Muscle for Life with Mike Matthews - Is Erythritol Dangerous and Bad For Your Heart?

Episode Date: March 10, 2023

Is erythritol bad for you? A new study has been making waves, claiming that this commonly used natural, zero-calorie sweetener could increase the risk of heart attack and stroke. However, as with many health-related headlines, the media has been quick to jump on the sensationalist bandwagon. So, should we be worried about erythritol? Or is this just another case of misleading information for the sake of advertising clicks? Listen to this podcast to separate fact from fiction. Timestamps: (0:00) - Please leave a review of the show wherever you listen to podcasts and make sure to subscribe! (1:20) - What is erythritol? (2:38) - Is erythritol safe? (10:55) - Find the Perfect Strength Training Program for You: www.muscleforlife.show/trainingquiz (15:41) - What are your thoughts on erythritol? Mentioned on the Show: Find the Perfect Strength Training Program for You in Just 60 Seconds: http://www.muscleforlife.show/trainingquiz

Howdy, howdy. I'm Mike Matthews. This is Muscle for Life. Thank you for joining me today for a new episode, a timely episode on erythritol, the sugar alcohol, the natural sweetener, which was scandal-free for a long time. But in the last week or so, a new study has been making the rounds in the media, and apparently erythritol is dangerous. Apparently it can increase your risk of heart attack and stroke. And many people are concerned. I'm hearing from people asking about it because erythritol is in my sports nutrition company, Legion's products. We sweeten with natural sweeteners. Stevia, erythritol are the two main ones. And erythritol is in a lot more than just sports nutrition supplements. Erythritol is in thousands of different products ranging from chewing gum to pancake syrup to candy and others.

And it's probably consumed every day by tens of millions of people all around the world. every day by tens of millions of people all around the world. And should those people be worried? Should you be worried if you are eating foods or taking supplements that contain erythritol? Well, you are going to get an in-depth and evidence-based answer to that question in this episode. Let's start this with a brief description of what erythritol is before we get into the juicier parts of this episode, the scandalous parts. And so erythritol is a sugar alcohol, which is a compound that is typically derived from a sugar molecule. And sugar alcohols are found naturally in different foods and beverages, wine, beer,

mushrooms, pears, grapes, soy sauce. Erythritol is also naturally produced in the body during glucose metabolism, and it is also produced industrially as a sweetener using glucose. And one of the reasons that many people, myself included, like erythritol as a sweetener, is it contains significantly fewer calories than sugar and other sugar alcohols by weight. And it is quite sweet and it has a mild taste. It doesn't have a strong aftertaste. So for example, table sugar sucrose contains about four calories per gram and sorbitol, which is another sugar alcohol that contains about 2.6 calories per gram. Xylitol is another one

that contains about 2.4 calories per gram. And erythritol contains just about 0.2 calories per gram. And again, it is very sweet and it tastes good. Okay, so that's what erythritol is. Let's talk safety, which until recently was nobody's concern. I mean, erythritol had an almost flawless safety record with study after study showing that it is well tolerated by humans and it may even confer health benefits. Until just recently, the only valid evidence-based case you could make against erythritol is that it could cause some unwanted side effects if you ate a lot of it, like vast amounts, or when you paired it with other sugar alcohols, but then you still had to eat very large amounts of both of them together

combined to experience any sort of negative side effects. And those negative side effects mostly were just gastrointestinal discomfort. So maybe an upset stomach or gassiness. But then a study came out just last month, February 2023, and it was published in the journal Nature Medicine. And it suggested that erythritol can actually increase your risk of heart attack and stroke. And this has unsettled a lot of people who are regularly eating foods or taking supplements or drinking beverages that contain erythritol, including many of my customers, many of Legion's customers, because again, my sports nutrition company, Legion, uses erythritol along with stevia and one or two other natural sweeteners. We don't use any artificial sweeteners. We don't use any artificial food dyes. We don't use any artificial chemicals whatsoever in our products. And people now are concerned, people who have

heard of this research are concerned that maybe these foods and supplements and beverages that they thought were contributing to their health are in fact undermining it. And these people's concerns are perfectly valid, of course, because of how alarming some of these headlines and some of the interpretations of the research are. Now, when I first saw this study last month, I was skeptical at first because of the amount of evidence that has accumulated over the years and over the decades that erythritol is not only safe, but it may actually improve health. But I was also skeptical because the media has misled us about a lot of things. If we just stick to health and fitness, I mean, over the years, the media has misled us about a lot of things. If we just stick to health and fitness, I mean,

over the years, the media has misled us about the realities concerning red meat and sitting and alcohol, saturated fat, cholesterol, creatine, adrenal fatigue, exercise and weight loss, high protein dieting, the list goes on and on. And so when I saw every major media outlet eagerly running this story that this common ingredient erythritol is secretly killing you, well, let's just say that I wanted to see the study for myself. I wanted to see the data for myself. And so let's do that. Let's unpack the actual study. So in this study, scientists at the Lerner Research Institute first looked at blood data from 1,157 overweight and obese people with poor cardiovascular health. And they found that many of those people also had a lot of erythritol in their blood,

had high levels of erythritol in their system. Spurred by this finding, they then took blood samples from another 2,149 overweight and obese people to investigate how much erythritol they had in their blood and how many suffered cardiovascular issues over a three-year period. And so when they pooled all of their data and did some analysis on it, they found that high levels of erythritol and poor cardiovascular health were correlated. There seemed to be an association, a relationship there. What's more, this relationship seemed to have a dose-response character. That is, the higher your blood levels erythritol,

the stronger the association with bad heart health outcomes. And the researchers then did two further experiments. First, they added erythritol to blood platelets in a petri dish, and they found that erythritol negatively impacted platelet function. Then they gave eight people food containing 30 grams of erythritol, and they found that the people's blood levels of erythritol remained elevated for two days. And so if higher levels of erythritol in the blood, if that is associated with poor cardiovascular health and erythritol metals with platelet function in a lab, and erythritol metals with platelet function in a lab and erythritol sticks around in your body for 48 hours. Well, that sounds like a recipe for disaster, right? It must be wreaking

havoc on your ticker and it must be increasing your chances of heart attack and stroke. Yay, science. Well, not quite, because that line of reasoning contains a number of fallacious conclusions and logical leaps. For example, the first is the only data showing a link between erythritol and poor cardiovascular health is observational, which means that it can only show that two things seem to be related, not that one causes the other. Another problem is the researchers never measured how much erythritol each participant ate, only how much was in their blood. That is, the data did not show that these people consumed large amounts of food containing erythritol, only that for whatever reason their blood contained a lot of erythritol, which could be influenced by factors other than their food choices.

And that point in particular is significant because the study's participants were very unhealthy. All of them were overweight or obese. 22 to 28% had diabetes, 70 to 80% had high blood pressure, 13 to 17% smoked, 69 to 75% had coronary artery disease, 17 to 19% had heart failure, and 40 to 50% had already had a heart attack. Now, studies show that unhealthy people like these people, especially the people with obesity, diabetes, cardiovascular disease, they produce more erythritol naturally in their body, which I mentioned earlier, than healthy people do regardless of how much erythritol they eat or drink. In other words, that there is good evidence to suggest that the association seen in this study

between erythritol in the blood and cardiovascular health is the result of reverse causation that these people were not or are not becoming unwell because they have high levels of erythritol in their blood. They have high blood levels of erythritol because they are unwell. Moreover, it's likely that their blood level of erythritol will increase as they get sicker, which explains why there appears to be a dose-response relationship between erythritol levels and cardiovascular issues. Another problem with the way this study is being presented in the media is much of the researcher's conclusion that is featured in the headlines, it rests on evidence from an in vitro, which means outside the body experiment,

in which the scientists mixed erythritol with blood platelets in a petri dish. However, unusual things routinely occur in experiments of this kind, which is why it is totally inappropriate to extrapolate in vitro results to living humans. In vivo would be the technical term, in a living person. So when you mix substances with isolated human cells, you can get fireworks. But if you were to do the same thing in a living organism, in a living person, you may not get any fireworks whatsoever. This is commonly known in scientific circles, not necessarily commonly known in media circles, however.

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Yet another reason why I don't buy the story that erythritol is unhealthy or that this study proves that is only eight people participated in the intervention part of the study where the researchers measured blood erythritol levels after people ate erythritol. Now that's a problem because it is a very small sample size and the fewer participants you have, the smaller the sample size, the lower the chance that your results are valid. But there's also a problem with how those participants were selected. And I would say it's an even bigger problem. The authors noted that they pulled the data for these people from a completely separate, non-randomized study involving 40 participants that's still ongoing. And interestingly, the authors of this study that everyone's talking about, they neglected to

mention that in the actual text of the study. Instead, they tucked it away in the supplementary material, which most people don't read. So what does that mean? Well, I don't know. The cynic in me would say, well, maybe these people just cherry pick these researchers, cherry pick eight individuals from this other study whose results aligned nicely with the conclusion that they were gunning for. But we don't know that, of course. It's plausible. Certainly possible. Things like that certainly happen in scientific research.

It's not the norm, but it certainly happens. And so that alone casts a shadow of doubt on the entire study. For that reason alone, you have to be skeptical of the research and how the researchers are presenting their information. And I have one more critique of this study. As part of the intervention trial, the researchers fed people 30 grams of erythritol, and then they claimed that some people consume up to that amount here in the United States. And that was the justification for the 30 grams of erythritol. And while that is technically true, some people may ingest that much erythritol. It is misleading because according to the FDA, most erythritol users eat about 13 grams in an entire day. And only 10% of people eat as much as 30 grams per day.

And basically nobody eats 30 grams in a single sitting. So we have 90% of people eating less than 30 grams per day, a lot of people eating a lot less and nobody eating 30 grams in a single sitting. And to give some context, you would need to eat or take about eight servings of my sports nutrition company, Legion's Greens Supplement Genesis, or about eight servings of our popular pre-workout pulse in one sitting to get 30 grams of erythritol. Now, are any of the mediocrats sharing these caveats with you? Are they putting asterisks on their vaguely ominous headlines warning about the dangers of erythritol? No, they are implying or outright stating that the science is settled.

Look, here it is. It's science. And this is what it says. Therefore, the matter is settled. And they are often padding their speculations with speculations from people with credentials. Maybe it's a doctor who clearly hasn't even bothered to read the study, but is just excited to get featured in a big publication, maybe get a backlink. And so here we are with a study that was poorly designed and poorly executed by researchers who appeared to deliberately obfuscate important data and who made a number of logical leaps to arrive at a very titillating conclusion that is giving them their 15 minutes of fame. And so my interpretation of this whole fiasco is that it is not an example of why it's

dangerous to consume erythritol, but more of an example of why it's dangerous to blindly consume media reporting on science. The vast majority of journalists, especially journalists who write these clickbait type of stories, are not scientists. They have no formal training in science whatsoever. They don't know how to read and understand research. And although they pretend like it's their job to honestly and accurately report on scientific research, it's not their job. Their job, first and foremost, many of these people, not all, is to make money for their employer. And how do their employers make money? They sell advertising. And how do you sell advertising? You need to have traffic. You need to have people to show the advertising to. And the more people you have coming to your articles or watching your videos or listening to your podcast, the more your advertising is worth.

And so if we remove ethics as a consideration, this erythritol study is a fantastic opportunity to make some money. But my position on erythritol's safety is unchanged because the weight of the scientific evidence clearly shows that it is safe. It's an innocuous molecule. You can eat it in moderation. You can even eat it in fairly large amounts without any risk to your health. Although if you eat too much, you probably are going to get an upset stomach or are going to get gassy. And if you have ever eaten too much erythritol, you know that already. You know your body's limit because your stomach probably will get upset at some point if you eat way more than you should. And most people, they don't get there through supplements or through bars or drinks. Usually, in my experience, it's through sweetening other

things, using erythritol as a sweetener and just using too much of it. Well, I hope you liked this episode. I hope you found it helpful. And if you did subscribe to the show, because it makes sure that you don't miss new episodes. And it also helps me because it increases the rankings of the show a little bit, which of course then makes it a little bit more easily found by other people who may like it just as much as you. And if you didn't like something about this episode or about the show in general, or if you have ideas or suggestions or just feedback to share, shoot me an email, mike at muscle

for life.com muscle for life.com. shoot me an email, mike at muscleforlife.com, muscleforlife.com, and let me know what I could do better or just what your thoughts are about maybe what you'd like to see me do in the future. I read everything myself. I'm always looking for new ideas and constructive feedback. So thanks again for listening to this episode, and I hope to hear from you soon.