Article Impact Level: HIGH Data Quality: STRONG Summary of Arteriosclerosis, Thrombosis, and Vascular Biology, ATVBAHA.124.321019. https://doi.org/10.1161/ATVBAHA.124.321019 Dr. Marco Witkowski et al.
Points
- Erythritol consumption significantly raised plasma levels and was associated with enhanced platelet aggregation, indicating a potential increase in thrombosis risk compared to glucose.
- The study found that erythritol significantly increased the release of key platelet markers, such as serotonin and CXCL4, crucial in blood clot formation.
- Unlike erythritol, glucose ingestion did not significantly affect the release of thrombotic markers, suggesting that the pro-thrombotic effects are specific to erythritol rather than a general feature of sweeteners.
- The findings raise concerns about the safety of erythritol as a food additive, especially given its current classification as Generally Recognized as Safe (GRAS) by regulatory bodies.
- Given the widespread use of erythritol and its potential impact on cardiovascular health, the study suggests a need for reevaluating its safety, particularly in the context of rising cardiovascular disease rates.
Summary
In a recent prospective interventional study, researchers evaluated the cardiovascular impacts of erythritol, a commonly used non-nutritive sweetener, particularly its effects on thrombosis phenotypes in humans. Conducted with healthy volunteers, the study compared the outcomes of consuming 30 grams of erythritol versus 30 grams of glucose on platelet function. Erythritol consumption significantly increased plasma levels, measured through liquid chromatography-tandem mass spectrometry, revealing concentrations of 6480 μmol/L compared to only 3.75 μmol/L for glucose (P<0.0001). This marked elevation was associated with increased platelet aggregation responses to various agonists and doses, signifying a potential rise in thrombosis risk.
Further analysis demonstrated that erythritol ingestion significantly enhanced the release of crucial platelet markers indicative of thrombotic activity. Specifically, erythritol led to increased release of serotonin from platelet dense granules (P<0.0001 for TRAP6 [thrombin activator peptide 6] and P=0.004 for ADP), and the platelet α-granule marker CXCL4 (P<0.0001 for TRAP6 and P=0.06 for ADP), both of which are critical in the formation of blood clots. These findings starkly contrasted with the effects of glucose ingestion, which did not significantly affect the release of these markers, suggesting that the thrombotic risks associated with erythritol are not a general characteristic of all sweeteners.
The study’s findings raise significant concerns about the safety of erythritol as a food additive, particularly in light of its widespread use and current classification as Generally Recognized as Safe (GRAS) by regulatory bodies. The evidence from this study, along with other recent clinical and mechanistic research, suggests that the impact of erythritol on thrombosis potential is substantial enough to warrant a reevaluation of its status. This discussion is particularly critical given the rising prevalence of cardiovascular diseases and the everyday consumption of erythritol in various food products.
Link to the article: https://www.ahajournals.org/doi/10.1161/ATVBAHA.124.321019
References Witkowski, M., Wilcox, J., Province, V., Wang, Z., Nemet, I., Tang, W. H. W., & Hazen, S. L. (2024). Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers. Arteriosclerosis, Thrombosis, and Vascular Biology, ATVBAHA.124.321019. https://doi.org/10.1161/ATVBAHA.124.321019
