Key points from article :
Erythritol, a popular sugar substitute found in many "sugar-free" and "keto-friendly" products, has long been considered safe—especially for people with diabetes or those managing weight. But a recent study led by Witkowski and colleagues, published in ATVB, challenges that assumption. Their research shows that consuming just 30 grams of erythritol significantly increases blood levels of the sweetener and causes heightened platelet activity, a known trigger for blood clots, strokes, and heart attacks.
In comparison to glucose, erythritol was uniquely linked to increased platelet aggregation and the release of pro-inflammatory markers like CXCL4, suggesting it could accelerate blood clot formation. These effects are especially concerning for older adults, whose platelets are already more reactive and who are at greater risk of cardiovascular disease. The findings raise concerns that erythritol may worsen age-related vascular inflammation and promote vascular aging through mechanisms linked to cellular senescence.
One possible explanation is that erythritol primes platelets indirectly by stimulating key signalling pathways—such as PI3K–Akt and MAPK—involved in clot formation. Though erythritol isn’t a direct trigger like ADP, it may make the system more reactive. This aligns with prior clinical studies that found higher plasma erythritol levels were associated with increased risk of major cardiovascular events, including heart attacks and strokes, over a 3-year period.
Adding to the concern is erythritol’s long-lasting presence in the bloodstream. Unlike other sweeteners, it's fully absorbed and not metabolized by the body, allowing it to circulate for hours and potentially build up in people who consume it regularly. Taken together, these findings suggest erythritol could have unintended cardiovascular consequences, particularly for aging populations. The authors call for more long-term studies and recommend caution, urging the development of safer sweetener options for at-risk individuals.
