Previous reviews have found that erythritol may be a good replacement for sugar, although much of that research has been performed in animals, said Joanne Slavin, a professor of food science and nutrition at the University of Minnesota-Twin Cities who was not involved with the new research.
“There are going to be studies that show that it’s good, bad or indifferent,” Dr. Nestle said. People have been consuming artificial sweeteners for years, she added, “it’s really hard to put your finger on any specific problem.”
And it’s especially challenging to examine the health effects of sugar substitutes and alternative sweeteners when they are consumed as part of a larger diet, Dr. Slavin said.
Dr. Slavin noted that the people who consume high amounts of artificial sweeteners may already be at risk for cardiovascular issues. If they have conditions like diabetes or obesity, they may be using artificial sweeteners to try to cut back on sugar, she said. “That’s the really important thing, for people to not say, ‘Hey, this stuff is terrible, it’s giving us heart attacks,’” Dr. Slavin said. “No. This is another data point that says, ‘Hey, we have to look into this.’”
For some people, sugar substitutes like erythritol can be an important tool for those who are trying to lower the amount of added sugars they’re consuming, Dr. Slavin said, which can help with weight management and blood glucose control. But there are alternative options to lower our overall sugar consumption, Dr. Hazen noted. While the research on the health risks of erythritol is still evolving, people may want to avoid large amounts of artificial sweeteners, Dr. Freaney said, especially if they already have heart disease or are at risk for heart attacks or strokes. That can start with small changes, she suggested — if you consume five artificially sweetened beverages a day, for example, try replacing two of those with water. But it doesn’t need to be all or nothing, she said.
“You take in erythritol, you will not die on the spot,” Dr. Nestle said. “You will not.”