Published: Less than 20 min ago
American researchers raise a warning finger that the sweetener erythritol can increase the risk of cardiovascular disease. But the conclusions, which have attracted attention in Sweden as well, are exaggerated, according to a Swedish expert.
The researchers in the US wanted to investigate whether they could find substances in the blood that characterized people at risk of cardiovascular disease. They responded that erythritol, which is used as a sweetener, was more common among those who suffered a heart attack or stroke.
The researchers did further studies, one of which involved patients who were to undergo heart surgery and who were asked about dietary habits. Those results pointed in the same direction – the people who reported having the highest consumption of erythritol had a higher risk of heart disease.
“As high a risk factor as diabetes”
The study has been published in Nature Medicine and lead author Stanley Hazen, told the news service Stat News that high levels of erythritol appear to be as big a risk factor as diabetes.
Erythritol, is a sugar alcohol just like xylitol and sorbitol. In Sweden, it is not as common in food as in the USA. But that is just one of the reasons why Ingrid Larsson, nutritionist at Sahlgrenska University Hospital and associate professor at Sahlgrenska Academy, does not think the results are alarming.
– The patients included in the analysis already had risk factors for suffering from cardiovascular disease. These have probably been advised to a large extent about dietary changes that include changing, for example, sugar-sweetened drinks to drinks with sweeteners. This, in turn, may explain their higher level of the substance in the blood, she says.
Surprised to miss
This is called reverse causation and is well known by nutritional physiologists and epidemiologists but has become more generally recognized in recent years. In short, this means that patients who have a higher risk of suffering from, for example, cardiovascular disease and stroke, because they have diabetes, are overweight or have already had a heart disease – are recommended to change their diet and choose sweets and soft drinks with sweeteners instead of sugar.
In the current study, the researchers do not discuss that explanation at all, which surprises Ingrid Larsson.
– This is a known phenomenon now. There was a study a few years ago that presented the conclusion that women who consumed sweeteners were more likely to suffer from strokes. But it turned out that those who suffered strokes were mainly those who were obese and that obesity is what lies behind the increased risk of stroke, says Ingrid Larsson.
Laxative effect
The researchers also examined blood samples in the lab and did animal experiments where they saw that high levels of erythritol increased the tendency of platelets to clump together.
Ingrid Larsson believes that if we were to start using erythritol in particular to a greater extent in Sweden, more long-term studies would be needed. But today there is no indication that sweeteners would increase the risk of cardiovascular disease or stroke. And it is not better for health to replace it with sugar.
– In addition, erythritol, just like sorbitol and xylitol, has a laxative effect. So there is a natural limitation in how much you can get in, she says.
Facts
Sweetener
Sweeteners are used to completely or partially replace sugar or other energy-containing sweeteners. The aim is to reduce the energy content of a food, reduce the risk of caries and the impact on the body’s blood sugar level.
There is no strong and unanimous support that the consumption of sweeteners can affect the composition of the intestinal flora in a way that could in the long run lead to unwanted health effects in humans.
Consumption of sweeteners has little or no effect on satiety. There are also no clear indications that sweeteners increase the sweet tooth.
Whether or not consumption of sweeteners affects total energy intake and body weight seems to depend on which comparison is made. In comparisons with sugar, research suggests that sweeteners can contribute to reduced total energy intake and slightly lower body weight.
Source: Swedish Food Agency
Read more