The alleged health harms of artificial sweeteners are mounting – and now a new study has linked a type of sugar substitute to higher risks of heart health problems.
Physician-researcher Stanley Hazen and his colleagues at the Cleveland Clinic’s Lerner Research Institute wanted to see if they could find any signs that could warn people they were at higher risk for heart attack and stroke.
They found it in blood levels of organic compounds used as sweeteners, particularly erythritol; a sweetener commonly used in low-sugar, sugar-free, and carbohydrate-free foods.
Among a group of 1,157 patients undergoing testing at a cardiovascular clinic, those with the highest levels of these compounds in their blood were twice as likely to die or suffer a major cardiovascular event within three years. follow up.
“Our results suggest the need for further safety studies examining the long-term effects of artificial sweeteners in general, and erythritol in particular, on the risk of heart attack and stroke, particularly in patients with higher risk of CVD,” the researchers write in their publication. paper.
Artificial sweeteners are thought to be chemically inert, but scientists are finding that these low-calorie compounds aren’t necessarily free of health consequences.
Although naturally present in very small amounts in fruits and vegetables, levels of sweeteners like erythritol can be 1,000 times higher in processed foods.
Research shows that artificial sweeteners can disrupt our gut microbes in ways that lead to weight gain and diabetes, and can increase the risk of developing cancer.
Part of the problem is that even though artificial sweeteners contain fewer calories than the sugars they replace – and this may help some people reduce their intake – they taste sweeter and encourage our bodies to crave even more taste. sugar.
“There is an ongoing discussion about the safety of sweeteners – in part because some studies show an increased risk of chronic disease in those who consume sweeteners, especially in soft drinks,” says Gunter Kuhnle, professor of nutrition and of Food Science at the University of Reading in the UK.
This new study found a link between blood erythritol levels and future risk of heart attack or stroke – an association that also appeared in two other cohorts of nearly 3,000 people, combined, from United States and Denmark.
This led Hazen and colleagues to investigate potential mechanisms by which erythritol might increase risk, with laboratory studies using blood samples from a small group of eight healthy volunteers.
Erythritol blood levels peaked and remained elevated for two to three days after the volunteers swallowed an erythritol-sweetened drink, before returning to normal. Adding erythritol to whole blood samples also increased blood viscosity and other measures related to blood clotting, with similar effects seen in animal studies.
This goes some way to showing how consuming high levels of artificial sweeteners could possibly trigger a cascade of changes in the blood that could lead to a cardiovascular event.
“(T)her paper effectively shows several pieces of a puzzle exploring the effects of erythritol,” says Duane Mellor, a dietitian at the University of Aston.
But he says the study doesn’t rule out other sources of erythritol in the blood, which can also be made from other sugars inside our bodies, especially if we eat a lot and move little. .
The amount of added erythritol the volunteers consumed was also significantly higher than the amounts allowed in store-bought drinks in the UK. But the study authors say the amount chosen reflects the daily intake of some Americans.
Regulators are alert to the potential health risks of artificial sweeteners; their job is to determine what levels of food additives are safe to consume based on the available evidence.
Last year, a study involving more than 100,000 French volunteers found an increased risk of heart disease with increased dietary intake of artificial sweeteners, which participants recorded daily.
Observational studies like this better reflect people’s usual diets, but are not without flaws. The challenge is to sift through the many other lifestyle factors that also affect heart health in important ways, such as physical activity, and try to isolate the possible effects of a food or additive. particular food from whole diets.
Nutritional epidemiologist Nita Forouhi from the University of Cambridge says the latest study extends previous research into the potential harmful health effects of artificial sweeteners and its findings warrant further investigation.
However, because the study participants already had many cardiovascular risk factors, it is difficult to generalize the study results to healthy populations. Three-quarters of study participants had high blood pressure or coronary heart disease, and one-fifth had diabetes.
Until we know more about the long-term health effects of erythritol and other artificial sweeteners, it’s probably best to stick with what we know is good for our overall health: reduce our sugar intake by reducing sugary drinks and highly processed foods of all varieties.
“Individual artificial sweeteners are currently unreported, which makes tracking them difficult and limits the ability to easily research their health effects,” says Forouhi.
The research has been published in Natural medicine.