Erythritol… So, It's Harmful Now?!?!?
We were all just warned to steer clear of erythritol! This was the advice stemming from a study that showed it is present in the plasma of people who are already at high risk for blood clots and heart disease.
This study was picked up by almost every major news network and they’ve been having a heyday with the headlines. Reminds us of when we had to respond when coconut oil was touted as a heart disease culprit just a few years back. (Let’s not forget the study of the fruit flies that died when they consumed Truvia… well Hmmm… Truvia has no calories. The flies starved. Only makes sense.) But this new sensational clickbait is even more fear inducing… erythritol is apparently out to give us heart attacks and strokes! There are already memes circulating… “Marked Safe From Erythritol.” The hysteria is upon us!
Allow us to respond… in depth. We can’t just say… “Nah… it’s fine!” and expect you to trust us. We will not only include our own common sense take away from this latest research, but we’ll start with that of Dr. Peter Cicero. He is a seasoned Ph.D. OrthoMolecular Organic Chemist, NPD, and R&D executive with over 30 years of significant experience in leading proactive product development initiatives and innovations for global organizations. He is a trusted food scientist that reads, undertakes and translates health studies as his profession.
From Dr. Peter Cicero:
So now one study makes us think that erythritol is going to kill us all. Not so fast! After a complete and thorough review of the findings, I would like to raise several issues which cast doubt on this study:
1. The study allegedly determined that erythritol is linked to heart issues including heart attacks and stroke. What we need to keep in mind is that no direct causation of erythritol leading to heart issues was made. In fact, only a weak correlation between erythritol to heart issues was made. The study showed that subjects with pre-existing conditions who experienced heart issues were found to have a high amount of erythritol in their blood. That’s it! Nothing else. That is similar to saying that drinking water kills people because you drink it, then eventually you die. At this point, further study is warranted to prove anything more than a very weak correlation between heart issues and erythritol intake.
2. In the present studies, they used an untargeted metabolomics approach as a discovery platform to identify circulating metabolites associated with incident CVD event risk. Untargeted metabolomics is only qualitative in nature, yet these results were used to state that erythritol is linked to heart issues! What does this actually mean? It means that they used second class unreliable testing methods to prove their theory. Several advanced quantitative testing methods exist which would better prove or disprove the researcher’s theory. Also, the level of erythritol in your blood is always changing. The largest amount of evidence shows the body completely rids itself of consumed erythritol within 24-hours, 90% from urination and 10% from colon. To be able to quantify a reliable level of erythritol in your blood that could cause heart issues is next to impossible since the level is always changing. For some reason, the study failed to use these advanced testing methods and neglected consideration of the body’s flux in erythritol levels. This again requires us to suspect the researcher’s ultimate goal of the study.
3. Erythritol is a naturally occurring sugar alcohol found in grapes, watermelons, pears, and wine. Even if the study followed proper testing methods, which we know is not true, there is no way to even remotely link erythritol consumption to heart issues. It is simply present in too many food products and is present in everyone’s bloodstream at various concentrations during various times. As stated above, it is similar to stating that water kills people. To say that something that could always be present in the blood is a cause for a heart issue is completely preposterous and incredibly unscientific.
At this point, I stand by the FDA in saying that erythritol is safe and poses no threat in its use. Until additional studies, performed using valid scientific methods are conducted, this researcher will continue to use erythritol as a natural sweetener.
Now Back to Us… This Is Personal:
We take everything we eat ourselves, feed our families and have shared with you through our books and online business very seriously. Being health enthusiasts, researchers, (and even one of us being a food purist to the core) we don’t just eat anything daily that is controversial or dangerous. For instance, we put weeks of study into erythritol before putting it into the diet of our family and then introducing it to so many of you.
We will later cite many studies on the safety and benefits of erythritol and why we introduced it into our own diets, allowed our children to eat it and even encouraged our 80-something-year-old parents to enjoy it. Before doing so, we want to assure you that we are not dismissing this new information and will keep looking at all the research as it comes in. We are not loyal to erythritol, we are loyal to our families and to you. But even with this recent frenzy, we are not worried at this point for our own families’ health and we are not changing how we use erythritol in our homes. This is important to note… the blood serum in the raw data for this scare was on 60- to 70-year-old men who were already diabetic and at risk for stroke and it was not even revealed if they even eat or drink erythritol. In fact, the initial cohort’s blood samples were collected in the early 2000s before erythritol was even popular!
Many people who have been using erythritol for well over a decade (like ourselves) are healthier and have better blood work than before we began. In the case of our own blood work… we both recently had our C-Reactive Protein (CRP) levels tested. This test reveals how much inflammation is in the body. High CRP numbers are associated with higher risks for heart attacks and cardiovascular diseases including poorer outcomes after strokes. Both of our CRP levels came back as so low, they were documented as “excellent” on our blood work. Our own father is at high stroke risk at 83 years old. Before we introduced him to our lifestyle of healthier eating a decade ago and advised that he put our Gentle Sweet (containing erythritol) on his morning oatmeal instead of higher glycemic sweeteners, he had already had a partial stroke. Since adding erythritol to his diet he has not had another stroke episode (this has spanned the last ten years).
Of course, we are not saying it was the erythritol that prevented another stroke. We are just pointing out real living examples of people using it and remaining healthy. If erythritol was really as dangerous for heart attacks and strokes as they are attempting to say, then most of our families would be dead by now. Just saying! There would be a much higher incidence of stroke and heart attacks amongst the millions of families who eat the Trim Healthy way. Instead, what we see in reality is greater health and so many testimonies of lowered risks and incidences of cardiovascular diseases.
All cards on the table… yes, we carry erythritol and erythritol-containing food products on our website. If we find factual data to make us pull it from our food line, you bet we will. We have a passion for health and that is what drives our lives and company. It is not the almighty dollar factoring into the reason we are not reacting strongly to this most recent article about erythritol. We simply don’t see compelling data that reveals dietary erythritol is the cause of the stroke and heart attack risk. When it comes to making money from our products, we’ve always tried to place our customers before ourselves. We’ve tried to keep our prices much lower than we should according to our frustrated finance team. This is because we know what it is like to struggle, and we’ve always wanted to honor our Mamas and the families and budgets they represent. If we truly do find concern in the future, please be assured we will pull erythritol and instead source other low or no glycemic impact sweeteners. Erythritol is not the only non-glycemic sweetener we currently use. And if this response does nothing to ease your concerns, consider using our pure stevia. But this is not where we are heading, in fact, one of us sprinkled some Gentle Sweet on her oatmeal this morning (Pearl) and the other of us just spooned some into her matcha latte as we sat down to write this response.
Safety:
As Dr. Peter mentioned, despite what the Headlines are screaming, erythritol is not an artificial sweetener. It naturally occurs in plants and is even made by the human body, but it is also currently produced commercially by fermentation. It can also be detected in the plasma of humans that don’t even eat dietary erythritol. (This is an important fact to note as we discuss this recent study correlating plasma erythritol to heart attack and stroke, so keep it in your mind as you continue to read). Erythritol was even found in the plasma and urine of a child with an inborn error of the pentose phosphate pathway (PPP) *Pub Med, NM Verhoeven et al. Am J Hum Genet. 2002 May. It has now been discovered that it is endogenously produced in healthy human erythrocytes from glucose via (PPP), which is a branch of glucose metabolism, present in all organisms *Pub Med, Katie C Hootman et al. Proc Natl Acad Sci U S A. 2017. It is thought that enzymes expressed in the liver and kidney are the main contributors to erythritol in mammals *Pub Med, Lisa Schilicker et al. J Biol Chem. 2019. (A bit of nerdy stuff to help you know that erythritol does not need to be eaten to be seen in human plasma.)
Erythritol has been reviewed for safety by multiple regulatory entities. It has been approved by the FDA as GRAS (generally recognized as safe) for dietary purposes which to us doesn’t mean much so we looked further, and others chimed in. The European Food Safety Authority (EFSA) approved erythritol in 2003 as safe which has much more strict guidelines. Also, the Joint Expert Commission on Food Additives of the World Health Organization (JECFA) has no safety concerns about erythritol.
Erythritol’s safety is founded on extensive evidence from human and animal studies on its absorption, distribution, metabolism and excretion. It has also been researched thoroughly with short- and long-term toxicological studies to examine potential mutagenic and carcinogenic effects as well as, reproductive, genotoxicity and developmental issues, Pub Med, I C Munro et al. Food Chem Toxicol. 1998 dec. One long-term study with rats was conducted for 107 weeks and examined the toxicity and carcinogenicity of diets that contained up to 10% erythritol. The research revealed that erythritol did not affect the survival of the animals and showed no signs of nephrotoxicity or tumor-inducing *Pub Med, B A Lina et al. Regul Toxicol Pharmacol. 1996 Oct.
Erythritol does not have an effect on blood levels of glucose or insulin. The glycemic index for erythritol is zero. That’s why so many of us are consuming it right? Quoting from a Pub Med, M Ishikawa et al. Regul Toxicol Pharmacol. 1996 Oct, “In a 2-week intervention trial, patients with diabetes consumed erythritol (20mg/day) and exhibited a significant decrease in hemoglobin A1c (HbA1c) from 8.5 to 7.5%”,*Pub Med, Bettina K Wolnerhanssen et al. Am J Physiopl Endocrinol Metab. 2016. Erythritol delays gastric emptying and glucose absorption from the small intestine and can even induce dose-dependent increases in the gut of the weight loss hormones glucagon-like peptide 1 (GLP-1), cholecystokinin (CCK), and Peptide YY (PYY), *Pub Med, Bettina K Wolnerhanssen et al. Diabetes Obes Metab. 2021 Jun. This is a very good thing considering that the GLP-1 peptide is the mechanism of the latest weight loss drugs like Ozempic, which have been shown in studies to decrease inflammatory heart conditions and other conditions such as Syndrome X. In fact, a study on Type 2 diabetes found that taking 36 grams of erythritol for a month improved the function of their blood vessels. To quote the study… “erythritol consumption acutely improved small vessel endothelial function, and chronic treatment reduced central aortic stiffness.” Acta Diabetol 2014, Epub 2013 Dec 24.
We could go on with study after study of the safety and benefits of erythritol and why we introduced it into our own diets, allowed our children to eat it and even encouraged our 80-something-year-old parents to enjoy it. But let’s stop and bring to light a bit of a sinister side of what might be happening here that we can’t help but notice and scratch our heads about.
Things Are Not Making Sense:
Imagine if the following headline came out tomorrow morning:
“New study – Sugar Causes Heart Attack and Increases All Known Mortality Risks.”
Would this headline trend like the current one we are questioning? Would it sweep through all the news networks? The fact is… when it comes to sugar… there is not just a correlation to Diabetes, Heart Attack and Stroke as there is with this erythritol study. There is actual causation. Study after study proves diets high in sugar consumption actually promote diseases such as Type 2 diabetes, Syndrome X, stroke and inflammatory heart diseases. Let’s look at just one of hundreds of studies. To quote… “A meta-analysis of cohort studies reported that intake of SSBs (sugar sweetened beverages) is associated with risk of CHD (coronary heart disease) [47]. A 22% greater risk of myocardial infarction was seen for each additional daily serving (RR: 1.22, CI 1.14–1.30). These findings are consistent with the results of RCTs which reveal that sugar causes an increase in the blood pressure and the blood level of triglycerides, TC, and LDL-cholesterol.” Nutrients. 2018 Jan; 10(1): 39. Published online 2018 Jan 4.
So, it is not a question of… Could sugar really do that? Let’s worry about it before we know… which is the case with this current erythritol study. No, sugar really does do it! Where’s the concern from the media? If these kinds of headlines came out about the lowered mortality and general harm sugar inflicts on our culture would people suddenly drop their sugar and fear it? Erythritol will now be feared by many millions of people. They will likely return to sugar! And that is a travesty because there is not just speculation… there is hard evidence that sugar causes disease! What is going on here? Where is the sanity?
New Villain on the Block:
This sort of villain-izing is not new. It has happened over and over again. Other natural substances have been smeared only to be found innocent with more research. Let’s take the case of Essential Amino Acids (EAAs) in supplement form as an example. They have been used with incredible results for transforming metabolic and muscular health. They regulate glucose and lipid metabolism, increase mitochondrial biogenesis, maintain immune homeostasis and increase energy production. EAAs also have a positive role with gut health and the microbiota. They enhance muscle protein synthesis and endurance and promote cardiac and skeletal muscle mitochondrial biogenesis. They also prevent oxidative damage. We could cite all the Pub Meds on EAAs, but they are not our topic here and we don’t have time. The point is that research plus real-world use in the sports and medicine arena for decades proved this supplement helped improve metabolic control and was associated with reduced body fat and healthier body composition. But then… several years ago it was found at the scene of the crime. Some research showed a correlation to high circulating serum levels of EAA’s with insulin resistance in diabetics. The headlines screamed… EAAs Will Make You Insulin Resistant!!! Suddenly EAAs were from hell and were making us all diabetics (although most people using them looked and felt healthier and had better lab work).
Yes, it was true that they were found at the scene of the crime but not because they were taken as a supplement. It was later understood that people who already have insulin resistance and Type 2 diabetes tend to have higher levels of BCAAs (three of the EAAs) and their metabolites in their blood. This is due to the fact that their insulin resistant condition speeds up protein breakdown in their muscles. This makes for more EAAs in the blood serum. Type 2 diabetics also inhibit the gene expression of enzymes that stimulate BCAA (three of the EAAs) breakdown. This way they can’t clear their blood of these EAAs like the rest of us. EAAs were and are not the cause of diabetes or insulin resistance, they were just innocent bystanders. When pre-diabetics or obese adults supplement with EAAs UCLA researchers found that it did not negatively affect their plasma insulin, glucose tolerance, or plasma amino acid levels. The verdict is that taking EAAs does not produce insulin resistance, Pub Med, Shih-Lung Woo et al. Am J Clin Nutr. 2019. They have now been vindicated but not before millions were scared off using them.
Do you remember some years back that a similar thing happened to collagen? A study showed collagen was associated with a greater risk for metastasis for breast cancer tumors. But it was nothing to do with eating collagen. We need collagen… we lose it as we age… and the ages when we lose it are actually the ages when breast cancer rates start soaring. It declines in our skin, in our bones, in our joints and in our hair. Just because collagen is seen at the crime of a tumor does not mean we shouldn’t eat it! Tumors are made up of all sorts of natural substances. Collagen has since been vindicated but not before many women became fearful of it.
Perhaps the greatest example (or should we call it the worst) of this kind of unfounded fear generated from study headlines occurred in 2002. A press release made headlines throughout the world. The WHI study, the most expensive study ever undertaken in history – costing around 260 million dollars, was suddenly halted. Why? An increased risk of breast cancer and stroke… at least that is what was reported. What was true was something else entirely.
This WHI study was set up to observe the benefits of Hormone Replacement Therapy for women but now the screaming headlines were… “Estrogen Causes Cancer!” The news spread like wildfire. Millions of women dropped their hormone therapy and a large majority of doctors stopped prescribing it altogether. The prescription rate for HRT fell by a dramatic 70% while the big pharma prescription rates for, antidepressants, osteoporosis meds, sleep meds and anti-anxiety meds like Prozac skyrocketed and remain elevated to this day! The Truth finally came out that estrogen was not the culprit for the increased risk of cancer after all. It was in fact the women who took the progestin (known as Prempro) along with the estrogen that had a very slight increased chance of breast cancer, stroke and heart disease. This risk was so small it “almost” reached statistical significance but not quite. The WHI data also revealed that women who started estrogen therapy under the age of 60 had a whopping 35% lower mortality rate than the control group. Yet the headlines and the hysteria overwhelmed these pieces of info. Headlines can harm. And they can hurt women.
Donning Our Foil Hats:
Look, we might lose a few of you here… but it’s too hard not to say it. There are a lot of strokes and heart issues happening lately and not many news articles want to talk about what might really be responsible. Maybe we’re getting a little conspiracy theory-ish, but it’s becoming challenging to believe things we are told in the media about our health lately. Is erythritol just a scapegoat here? You can go to the original source of this study and there you will see how it was funded… page 12 under “Acknowledgments”. You will see where the funding came from and you can make your own conclusions. Our foil hats are sparking but whatever you decide after your own research, hopefully we can still remain friends. We are not trying to be controversial here, (ahem… well maybe we are) but it seems like erythritol is being smeared while the real dangerous lifestyle factors are being ignored. A diet high in processed foods and sugars causes strokes and heart attacks… that cannot be refuted. Let’s put the focus on where it should be! We have testimony after testimony of people on our plan that have discovered enhanced health and less inflammation, and they have the blood work to prove it!
Okay… we’re done. Rant over. Time for our afternoon snack… you can guess what is going in our accompanying drinks.