person years, respectively. Artificial sweeteners were more particularly associated with cerebrovascular disease risk (777 events, 1.18, 1.06 to 1.31, P=0.002; incidence rates 195 and 150 per 100 000 person years in higher and non-consumers, respectively). Aspartame intake was associated with increased risk of cerebrovascular events (1.17, 1.03 to 1.33, P=0.02; incidence rates 186 and 151 per 100 000 person years in higher and non-consumers, respectively), and acesulfame potassium and sucralose were associated with increased coronary heart disease risk (730 events; acesulfame potassium: 1.40, 1.06 to 1.84, P=0.02; incidence rates 167 and 164; sucralose: 1.31, 1.00 to 1.71, P=0.05; incidence rates 271 and 161).
This study shows the same thing with _all_ artificial sweeteners, and has way more people (n=103,388) than the present Nature study (n=1,157). And we know that erythritol is often used by type 2 diabetics due to its low effect on insulin levels. That population is predisposed to cardiac events to begin with.
When adjusting the US/EU cohorts for cardiovascular risk factors, the observed effect with erythritol are smaller and closer to this study of other artificial sweeteners.
> Consistent with the results observed within the discovery cohort (adjusted HR = 2.95 (1.70–5.12) P < 0.001; Fig. 1 and Supplementary Table 4), the association between erythritol levels (fourth quartile versus first quartile) and incident MACE risk remained significant in both US and European validation cohorts following adjustments for cardiovascular risk factors (adjusted HR (95% CI) = 1.80 (1.18–2.77) and 2.21 (1.20–4.07), P = 0.007 and P = 0.010, respectively
I'm not convinced of the validity of this study. They ignored the rat chronic toxicity data and proposed a mechanism for what they saw in a small cohort of humans, but it should be reproducible in mammals.
I've read 2022 studies on various non-sugar sweeteners, and statistically, sucralose seems to have a slight advantage over aspartame and acesulfame-k in regards to cancer risk correlation.[1] Whereas aspartame and stevia didn't significantly impair glycemic response / glucose tolerance over a 2-week trial, but sucralose and saccharin did.[2] So each sweetener probably has different downsides. In the end, I think they seem safe enough to have occasionally in place of sugar, though I wouldn't go wild with them.
(It's also interesting that this new study comes from Stanley Hazen's lab. He's also published research about the potential cardiovascular risk impact of choline through its metabolite TMAO.)
[1] [(Mar 2022) Artificial sweeteners and cancer risk: Results from the NutriNet-Santé population-based cohort study](https://journals.plos.org/plosmedicine/article?id=10.1371/jo...).
[2] 2022 Suez: https://www.cell.com/cell/fulltext/S0092-8674(22)00919-9 - from https://www.reddit.com/r/ScientificNutrition/comments/wt813r...