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How much erythritol one can eat per day (and per meal) safely, if a healthy adult human consumes it for lifetime?

[edit]

To avoid toxicity and side-effects. You can assume it is mostly eaten with food as a sweetener.

--ee1518 (talk) 15:48, 25 January 2020 (UTC)[reply]

I reworked the section on uses, adding absorption and tolerance levels with this edit. EFSA scientific panels have studied the tolerance and safety levels submitted by applicants for food and beverage uses in the EU, giving them a multinational view of available science. 1.6% of a given product, or 0.78 grams per kg body weight are the upper threshold levels for erythritol in adults, according to the EFSA review cited. The FDA has concluded erythritol is generally safe, listing these documents. To my knowledge, there are no assessments of lifetime "exposure", but the safety data can be interpreted that erythritol is safe if used below amounts that cause GI upset. --Zefr (talk) 17:21, 25 January 2020 (UTC)[reply]

Wanted to post that updated studies have shown possible links to thrombosis (blood clots) and heart issues, as a result of having too much erythritol in your daily diet. Many articles, but here’s one: using erythritol https://www.popsci.com/health/heart-attack-stroke-sugar-substitute-erythritol/ Smeeshi5 (talk) 02:30, 4 March 2023 (UTC)[reply]

flavour

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does it have a flavour as Stevia does? 88.148.0.7 (talk) 15:59, 4 June 2021 (UTC)[reply]

No. It is much better. Unfortunately, for me, the negative G.I. effect rate is about 6 g (for 90 kg). HillbillyWoman (talk) 20:21, 6 February 2024 (UTC)[reply]

Occurs naturally in animals?

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From the Belgica antarctica article: To adapt to the cold temperatures, B. antarctica accumulates trehalose, glucose, and erythritol. Is this common for insects, and maybe other animals? Prevalence 04:26, 22 August 2021 (UTC)[reply]

CAS No

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The CAS No entry will have to retain its red cross because the inchikey is wrong The entry for Erythritol at https://commonchemistry.cas.org/detail?cas_rn=149-32-6 has

  • UNXHWFMMPAWVPI-ZXZARUISNA-N
  • UNXHWFMMPAWVPI-ZXZARUISSA-N

Wheras this is from chemspider, pubchem, and when calculated from the inchi. So it is looking as if CAS Common Chemistry has a wrong value. Will they correct it if they are contacted? I have contacted them to see what happens. Graeme Bartlett (talk) 00:04, 4 January 2022 (UTC)[reply]

Natural occurrence and production and Production sections

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There is one section called Natural occurrence and production and another called Production. Should these two sections be merged in some kind of way? --Incendio2348 (talk) 00:44, 5 March 2022 (UTC)[reply]

Article (27Feb2023) Nature Medicine

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The artificial sweetener erythritol and cardiovascular event risk.

‘Our findings reveal that erythritol is both associated with incident MACE risk and fosters enhanced thrombosis. Studies assessing the long-term safety of erythritol are warranted.’ 174.93.216.29 (talk) 20:03, 27 February 2023 (UTC)[reply]

The article was also cited here. Jarble (talk) 07:39, 28 February 2023 (UTC)[reply]
Editor @BenHeideveld added info about the study, it was reverted by @Gugrak, (probably lack of citations, but no reason was provided, and I added the edit by BenHeideveld back with citations with this edit. P37307 (talk) 10:55, 28 February 2023 (UTC)[reply]
This study is primary research and news - see WP:MEDASSESS. It is not a WP:MEDRS review, clinical statement, or final confirmed effect of erythritol, which would be determined by a regulatory agency, such as the FDA or European Food Safety Authority. Until/Unless we have that kind of regulatory review, it is not a source for use in the article. Zefr (talk) 16:52, 28 February 2023 (UTC)[reply]
I removed it around 40 minutes prior to your reply with this edit on the basis of your stevia revert reasoning

here. P37307 (talk) 17:00, 28 February 2023 (UTC)[reply]

A study of over 4,000 people by the Cleveland Clinic found erythriol increased clotting risk, is this what you are disputing? [1] From the study report: "Results revealed that erythritol made platelets easier to activate and form a clot. Pre-clinical studies confirmed ingestion of erythritol heightened clot formation." The study was partially funded by the NIH, but states the conclusions are solely those of the authors. The Cleveland Clinic reports contradict itself by saying they have determined association, not cause and effect, in spite of the quote from the article I included above. 2600:1700:B9C1:20C0:558B:1520:D225:1388 (talk) 23:32, 28 February 2023 (UTC)[reply]

References

  1. ^ https://newsroom.clevelandclinic.org/2023/02/27/cleveland-clinic-study-finds-common-artificial-sweetener-linked-to-higher-rates-of-heart-attack-and-stroke/

Note that the press release from the Cleveland Clinic stated the obvious nature of primary research that this study exhibits: "The authors note the importance of follow-up studies to confirm their findings in the general population. The study had several limitations, including that clinical observation studies demonstrate association and not causation" (underlining for emphasis). The study is preliminary, and it is getting news headlines (note WP:NOTNEWS). Because erythritol is such a common sweetening agent used in diverse food and beverage products, the finding of the study, if a fact, will be announced by a clinical or government organization - when it would be worthy to mention in the encyclopedia, WP:MEDORG. Zefr (talk) 04:53, 1 March 2023 (UTC)[reply]

Absurd!"worthy"?? Wow, that is just sad. Since the Nature finding is noteworthy (I can cite 100's of mentions of it from 'authoritative' news sites), the issue isn't one of it being "worthy" but whether it is correct. The sample size was not huge, but not just a few dozen patients, either. I am ignorant of the forms that have to be filled out, and the hoops that have to be jumped through for a medical finding to get incorporated into WP, but setting the bar too high is worse than setting it too low. I am not arguing that Witkowski, et al are correct, nor that the findings show cause and effect. What I am arguing is that the findings deserve to be noted (perhaps that is *exactly* what is needed, a note?) in this article. It could be that peer review shows some serious flaw in methodology, analysis, or data, but replication is, probably, years away. It is not reasonable to wait for replication, nor to wait for some slow, bureaucratic and political body to make the decision to "do something about it". Facts aren't dependent on authority, consensus, majority, or plurality. The problem is a moral/ethical one. If, by not including mention of a potentially LIFE-THREATENING issue with erythritol as a non-caloric FOOD additive (not medicine), WP contributes to one adverse event, then WP has lost its moral compass. If the editors of this article don't see that, then it is unfortunate. Look at it this way, even if, 5 years from now, the various attempts to replicate it fail to confirm it, the finding will still be "worthy" to mention as a historical fact. So, seems to me there's three options: 1. Add mention of it to history section, add a note in the safety discussion, or add a Risk Controversy (or the like) section.174.130.71.156 (talk) 05:14, 7 March 2023 (UTC)[reply]
The NIH now cites the study. It is definitely time to update the page. https://www.nih.gov/news-events/nih-research-matters/erythritol-cardiovascular-events
I suggest the following change, which Zefr rejected, arguing that this issue "was settled", which the talk shows clearly is not the case (many opinions arguing for the inclusion of the study):
A possible link between erythritol and heart disease has recently been proposed. A metabolomics analysis found that higher levels of the artificial sweetener erythritol were associated with increased risk of heart attack and stroke. In vitro and in vivo experiments showed that erythritol enhances platelet reactivity and thrombosis at concentrations reached after consuming foods and beverages containing erythritol.[1] This finding was replicated in several studies. A prospective cohort analysis found that, after adjustment of confounding variables, elevated serum erythritol was associated with an increased risk of overall mortality, cardiovascular disease mortality, particularly heart disease mortality, and cancer mortality, with stronger associations observed in older men and those with higher diastolic blood pressure.[2] A nested case-control study found that higher levels of erythritol were associated with more adverse cardiometabolic risk factors and an increased risk of CHD, even after adjusting for diet quality, lifestyles, adiposity, hypertension, and dyslipidemia; however, the association between erythritol and CHD risk was attenuated after adjusting for diabetes.[3]
Nevertheless, although biologically plausible,[4] whether erythritol plays a causal role in heart disease remains uncertain.[5] As outlined in a recent review, erythritol in human blood can be either exogenous (ingested from food) or endogenous (synthesized in the body via the pentose phosphate pathway).[6] Elevated erythritol levels may indicate dysregulation of the pentose phosphate pathway due to glucose and fructose-rich diets or oxidative stress, and this pathway is more active in individuals with pre-existing cardiovascular disease. The fact that studies conducted before erythritol was widely used as a sweetener still found associations between higher erythritol levels and diabetes or coronary artery disease suggests that the elevated concentrations were at least partly due to endogenous production rather than dietary intake.
A small selection of studies used designs suited to infer causality. In a prospective interventional study, healthy volunteers who consumed 30g of erythritol exhibited a greater than 1000-fold increase in plasma erythritol levels and showed acute enhancement of platelet aggregation and granule release in response to agonists.[7] In contrast, consumption of 30g glucose did not significantly impact stimulus-dependent platelet activation, raising concerns that dietary erythritol may increase thrombosis risk. However, the sample size in the interventional arm and control was small. A two-sample bidirectional Mendelian randomization study found no consistent evidence supporting a causal effect of higher erythritol on increased coronary artery disease risk, and in fact observed that erythritol may potentially decrease BMI, although prospective studies are still needed to confirm these findings.[8] Psychwilly2 (talk) 06:57, 26 December 2024 (UTC)[reply]

Semi-protected edit request on 1 March 2023

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Suggest adding a statement in the "Uses, absorption, and safety" section:

There is a study published in nature medicine that shows a link between erythritol and cardiovascular event risk. Witkowski, M., Nemet, I., Alamri, H. et al. The artificial sweetener erythritol and cardiovascular event risk. Nat Med (2023). https://doi.org/10.1038/s41591-023-02223-9 Q-Hack (talk) 05:52, 1 March 2023 (UTC)[reply]

 Not done: See this discussion above Talk:Erythritol#Article_(27Feb2023)_Nature_Medicine --P37307 (talk) 16:36, 1 March 2023 (UTC)[reply]

New concerns about heart attack and stroke

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A lot of articles raising concern about possible heart attacks and strokes found in a recent study.

Should this be added to the article?

https://newsroom.clevelandclinic.org/2023/02/27/cleveland-clinic-study-finds-common-artificial-sweetener-linked-to-higher-rates-of-heart-attack-and-stroke/ 38.94.252.30 (talk) 15:49, 1 March 2023 (UTC)[reply]

No, it should not be added yet. We need to wait for confirming studies and then review articles, see WP:MEDRS. - MrOllie (talk) 15:59, 1 March 2023 (UTC)[reply]
See discussion Talk:Erythritol#Article_(27Feb2023)_Nature_Medicine above. It goes into detail as to why it should not be added to the article yet. P37307 (talk) 16:34, 1 March 2023 (UTC)[reply]
Its been reported as as a confirmed link. https://www.cnn.com/2023/02/27/health/zero-calorie-sweetener-heart-attack-stroke-wellness/index.html 184.184.116.196 (talk) 20:40, 29 September 2023 (UTC)[reply]
Common sense approach - Acknowledge the growing body of legitimate peer-reviewed research with regard to cardiovascular and stroke risk that has been replicated in multiple studies of sugar alcohols Erythritol AND Xylitol, BUT put it in the proper context with all caveats given in the researchers' conclusions (related to study design, relative risk, dosage/kg/day, "more research is needed"). Most readers coming to this article are probably already aware of these findings, and it is just an odd and confusing experience for there to be absolutely zero mention of it in the main article. 69.249.103.131 (talk) 18:19, 27 June 2024 (UTC)[reply]
Half a year later, a lot of new evidence has been published, including reviews and studies utilizing randomization. I tried to add these, somewhat inconsistent studies, but the change was rejected to my surprise. Here is my suggestion:
A possible link between erythritol and heart disease has recently been proposed. A metabolomics analysis found that higher levels of the artificial sweetener erythritol were associated with increased risk of heart attack and stroke. In vitro and in vivo experiments showed that erythritol enhances platelet reactivity and thrombosis at concentrations reached after consuming foods and beverages containing erythritol.[9] This finding was replicated in several studies. A prospective cohort analysis found that, after adjustment of confounding variables, elevated serum erythritol was associated with an increased risk of overall mortality, cardiovascular disease mortality, particularly heart disease mortality, and cancer mortality, with stronger associations observed in older men and those with higher diastolic blood pressure.[10] A nested case-control study found that higher levels of erythritol were associated with more adverse cardiometabolic risk factors and an increased risk of CHD, even after adjusting for diet quality, lifestyles, adiposity, hypertension, and dyslipidemia; however, the association between erythritol and CHD risk was attenuated after adjusting for diabetes.[11]
Nevertheless, although biologically plausible,[12] whether erythritol plays a causal role in heart disease remains uncertain.[13] As outlined in a recent review, erythritol in human blood can be either exogenous (ingested from food) or endogenous (synthesized in the body via the pentose phosphate pathway).[14] Elevated erythritol levels may indicate dysregulation of the pentose phosphate pathway due to glucose and fructose-rich diets or oxidative stress, and this pathway is more active in individuals with pre-existing cardiovascular disease. The fact that studies conducted before erythritol was widely used as a sweetener still found associations between higher erythritol levels and diabetes or coronary artery disease suggests that the elevated concentrations were at least partly due to endogenous production rather than dietary intake.
A small selection of studies used designs suited to infer causality. In a prospective interventional study, healthy volunteers who consumed 30g of erythritol exhibited a greater than 1000-fold increase in plasma erythritol levels and showed acute enhancement of platelet aggregation and granule release in response to agonists.[15] In contrast, consumption of 30g glucose did not significantly impact stimulus-dependent platelet activation, raising concerns that dietary erythritol may increase thrombosis risk. However, the sample size in the interventional arm and control was small. A two-sample bidirectional Mendelian randomization study found no consistent evidence supporting a causal effect of higher erythritol on increased coronary artery disease risk, and in fact observed that erythritol may potentially decrease BMI, although prospective studies are still needed to confirm these findings.[16] Psychwilly2 (talk) 06:48, 26 December 2024 (UTC)[reply]
The article isn't a summary of primary research - WP:NOTJOURNAL #6,7. See WP:MEDASSESS. The telltale for change of the overall science and regulation will be when the FDA updates this guideline. Zefr (talk) 07:08, 26 December 2024 (UTC)[reply]
Why is an American institution the standard here? This is inherently US centric. Psychwilly2 (talk) 09:34, 26 December 2024 (UTC)[reply]
Choose any national food safety authority or clinical organization you want. The FDA is widely regarded as the world's most rigorous scientific organization on food safety, and has constant surveillance on safe levels of ingredients used in foods via the FDA warning letter system. Zefr (talk) 16:36, 26 December 2024 (UTC)[reply]
Please provide sources supporting the claim that it is widely regarded as the world most rigorous scientific organisation on food safety. Alone in the US, just above 50% of the population trust the FDA. https://news.gallup.com/poll/650024/trust-government-assurance-food-safety-hits-record-low.aspx Psychwilly2 (talk) 19:38, 26 December 2024 (UTC)[reply]
Which of these citations to do you believe meet WP:MEDRS? As far I can tell these are all primary studies (which do not meet WP:MEDRS), but perhaps I am missing something. MrOllie (talk) 19:55, 26 December 2024 (UTC)[reply]

References

  1. ^ Witkowski, Marco; Nemet, Ina; Alamri, Hassan; Wilcox, Jennifer; Gupta, Nilaksh; Nimer, Nisreen; Haghikia, Arash; Li, Xinmin S.; Wu, Yuping; Saha, Prasenjit Prasad; Demuth, Ilja; König, Maximilian; Steinhagen-Thiessen, Elisabeth; Cajka, Tomas; Fiehn, Oliver (2023-03). "The artificial sweetener erythritol and cardiovascular event risk". Nature Medicine. 29 (3): 710–718. doi:10.1038/s41591-023-02223-9. ISSN 1546-170X. {{cite journal}}: Check date values in: |date= (help)
  2. ^ Lim, Jungeun; Hong, Hyokyoung G.; Huang, Jiaqi; Stolzenberg-Solomon, Rachael; Mondul, Alison M.; Weinstein, Stephanie J.; Albanes, Demetrius (2024-01). "Serum Erythritol and Risk of Overall and Cause-Specific Mortality in a Cohort of Men". Nutrients. 16 (18): 3099. doi:10.3390/nu16183099. ISSN 2072-6643. {{cite journal}}: Check date values in: |date= (help)CS1 maint: unflagged free DOI (link)
  3. ^ Heianza, Yoriko; Sun, Qi; Wang, Xuan; Tiwari, Saumya; Watrous, Jeramie D; Rexrode, Kathryn M; Alotaibi, Mona; Jain, Mohit; Mora, Samia; Willett, Walter C; Qi, Lu; Manson, JoAnn E (2024-09-04). "Plasma levels of polyols erythritol, mannitol, and sorbitol and incident coronary heart disease among women". European Journal of Preventive Cardiology. doi:10.1093/eurjpc/zwae288. ISSN 2047-4873.
  4. ^ Pafili, Kalliopi; Roden, Michael (2023-06-16). "The sugar-free paradox: cardiometabolic consequences of erythritol". Signal Transduction and Targeted Therapy. 8 (1): 1–3. doi:10.1038/s41392-023-01504-6. ISSN 2059-3635.
  5. ^ Mazi, Tagreed A.; Stanhope, Kimber L. (2023-01). "Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?". Nutrients. 15 (18): 4011. doi:10.3390/nu15184011. ISSN 2072-6643. {{cite journal}}: Check date values in: |date= (help)CS1 maint: unflagged free DOI (link)
  6. ^ Cramer, Thorsten; Gonder, Ulrike; Kofler, Barbara (2023-05-23). "Plasma erythritol and cardiovascular risk: is there evidence for an association with dietary intake?". Frontiers in Nutrition. 10. doi:10.3389/fnut.2023.1195521. ISSN 2296-861X.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  7. ^ Witkowski, Marco; Wilcox, Jennifer; Province, Valesha; Wang, Zeneng; Nemet, Ina; Tang, W.H. Wilson; Hazen, Stanley L. (2024-09). "Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers—Brief Report". Arteriosclerosis, Thrombosis, and Vascular Biology. 44 (9): 2136–2141. doi:10.1161/ATVBAHA.124.321019. PMC 11338701. PMID 39114916. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  8. ^ Khafagy, Rana; Paterson, Andrew D.; Dash, Satya (2023-11-08). "Erythritol as a Potential Causal Contributor to Cardiometabolic Disease: A Mendelian Randomization Study". Diabetes. 73 (2): 325–331. doi:10.2337/db23-0330. ISSN 0012-1797.
  9. ^ Witkowski, Marco; Nemet, Ina; Alamri, Hassan; Wilcox, Jennifer; Gupta, Nilaksh; Nimer, Nisreen; Haghikia, Arash; Li, Xinmin S.; Wu, Yuping; Saha, Prasenjit Prasad; Demuth, Ilja; König, Maximilian; Steinhagen-Thiessen, Elisabeth; Cajka, Tomas; Fiehn, Oliver (2023-03). "The artificial sweetener erythritol and cardiovascular event risk". Nature Medicine. 29 (3): 710–718. doi:10.1038/s41591-023-02223-9. ISSN 1546-170X. {{cite journal}}: Check date values in: |date= (help)
  10. ^ Lim, Jungeun; Hong, Hyokyoung G.; Huang, Jiaqi; Stolzenberg-Solomon, Rachael; Mondul, Alison M.; Weinstein, Stephanie J.; Albanes, Demetrius (2024-01). "Serum Erythritol and Risk of Overall and Cause-Specific Mortality in a Cohort of Men". Nutrients. 16 (18): 3099. doi:10.3390/nu16183099. ISSN 2072-6643. {{cite journal}}: Check date values in: |date= (help)CS1 maint: unflagged free DOI (link)
  11. ^ Heianza, Yoriko; Sun, Qi; Wang, Xuan; Tiwari, Saumya; Watrous, Jeramie D; Rexrode, Kathryn M; Alotaibi, Mona; Jain, Mohit; Mora, Samia; Willett, Walter C; Qi, Lu; Manson, JoAnn E (2024-09-04). "Plasma levels of polyols erythritol, mannitol, and sorbitol and incident coronary heart disease among women". European Journal of Preventive Cardiology. doi:10.1093/eurjpc/zwae288. ISSN 2047-4873.
  12. ^ Pafili, Kalliopi; Roden, Michael (2023-06-16). "The sugar-free paradox: cardiometabolic consequences of erythritol". Signal Transduction and Targeted Therapy. 8 (1): 1–3. doi:10.1038/s41392-023-01504-6. ISSN 2059-3635.
  13. ^ Mazi, Tagreed A.; Stanhope, Kimber L. (2023-01). "Elevated Erythritol: A Marker of Metabolic Dysregulation or Contributor to the Pathogenesis of Cardiometabolic Disease?". Nutrients. 15 (18): 4011. doi:10.3390/nu15184011. ISSN 2072-6643. {{cite journal}}: Check date values in: |date= (help)CS1 maint: unflagged free DOI (link)
  14. ^ Cramer, Thorsten; Gonder, Ulrike; Kofler, Barbara (2023-05-23). "Plasma erythritol and cardiovascular risk: is there evidence for an association with dietary intake?". Frontiers in Nutrition. 10. doi:10.3389/fnut.2023.1195521. ISSN 2296-861X.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  15. ^ Witkowski, Marco; Wilcox, Jennifer; Province, Valesha; Wang, Zeneng; Nemet, Ina; Tang, W.H. Wilson; Hazen, Stanley L. (2024-09). "Ingestion of the Non-Nutritive Sweetener Erythritol, but Not Glucose, Enhances Platelet Reactivity and Thrombosis Potential in Healthy Volunteers—Brief Report". Arteriosclerosis, Thrombosis, and Vascular Biology. 44 (9): 2136–2141. doi:10.1161/ATVBAHA.124.321019. PMC 11338701. PMID 39114916. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
  16. ^ Khafagy, Rana; Paterson, Andrew D.; Dash, Satya (2023-11-08). "Erythritol as a Potential Causal Contributor to Cardiometabolic Disease: A Mendelian Randomization Study". Diabetes. 73 (2): 325–331. doi:10.2337/db23-0330. ISSN 0012-1797.

Corn

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The first paragraph mentions corn. There is a disambiguation page on corn. Some corn should be [ [ grain | corn ] ] (spaces inserted for clarity) and some, I suppose, [ [ maize | corn ] ]. I think this page should disambiguate "corn", but I don't know which meaning is appropriate. (Could erythritol come from both?) Editing "corn" to [ [ corn (disambiguation) | corn ] ] is a possibility, but it wouldn't help, would it? It needs someone who knows what they are talking about. Nick Barnett (talk) 01:30, 16 March 2024 (UTC)[reply]

@Nick Barnett Sending a reader to the disambiguation page "corn" is not helpful. If I were ignorant of the source of erythritol, I would put a link to the corn starch page. Tosha Langue (talk) 02:08, 16 March 2024 (UTC)[reply]
Would you Tosha Langue? Corn starch comes from maize (corn), not other grains (corn), and so you would be making the decision that I said I didn't have the knowledge to make, but you said you'd make it if you were ignorant of erythritol's sources. Are you? If you are, why would you plump? Or aren't you? Do you know erythritol comes from corn starch?
Nick Barnett (talk) 09:22, 16 March 2024 (UTC)[reply]
I have no idea where erythritol comes from, but the source says corn starch.[1]

References

  1. ^ https://web.archive.org/web/20161030174650/http://www.decodedscience.org/erythritol-made-manufacture-low-calorie-sugar-substitute/42248. {{cite web}}: Missing or empty |title= (help)
Tosha Langue (talk) 10:13, 16 March 2024 (UTC)[reply]

Sweetener erythritol

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(Subscriber to) See New Scientist, 17th August 2024, page 17 - “evidence mounts that sweetener erythritol raises blood clot risk.” 82.69.102.111 (talk) 09:38, 17 August 2024 (UTC)[reply]

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