>> For decades, Americans have
been consuming sugar substitutes
in their morning coffee, their
desserts and diet drinks.
From the early days of
artificial sweeteners, questions
have been raised about their
safety.
A popular artificial sweetener
has been linked to greater risk
of blood clots that could lead
to heart attacks or strokes.
It's used in sugar substitutes
like splenda and truvia.
I spoke to a doctor of the
Cleveland clinic.
>> We were looking for new
pathways that contribute to
cardiac disease risk.
We are measuring inpatient blood
samples different compounds to
see whether or not they
predicted the future risk of
heart attack, stroke or death.
What we found is at the very top
of the list turned out to be a
compound that once we discovered
its structure it turned out to
be erythritol.
We added erythritol to animals
and they developed thrombotic
events like a heart attack or
stroke.
That's a clot in the vessel that
feeds the brain or heart.
When you add erythritol to
blood, it increases the
likelihood of clotting.
>> What products that might be
on people's shelves or in the
refrigerators would have
erythritol?
>> You find it in keto foods,
highly processed foods where it
replaces sugar and provides the
same sweetness as sugar but zero
calories.
It has become very common to
find it in highly processed
foods.
It's also in things like
condiments and even oral care
products.
Like cholesterol, we make it
ourselves.
And the natural variation, some
people have higher levels,
others have lower levels.
When you eat erythritol in keto
friendly ice cream, it became
super physiologic outside the
normal range and it took days
for it to come down below the
threshold.
>> Erythritol has been approved
by the fda.
Do you think that should be
reconsidered?
>> I don't know as far as being
reconsidered.
I think for their safety studies
are definitely being called for.
This was unexpected.
Is there a compound or chemical
in blood that predicts future
risk of disease, it just so
happened that erythritol just
showed up at the top of the pile
as being a predictor of future
events and it may be that it's
only more important for people
who are more vulnerable to
experiencing heart attack or
stroke.
Of course those are the very
people who are reaching for the
artificial sweeteners to try and
do something that's beneficial
for their health with lower
calories and weight reduction or
better control of their diabetes
and blood sugar.
>> Researchers not involved in
this study have noted while they
agree that it's not proved to be
safe, they do say that the fact
that most of your studies --
study subjects either had
cardiovascular disease or had
risk factors for cardiovascular
disease.
Might have skewed some of the
numbers.
You are saying those are the
very people who would be using
these products?
>> If you look at who uses
artificial sweeteners, it's more
common in people who are obese
or have diabetes or other
conditions where they are trying
to limit their calories and
limit the blood sugar increases.
It is clear that erythritol when
ingested does not make your
blood sugar grow up.
-- Go up.
There have been a couple
randomized trials looking at
artificial sweeteners including
erythritol for weight reduction
or improvement in blood sugar
and many times they have not
shown beneficial effects.
It certainly deserves further
attention and study.
>> What would be your advice to
people who are watching and
maybe eating and drinking these
products?
Should they be concerned?
>> I do think there is reason to
try and avoid the use of
erythritol.
I'm recommending to my patients
that they try natural sweeteners
and just watch the calories.
Make sure that they use
moderation so they don't gain
weight.
Use a little bit of honey or
sugar.
Those in moderation are not
going to be increasing their
risk over the next couple days.
I hope people understand that a
compound like a erythritol,
everything is not all black and
white.
It may be that it is beneficial
in terms of an alternative to
sugar and being a low-calorie
alternative from a diabetes
standpoint or obesity
standpoint.
I think the exciting thing about
this actually is we now
recognize this as a pathway just
like cholesterol that is linked
to causing heart disease that's
in every one of us.
So in the future there may be
therapeutic approaches to help
modify this pathway.
And contribute to better
treatments for heart disease.
That's where I am most excited
and enthusiastic about this.
>> Dr. Stanley Hayes and of the
Cleveland clinic, thank you.
>> Thank you for having me.