Zero calorie sweetner linked to heart attack and stroke

[reader]

From CNN

A sugar replacement called erythritol — used to add bulk or sweeten stevia, monkfruit and keto reduced-sugar products — has been linked to blood clotting, stroke, heart attack and death, according to a study.

“The degree of risk was not modest,” said lead study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute.

People with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their blood, according to the study, published February 27 in the journal Nature Medicine.

“If your blood level of erythritol was in the top 25% compared to the bottom 25%, there was about a two-fold higher risk for heart attack and stroke,” Hazen said. “It’s on par with the strongest of cardiac risk factors, like diabetes.”

Additional lab and animal research presented in the paper revealed that erythritol appeared to be causing blood platelets to clot more readily. Clots can break off and travel to the heart, triggering a heart attack, or to the brain, triggering a stroke.

[unicorn]

This is a very preliminary study that shows at best an association, not causation. As the authors of the study put it: "Studies assessing the long-term safety of erythritol are warranted." That's the most one can conclude from that study. It was not a randomized controlled trial, just an observational one. It's easy to show associations, but one can easily be fooled by observational studies. 

I would also add that many observational studies have shown very similar associations for just about every artificial sweetener out there. The association seems the same despite extremely different chemical compositions of these artificial sweeteners. The fact that the associations are similar but the chemistry is vastly different suggests the associations are linked to a different variable (for example, people who use artificial sweeteners may have similar otherwise unhealthful diets or exercise less). An easy way to understand the difference between association and causation would be to imagine a study observing over time people who carried matches or gas lighters. One would observe over the years that both matches and lighters have a similar association with the development of lung cancer in those who carry them. However, neither the matches nor the lighters are causative. 

Observational studies (which are cheaper and easier to conduct that clinical trials) can only serve to suggest directions for randomized clinical trials. A prospective observational (case-control) study can NEVER show causation. 

[omega]

I tend to ignore mainstream media when it comes to their reporting of science.

The journalists are not scientists themselves. They don't understand the science. They don't understand what the studies they're reporting on actually mean. They just regurgitate it into some form that'll get people clicking on their article.

Either read the study for yourself, or don't and go about your life as normal.

[vinapu]

On 9/30/2023 at 6:31 AM, reader said:

 

A sugar replacement called erythritol —

whatever it is I always say real thing is better than replacement, can you pass me that sugar please ?

[caeron]

 

My diabetic partner(whom I usually cook for) and I took note and avoid this for now.  While what unicorn said is true, the correlation here was big. "the degree of risk was not modest," is a scientist's way of saying "Holy Fuck!"

If you regularly eat things with sugar replacements in it as we do, this study is worth taking a look at yourself.

 

[unicorn]

16 hours ago, caeron said:

 

My diabetic partner(whom I usually cook for) and I took note and avoid this for now.  While what unicorn said is true, the correlation here was big. "the degree of risk was not modest," is a scientist's way of saying "Holy Fuck!"

If you regularly eat things with sugar replacements in it as we do, this study is worth taking a look at yourself.

 

I was unable to pull the full scientific article (not the lay press article), but in none of the portions I saw quoted an author say "the degree of risk was not modest." If the actual scientific article said that, I can only respond by saying that no reputable journal would allow such language in an observational/case-control study. That why there's something called peer review for reputable journals. With such a study, the only thing a real scientist would said was that the degree of association was not modest. 

If someone responds to this article by replacing artificially sweetened drinks with drinks that have NO sweeteners, including sugars (glucose, sucrose, or fructose), then no harm done. However, if someone were to react by replacing diet sodas with regular (sugar-filled) sodas, then there could be some real damage done. Sugars such as those found in sodas are known to put a stress on the pancreas's insulin-making cells (without even mentioning the empty calories sugars add). The lazy authors of this study picked a low-lying fruit, so to speak. Similar associations have been observed with all other artificial sweeteners, including the dipeptide aspartame, which simply consists of two amino acids (the building blocks of proteins). I cannot imagine a biological/physiological mechanism which would lead to a cardiovascular risk from a dipeptide. These authors simply appear to have picked the one artificial sweetener which hadn't been so associated yet. 

What needs to be done to ascertain any risk is to randomize assignment to drinks (or whatever) which are sweetened with sugar vs various artificial sweeteners, in which neither the patients nor the scientists know who gets what sweetening agent, then count the events over time. If one wishes to be extra-cautious before those studies are done, the wisest course is to simply avoid ALL sweeteners, including real sugars and artificial ones. I would certainly not conclude at this time that diabetics are better off consuming sugary drinks and pastries.