This is a study done on cell cultures. It should NOT be used to influence behaviors regarding human health. The article linked makes a lot of leaps not supported by the study itself.
This sounds like a smart comment, but the main reason you shouldn't take in vitro studies as indicative of real medical outcomes is largely due to unknown bio availability when consuming realistic doses. However, this study shows that the concentration of erithritol is well above the concentration where they see negative effects in vitro when consuming a realistic dose.
In addition epidemiological studies have found associations between higher plasma erythritol and clotting/cardiovascular events. So, regular disclaimers about difficulty of establishing health science aside, I would disagree this should 'not influence behaviors'.
> However, this study shows that the concentration of erithritol is well above the concentration where they see negative effects in vitro when consuming a realistic dose.
Are you saying that when you eat a normal/largish amount of erithritol (say 1-10g), the concentration of erithritol in your brain is similar to what they tested on brain cells in vitro here?
Also, how can they make a link to stroke when testing in vitro?
The study used a concentration of 6mM erythritol. This would be the mean (“bulk”) concentration found in the body after drinking 2-3 erythritol-sweetened soft drinks. I can find several with 10+ grams of it per bottle/can.
Erythritol Concentration: 6 mM (0.006 mol/L)
Molar Mass of Erythritol: 122.12 g/mol
Water in human body: 42 Liters
Calculated Total Mass: 30.77 grams (0.006 * 122.12 * 42)
>It should NOT be used to influence behaviors regarding human health.
It's not like erythritol is hard for a consumer to avoid. P(serious problems like brain cell damage) does not need to get very high for it to start to make sense to avoid it, and it seems to me that studies done on cell culture can raise P high enough.
The test setup ignores the digestive system. There are going to be a lot of substances you can pour on a culture of brain cells with negative affect that your body produces or happily consumes. That’s the point of the parent.
Add milk, an alcoholic beverage, or some lemon juice and those cells are unlikely to survive. Meanwhile the standard path of consumption handles the situation just fine before your brain is ever involved in metabolism.
In vitro studies demonstrate potential mechanisms but cannot establish causality in humans due to differences in metabolism, bioavailability, and the blood-brain barrier's protective effects.
The German Wikipedia article says it appears naturally in cheese, funghi, plums, strawberries and pistachios. So maybe the lab experiment might be a bit artifial, or the dose much higher than from normal consumption if the above?
The dose people use for sweetener can be 1,000x - 10,000x the amount you'd find in fruit. There's micro to milligrams of it in some foods, people eat anywhere between 3g to 20g+ if they're eating goods baked with it as a sugar replacement.
There is also the topic of erythritol-induced diarrhea in higher consumption.
Its almost like these days people are desperately grasping for anything that will deliver weight loss, apart from changing their longterm unhealthy fucking eating habits. US is a long term champion but it has slowly crept into most cultures, just not at that scale yet.
Food portion size, its composition and breaking some sweat regularly works wonders but nobody ain't got time or willpower for that.
Migrants who move to the US skinny on average gain weight, and these are people who have good eating habits and willpower. When 30% are obese and 60% overall are overweight, willpower and individual responsibility are not the tools for the job.
I'd be looking at breaking up food conglomerates first personally.
In natural foods, there are other substances that balance out the harm, making it healthy overall. These other substances are absent when it's used as an additive.
No, I'm sorry but that's not correct. "Natural" is a meaningless health and wellness buzzword that handwaves away the details that each food comes with benefits and disadvantages. There are variable amounts of anti-nutrients almost every "natural" ingredient, some of which we process or cook to lessen them.
Indigenous people processed acorns to remove tanins.
Kidney beans (and many other legumes to variably lesser degree) naturally contain phytohaemagglutinins (PHA-E) which cause red blood cells to clump together. These can be reduces several orders of magnitude by repeated cooking, washing, and draining.
Men shouldn't eat too much soy or chia seeds. Small amounts of chia seeds are fine.
Most adults are lactose intolerant unless they have lactase persistence genes.
Spinach, pepper (the spice kind), rhubarb, almonds, and more contain oxalate that can lead to kidney stone formation. Excess vitamin C does also. Increasing citrate intake helps prevent calcium kidney stone formation, but doesn't help with oxalate kidney stones as much.
The list of antinutrients is long. Don't overdo eating one "natural" ingredient or another because that's the greatest risk of becoming a Chubbyemu video subject.
Exactly. Nature is there mostly to kill you, that is only natural, and thinking otherwise is basically resorting to divine. No living being wants to be food. There can be symbiotic behavior and plants can produce certain chemicals that attract animals that do some things for them like helping reproduction, but its huge stretch to claim that evolution optimizes for health by proxy. Most off beneficial effects of plant chemicals are due to shared pathways and hormesis.
Fiber is great for gut health but it's actually works against nutrient absorption. Increasing fiber intake requires increasing intake of certain vitamins, possibly with supplementation.
It's better to eat things in moderation and know what antinutrients are in what foods. There are tradeoffs.
I found a Stevia product, White Stevia, in my local organic market. It has maltodextrin added, but that's it. The downside is it's not measure-for-measure with sugar (1/6 tsp vs 1 tsp sugar).
I can not speak to this study, just my own anecdotal experience. I consumed sugar free monsters erythritol for a long time and it now causes pain in my left temple and visual auras in my left eye if I consume more than two cans in a day.
As you say I believe the correlation is reverse causality. It's much more likely that people who consume stuff with "artificial" sweetener are already at risk for stroke than the other way around.
If you don't have weight/cardio problems it is weird to consume "sugar-free" stuff and associated because they are almost always worse tasting than the real deal.
To have any importance they would need a big population sample and correct for already existing risks for stroke and I believe they would find that this stuff has very little impact, if any.
But as always, it doesn't cost much to limit consumption, so why not?
Evidence in vitro suggests enhanced platelet activity. Plasma levels of erythritol are sustained for >2d above thresholds associated with platelet hyper-reactivity after consumption of realistic doses.
I use artificial sweeteners, but prefer sucralose or anything else to erythritol. I actually don't understand why people still use it (often in 'health food' because it's seen as 'natural'), there are much safer options.
I could be off, my molar math is pretty rusty, but a back of the envelope stab seems like 6mM concentration would be _way_ below the 30g "serving" in a drink so assume their "equivalent of" is taking into account the concentrations estimated in the body after consumption or some such.
Seeing as this is an in vitro study, they fall back on a specific human study (Witkowski et al., 2023) for many of the human effect claims. However the referenced study has a few issues:
- All study subjects had a "high prevalence of CVD [cardiovascular disease] and risk factor burden"
- Erythritol occurs naturally in the body and and this was not accounted for
- The study subjects were already suffering from cardiovascular disease and were likely to be consuming more artificial sweeteners than a general population, but this was not recognized or accounted for
- Erythritol's presence after a cardiovascular incident could be from consumption or from natural production but only baseline was measured despite data showing dramatic fluctuations after consumption
Another one of the studies cited for evidence of human claims (Khafagy et al., 2024) directly contradicts them. It stated said "we did not find supportive evidence from MR that erythritol increases cardiometabolic disease".
There are two more human studies referenced but I didn't read them.
Using traditional sugar as a sweetener is well established as having negative effects, including inflammation. Many of the alternative sweeteners have a much lower glycemic index, so are thought to be healthier than ordinary sugar in that respect.
If you regularly consume ordinary sugar, you may be in the “not that healthy to begin with” category yourself.
It's only present in miniscule amounts in fruit and other produce. As a sweetener it's 1000x to 10000x more concentrated, which puts it in a completely different context.
This is a study done on cell cultures. It should NOT be used to influence behaviors regarding human health. The article linked makes a lot of leaps not supported by the study itself.
Link to actual study: https://journals.physiology.org/doi/full/10.1152/japplphysio...
This sounds like a smart comment, but the main reason you shouldn't take in vitro studies as indicative of real medical outcomes is largely due to unknown bio availability when consuming realistic doses. However, this study shows that the concentration of erithritol is well above the concentration where they see negative effects in vitro when consuming a realistic dose.
In addition epidemiological studies have found associations between higher plasma erythritol and clotting/cardiovascular events. So, regular disclaimers about difficulty of establishing health science aside, I would disagree this should 'not influence behaviors'.
> However, this study shows that the concentration of erithritol is well above the concentration where they see negative effects in vitro when consuming a realistic dose.
Are you saying that when you eat a normal/largish amount of erithritol (say 1-10g), the concentration of erithritol in your brain is similar to what they tested on brain cells in vitro here?
Also, how can they make a link to stroke when testing in vitro?
The study used a concentration of 6mM erythritol. This would be the mean (“bulk”) concentration found in the body after drinking 2-3 erythritol-sweetened soft drinks. I can find several with 10+ grams of it per bottle/can.
Erythritol Concentration: 6 mM (0.006 mol/L)
Molar Mass of Erythritol: 122.12 g/mol
Water in human body: 42 Liters
Calculated Total Mass: 30.77 grams (0.006 * 122.12 * 42)
>It should NOT be used to influence behaviors regarding human health.
It's not like erythritol is hard for a consumer to avoid. P(serious problems like brain cell damage) does not need to get very high for it to start to make sense to avoid it, and it seems to me that studies done on cell culture can raise P high enough.
The test setup ignores the digestive system. There are going to be a lot of substances you can pour on a culture of brain cells with negative affect that your body produces or happily consumes. That’s the point of the parent.
Add milk, an alcoholic beverage, or some lemon juice and those cells are unlikely to survive. Meanwhile the standard path of consumption handles the situation just fine before your brain is ever involved in metabolism.
OK. Thanks for explaining.
Alcoholic beverage, just fine ? I disagree.
Learn about hormesis then and don't succumb to the yt's med-bros click-bait hype
In vitro studies demonstrate potential mechanisms but cannot establish causality in humans due to differences in metabolism, bioavailability, and the blood-brain barrier's protective effects.
Because we are not composed of cells, right? (in jest)
Aka: https://xkcd.com/1217/
If you poured distilled water on cells in culture they'd also all die.
”Erythritol occurs naturally in some fruit and fermented foods." https://en.wikipedia.org/wiki/Erythritol
The German Wikipedia article says it appears naturally in cheese, funghi, plums, strawberries and pistachios. So maybe the lab experiment might be a bit artifial, or the dose much higher than from normal consumption if the above?
The dose people use for sweetener can be 1,000x - 10,000x the amount you'd find in fruit. There's micro to milligrams of it in some foods, people eat anywhere between 3g to 20g+ if they're eating goods baked with it as a sugar replacement.
Erithritol is also produced endogenously from glucose in the lower intestine of humans.
I'm struggling to find a good source on this right now but I remember reading that it could be as high as 10% of all glucose is converted this way.
The concern is more unnatural consumption. Some use it as a sugar replacement in drinks and foods.
There is also the topic of erythritol-induced diarrhea in higher consumption.
Its almost like these days people are desperately grasping for anything that will deliver weight loss, apart from changing their longterm unhealthy fucking eating habits. US is a long term champion but it has slowly crept into most cultures, just not at that scale yet.
Food portion size, its composition and breaking some sweat regularly works wonders but nobody ain't got time or willpower for that.
Migrants who move to the US skinny on average gain weight, and these are people who have good eating habits and willpower. When 30% are obese and 60% overall are overweight, willpower and individual responsibility are not the tools for the job.
I'd be looking at breaking up food conglomerates first personally.
Note that erithritol has a much lower laxative effect than other sugar alcohols.
Going on a tangent, another natural sugar alternative called allulose also induces diarrhea in higher doses.
So does the Vitamin C. Not sure what is your point.
In natural foods, there are other substances that balance out the harm, making it healthy overall. These other substances are absent when it's used as an additive.
No, I'm sorry but that's not correct. "Natural" is a meaningless health and wellness buzzword that handwaves away the details that each food comes with benefits and disadvantages. There are variable amounts of anti-nutrients almost every "natural" ingredient, some of which we process or cook to lessen them.
Indigenous people processed acorns to remove tanins.
Kidney beans (and many other legumes to variably lesser degree) naturally contain phytohaemagglutinins (PHA-E) which cause red blood cells to clump together. These can be reduces several orders of magnitude by repeated cooking, washing, and draining.
Men shouldn't eat too much soy or chia seeds. Small amounts of chia seeds are fine.
Most adults are lactose intolerant unless they have lactase persistence genes.
Spinach, pepper (the spice kind), rhubarb, almonds, and more contain oxalate that can lead to kidney stone formation. Excess vitamin C does also. Increasing citrate intake helps prevent calcium kidney stone formation, but doesn't help with oxalate kidney stones as much.
The list of antinutrients is long. Don't overdo eating one "natural" ingredient or another because that's the greatest risk of becoming a Chubbyemu video subject.
Exactly. Nature is there mostly to kill you, that is only natural, and thinking otherwise is basically resorting to divine. No living being wants to be food. There can be symbiotic behavior and plants can produce certain chemicals that attract animals that do some things for them like helping reproduction, but its huge stretch to claim that evolution optimizes for health by proxy. Most off beneficial effects of plant chemicals are due to shared pathways and hormesis.
Can you go into detail about these substances?
Maybe the fiber helps?
Fiber is great for gut health but it's actually works against nutrient absorption. Increasing fiber intake requires increasing intake of certain vitamins, possibly with supplementation.
It's better to eat things in moderation and know what antinutrients are in what foods. There are tradeoffs.
Exactly. Fiber sucks up some nutrients so they are either pooped out due to limited digestibility of the colon, or get consumed by gut bacteria.
Oddly erythritol is one of the few things I'm allergic to - it causes me to break out in hives.
Since I have to watch out for it, I've noticed it's becoming more and more common as a sweetener.
I find it flare IBS. Which means anything with Stevia I can't have as it appears erythritol is used, I think, as a bulking agent
I found a Stevia product, White Stevia, in my local organic market. It has maltodextrin added, but that's it. The downside is it's not measure-for-measure with sugar (1/6 tsp vs 1 tsp sugar).
https://www.nunaturals.com/products/stevia-white-stevia-powd...
I've consumed large amounts of erythritol for probably 10+ years. What should I watch for? Blood pressure?
I can not speak to this study, just my own anecdotal experience. I consumed sugar free monsters erythritol for a long time and it now causes pain in my left temple and visual auras in my left eye if I consume more than two cans in a day.
Unless you're a cell, this study isn't super relevant to you.
* It does not show human harm, only cellular disruption.
* It uses an unnatural exposure method.
* It builds on epidemiological correlations that may be reverse causality.
* It does not account for systemic factors, metabolism, or adaptive responses.
Yes the conclusion is baffling.
As you say I believe the correlation is reverse causality. It's much more likely that people who consume stuff with "artificial" sweetener are already at risk for stroke than the other way around.
If you don't have weight/cardio problems it is weird to consume "sugar-free" stuff and associated because they are almost always worse tasting than the real deal.
To have any importance they would need a big population sample and correct for already existing risks for stroke and I believe they would find that this stuff has very little impact, if any.
But as always, it doesn't cost much to limit consumption, so why not?
blood clots: https://www.nature.com/articles/s41591-023-02223-9.
Evidence in vitro suggests enhanced platelet activity. Plasma levels of erythritol are sustained for >2d above thresholds associated with platelet hyper-reactivity after consumption of realistic doses.
I use artificial sweeteners, but prefer sucralose or anything else to erythritol. I actually don't understand why people still use it (often in 'health food' because it's seen as 'natural'), there are much safer options.
I would discontinue it immediately, then focus on optimizing overall health, just as everyone else.
Hmm, the dose seems odd.
Would the whole drink amount really all be given to those cells?
I could be off, my molar math is pretty rusty, but a back of the envelope stab seems like 6mM concentration would be _way_ below the 30g "serving" in a drink so assume their "equivalent of" is taking into account the concentrations estimated in the body after consumption or some such.
Seeing as this is an in vitro study, they fall back on a specific human study (Witkowski et al., 2023) for many of the human effect claims. However the referenced study has a few issues:
- All study subjects had a "high prevalence of CVD [cardiovascular disease] and risk factor burden"
- Erythritol occurs naturally in the body and and this was not accounted for
- The study subjects were already suffering from cardiovascular disease and were likely to be consuming more artificial sweeteners than a general population, but this was not recognized or accounted for
- Erythritol's presence after a cardiovascular incident could be from consumption or from natural production but only baseline was measured despite data showing dramatic fluctuations after consumption
Another one of the studies cited for evidence of human claims (Khafagy et al., 2024) directly contradicts them. It stated said "we did not find supportive evidence from MR that erythritol increases cardiometabolic disease".
There are two more human studies referenced but I didn't read them.
Right but, what are the odds you aren't all that healthy to begin with if you decide to swap normal sweeteners for chemicals?
Using traditional sugar as a sweetener is well established as having negative effects, including inflammation. Many of the alternative sweeteners have a much lower glycemic index, so are thought to be healthier than ordinary sugar in that respect.
If you regularly consume ordinary sugar, you may be in the “not that healthy to begin with” category yourself.
"Normal sweeteners" are, in fact, chemicals.
For example erythritol itself occurs naturally in some fruit and fermented foods, making it a "normal sweetener".
It's only present in miniscule amounts in fruit and other produce. As a sweetener it's 1000x to 10000x more concentrated, which puts it in a completely different context.
and specifically in that high risk group, those chemicals are correlated with an even higher rate of cardiovascular issues than baseline
https://www.nature.com/articles/s41392-023-01504-6
Plenty of "fit" products like Quest protein bars use them
https://www.samsclub.com/p/quest-protein-bar-variety-chocola...
“Normal” sweeteners are also chemicals.
Probably a significant majority of Americans use sugar substitutes.
Of course, a significant majority of Americans aren't all that healthy - I guess I'm not sure what your point is.