The sugar alcohol erythritol is naturally occurring in some fruits such as grapes, melons, pears and fermented products like soy sauce, red wine and cheese. In addition, erythritol is an endogenously occurring polyol. A study published in early 2023 in Nature Medicine entitled “The artificial sweetener erythritol and cardiovascular event risk” has caused quite some controversy and uncertainty in the nutrition field inter alia clinicians and dieticians as well as the general public. The data presented in this paper seem to be interpreted in a way that consumption of erythritol leads to a significantly increased risk of suffering “cardiovascular events” [death or non-fatal heart attack or non-fatal stroke, summarized as “major adverse cardiovascular events” (MACE)].

This article first provides a summary of the results of the study by Witkowski and Nemet et al. and a critical evaluation of whether or not there are enough research data available to conclude with confidence, whether or not dietary erythritol intake is associated with enhanced cardiovascular risk or death. In addition, we briefly discuss endogenous erythritol synthesis and selected studies reporting the effect of erythritol intake on other diseases.

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