3/1/23-UPDATE! This is a solid analysis from Dr. Soto-Mota. He goes through largely the same process I did and arrives at largely the same conclusion: there might be something concerning here. I’m not going to stop using erythritol, in fact I doubt this really influences anything I do as “keto treats” tend to be a highly enjoyable but fairly infrequent thing for me.
Thank you for delving into this study, Robb. I saw it earlier today and admit it concerned me. I started inspecting my various low-carb products (e.g., Ancient Nutrition Bone Broth Protein Powder) for erythritol, stevia, and monk fruit. That pretty much wipes out the kitchen cabinet of keto-friendly sweeteners.
At first, I thought it may be another comical attempt to find a culprit for the spike (pun intended) in excess mortality that started in 2021, but then I saw this was based on blood samples collected between 2004 and 2011.
I hope there are further high-quality studies to probe these findings. Meanwhile, I’ll start reducing my intake as a precaution.
Thanks Robb. I'd love to see more articles coming out from you. You keep promising new substack pieces on Healthy Rebellion podcast but they are nowhere to be seen. Maybe the topics make your blood boil too much which probably increases your risk of CVD more than Erythritol LOL!!
I wonder if this correlates to the digestive problems some face with erythritol consumption. Microbiome effects? There's something about it that the body wants to kick it out fast.
Thank you, Robb. This was very timely as I had a text from a friend this morning asking if I was aware of the study. I had just finished reading it and was going to reply back to her when your email came through. I was struggling with understanding what AHG is and why it would be used in comparison to erythritol and glucose. I appreciate your insights.
I haven't read the full article, but wonder if the action pathway for MACE is only via clotting directly from the presence of erythritol or is there any mention of insulin playing a role and the metabolic effects of the cephalic phase of digestion? Curious! Thank you!
My question for Robb - are you going to limit your Erythritol as a result of this study? I've got a boatload quests bars sitting around that I am considering pitching :)
Awesome breakdown of the study. My question would be if the rather large dose (30g) of erythritol and it's elevated levels/duration would be at all attenuated by consuming it with a meal, esp a complete meal with protein+fats. My rather uneducated guess is that the 30g in a beverage was just erythritol+water and that concentration on an empty stomach may be the issue, where normal consumption (in a pint of ice cream or in a sugar-free cookie) wouldn't be have as much of a spike.
This is Rebel Creamery’s response to Erythritol issue:
“This study was focused and performed on a segment of participants who had coronary disease, high blood pressure, or were otherwise at an increased risk for cardiovascular events. We've seen similar studies and headlines about meat, butter and eggs. Erythritol is produced endogenously in our bodies and has many decades of studies showing its safety. In fact, a recent study (PubMed 24366423) found erythritol improved blood pressure in participants. The authors of this latest study admit they found an association with erythritol, not causation. It was merely observational, and they don't even know what the subjects ate, if they even consumed erythritol. It was naturally produced in their bodies. This one study does not disprove the numerous scientific research showing erythritol's safety and benefits.
You likely have reverse causality here. The study did not measure erythritol intake. Metabolically sick people have a very active pentose phosphate pathway. This is not people getting sick from high levels of erythritol in their blood, but they have high levels of erythritol in their blood because they're so sick.”
Appreciate your work very much Robb! Thank you for all you do to help others. Did you see the Methods about how they a) used platelet rich plasma, added clot-inducing factors to force aggregation, and that no clotting occurred without those factors? How they injured the mouse carotid artery to induce thrombosis, and so on? I have an MSc in Personalised Nutrition and Functional Medicine. My MSc Dissertation was a Mechanism Review on Fructose and Atherosclerosis Cardiovascular Disease. I thus studied the pathophysiology of heart disease in detail. I have been studying sweet compounds for the past 10 years, reading every paper that comes out on non-sucrose/sugar sweetening ingredients, including erythritol. This is my deep dive analysis of the paper. Hope it may be helpful. https://www.linkedin.com/pulse/erythritol-pathways-physiology-sakiko-reuterski%25C3%25B6ld/?trackingId=QTRwABYaTGypVl9wpsnjTw%3D%3D
Thank you for delving into this study, Robb. I saw it earlier today and admit it concerned me. I started inspecting my various low-carb products (e.g., Ancient Nutrition Bone Broth Protein Powder) for erythritol, stevia, and monk fruit. That pretty much wipes out the kitchen cabinet of keto-friendly sweeteners.
At first, I thought it may be another comical attempt to find a culprit for the spike (pun intended) in excess mortality that started in 2021, but then I saw this was based on blood samples collected between 2004 and 2011.
I hope there are further high-quality studies to probe these findings. Meanwhile, I’ll start reducing my intake as a precaution.
Thanks Robb. I'd love to see more articles coming out from you. You keep promising new substack pieces on Healthy Rebellion podcast but they are nowhere to be seen. Maybe the topics make your blood boil too much which probably increases your risk of CVD more than Erythritol LOL!!
I wonder if this correlates to the digestive problems some face with erythritol consumption. Microbiome effects? There's something about it that the body wants to kick it out fast.
Good post Robb. No idea what to think about this. But some red flags about the study (That don’t think you touched on) are summarized here: https://twitter.com/dr__guess/status/1630548171666456578?s=46&t=3We7GhfcdsTlYRpWRWeamQ
Nice to see your article, Robb!
I personally don't use sweeteners myself as my body reacts to them either more or less, so they're definitely bad for my body.
Thank you, Robb. This was very timely as I had a text from a friend this morning asking if I was aware of the study. I had just finished reading it and was going to reply back to her when your email came through. I was struggling with understanding what AHG is and why it would be used in comparison to erythritol and glucose. I appreciate your insights.
I haven't read the full article, but wonder if the action pathway for MACE is only via clotting directly from the presence of erythritol or is there any mention of insulin playing a role and the metabolic effects of the cephalic phase of digestion? Curious! Thank you!
Thank you for breaking it down for us!
Typo in the first paragraph: "wuite" -> "quite"
My question for Robb - are you going to limit your Erythritol as a result of this study? I've got a boatload quests bars sitting around that I am considering pitching :)
Thank you for this, Robb. Great information.
so who funded the study? there should be no discussion of a study without noting who paid for it and what their agenda may be.
Awesome breakdown of the study. My question would be if the rather large dose (30g) of erythritol and it's elevated levels/duration would be at all attenuated by consuming it with a meal, esp a complete meal with protein+fats. My rather uneducated guess is that the 30g in a beverage was just erythritol+water and that concentration on an empty stomach may be the issue, where normal consumption (in a pint of ice cream or in a sugar-free cookie) wouldn't be have as much of a spike.
Would xylitol, also being a sugar alcohol possibly have the same effects?
This is Rebel Creamery’s response to Erythritol issue:
“This study was focused and performed on a segment of participants who had coronary disease, high blood pressure, or were otherwise at an increased risk for cardiovascular events. We've seen similar studies and headlines about meat, butter and eggs. Erythritol is produced endogenously in our bodies and has many decades of studies showing its safety. In fact, a recent study (PubMed 24366423) found erythritol improved blood pressure in participants. The authors of this latest study admit they found an association with erythritol, not causation. It was merely observational, and they don't even know what the subjects ate, if they even consumed erythritol. It was naturally produced in their bodies. This one study does not disprove the numerous scientific research showing erythritol's safety and benefits.
You likely have reverse causality here. The study did not measure erythritol intake. Metabolically sick people have a very active pentose phosphate pathway. This is not people getting sick from high levels of erythritol in their blood, but they have high levels of erythritol in their blood because they're so sick.”
Appreciate your work very much Robb! Thank you for all you do to help others. Did you see the Methods about how they a) used platelet rich plasma, added clot-inducing factors to force aggregation, and that no clotting occurred without those factors? How they injured the mouse carotid artery to induce thrombosis, and so on? I have an MSc in Personalised Nutrition and Functional Medicine. My MSc Dissertation was a Mechanism Review on Fructose and Atherosclerosis Cardiovascular Disease. I thus studied the pathophysiology of heart disease in detail. I have been studying sweet compounds for the past 10 years, reading every paper that comes out on non-sucrose/sugar sweetening ingredients, including erythritol. This is my deep dive analysis of the paper. Hope it may be helpful. https://www.linkedin.com/pulse/erythritol-pathways-physiology-sakiko-reuterski%25C3%25B6ld/?trackingId=QTRwABYaTGypVl9wpsnjTw%3D%3D