Erythritol
Also known as: E968, Meso-erythritol, Tetrahydroxybutane, E-968, E 968
Erythritol is FDA-GRAS and EFSA-approved, but a 2023 Nature Medicine study (Witkowski et al.) linked elevated plasma erythritol to a roughly 2-fold increase in major adverse cardiovascular events across U.S. and European cohorts, with mechanistic data showing enhanced platelet reactivity and thrombosis.
What it is
Erythritol — a four-carbon sugar alcohol (polyol) produced commercially by yeast fermentation of glucose.
Bulk sweetener (~70% sweetness of sucrose) with near-zero calories; used in sugar-free and keto products.
Why it's flagged
- 2023 Nature Medicine study associated elevated plasma erythritol with ~2-fold increase in major adverse cardiovascular events
- Mechanistic data show enhanced platelet reactivity and thrombosis
- GI distress at intakes above ~50 g/day
What regulators actually say
"Subsequent targeted metabolomics analyses in independent US (n = 2,149) and European (n = 833) validation cohorts of stable patients undergoing elective cardiac evaluation confirmed this association (fourth versus first quartile adjusted hazard ratio (95% confidence interval), 1.80 (1.18–2.77) and 2.21 (1.20–4.07), respectively)."
"Mechanistic studies showing that high levels of erythritol enhanced platelet reactivity and thrombosis formation."
Regulatory status
United States — FDA
GRAS (multiple GRAS notices)
European Union — EFSA
Authorized as E 968; ADI 'not specified'
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