This content was created by Nick Norwitz. This content was uploaded by Nick Norwitz. This is a YouTube video titled "Is This The End of Erythritol?" (published 2025-02-09) presented by Nick Norwitz. It is a single-speaker video review of recent research comparing effects of the sugar alcohol erythritol and the rare sugar allulose on platelet aggregation, mitochondrial function, and potential cardiovascular risk. The presenter summarizes mouse and human-data (mice fed a Western-style diet; human samples: 18 sickle cell patients vs 12 controls), explains that erythritol exacerbated pro-thrombotic/sickle-cell-related pathways while allulose had opposing, protective effects, and discusses mechanistic findings (electron transport chain/ATP synthesis changes). He discloses he is on the scientific advisory board of RXSugar (an allulose company) and provides a discount code, and notes the study funding and absence of declared conflicts.
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I just came across new data that has me asking the provocative question: Is this the end of erythritol? Now, for context, there have been several high-profile papers recently raising concerns about the common no-calorie sugar alcohol erythritol, which is in many common products like dark chocolates and popular reduced sugar ice creams. And specifically, there is concern over whether erythritol promotes blood clots, and can even contribute to increased risk of cardiovascular events. And as a quick aside, it appears some of the companies making erythritol-based products are even aware of the bad rap erythritol has acquired since they're presenting misleading packaging apparently meant to cover up erythritol's presence in their products. Hmm, little suspicious. But this video isn't going to be about big food marketing or lawsuits rendered against the Hershey's Company. No, I want to review new research that I found fascinating about erythritol and another sweet molecule, allulose, which I'll get to in a little bit. Also blood clottingness and sickle cell disease. And if you don't know what sickle cell disease is, don't worry, I'll explain what it is and why it's relevant momentarily. But to cut to the chase, This new research looked at pathways related to platelet aggregation, the basis of blood clot formation, in mice fed a high-carb, high-fat Western-style diet. And they found that the Western-style diet increased pathways related to platelet aggregation and blood clots, and that erythritol made this effect even worse.— it exacerbated it. So, in effect, erythritol was the cherry on top of the blood clot sundae. How's that for dark chocolate humor? But sweet puns aside, back to the data. Using what's called gene set enrichment analysis, they also looked at genetic pathways upregulated and downregulated in sickle cell disease, a common inherited genetic disorder affecting 1 in about 365 Black individuals and 8 million people worldwide. Sickle cell disease is characterized by the literal sickling of blood cells in vessels, which causes them to get stuck in smaller blood vessels and cause clots. And this can have many serious consequences, including anemia, stroke, increased risk of infection, and chronic damage to the heart, kidneys, lung, and bones. It can cause bone death. And extreme, extreme pain. It's a common and serious clotting disorder. And in this study, they use samples from 18 human patients with sickle cell disease and 12 healthy control patients to help elucidate the potential clinical relevance of their findings. And they found that erythritol mimicked many of the pathways upregulated in sickle cell disease. This blood clotting disorder. The authors wrote, they literally wrote, "Erythritol mirrors sickle cell disease pathways." And as part of this study, they also tested another sugar substitute, the rare natural low-calorie sugar allulose, a topic I've covered before in some depth on this channel. And very interestingly, opposite to erythritol, which again increased platelet aggregation and sickle cell disease pathways, allulose actually reduced blood clot effect and opposed sickle cell disease pathways. You can see that very clearly here in Figure 3A, which I've recreated for ease of reading for you. And what you see here is a dot plot of platelet activation and sickle cell disease gene groups organized by treatment. Each row is a gene group and each column is a treatment, with red indicating pathway upregulation and blue indicating pathway downregulation. And it's not really important for you to know what each pathway is. What is critical to point out is that sickle cell disease, column 1, and Western-style diets, column 2, lead to increases in these blood clotty pathways., and erythritol treatment further exacerbates this effect on top of Western diet. That's column 4. But allulose is the standout, clearly having an opposite effect since it's the only column on the blue downregulation side of the spectrum. You can see if you look column by column, allulose stands out blue on red. It's as clear as night. And day, or literally as red versus blue. Now, in trying to dissect the mechanisms underlying the opposing effects of erythritol versus allulose on platelet aggregation, and by extension, blood clotting and possible cardiovascular risk, the researchers examined the effect on mitochondrial function and mitochondrial pathways, and they found that erythritol caused downregulation of electron transport chain and ATP synthesis pathways, which in effect hinders mitochondrial function. The erythritol was hindering, harming mitochondrial function. And this was in parallel, similar to sickle cell disease. But by contrast, allulose again had this opposite effect, enhancing electron transport chain and ATP synthesis pathways. Predicted to reduce cellularly harmful oxidative stress and boost mitochondrial function. Now, to reinforce this, and as stated by the authors, the ability of allulose to improve ATP production and mitigate oxidative stress could be critical, could be a critical mechanism through which it, allulose, modulates platelet function and reduces the prothrombotic environment. I.e., reduces blood clottiness. And they, the researchers, advocate that allulose is a safer alternative to erythritol, particularly in individuals at heightened risk for thrombotic events, including those with sickle cell disease or those eating a Western-style diet. Now, for an important and relevant tangent, because I know I will get asked this question given how the data fell. And it's a fair question. Was this research paid for by Big Allulose? And the short answer is no, it was not. This research was funded by National Korean Research Foundation grants, the following grant numbers, and the authors reported no conflicts of interest. Now, I, I being Nick Norwitz, was in no way involved in this research or its publication. I'm just reporting on the data. But I do have a disclosure that I'm on the scientific advisory board of RXSugar, a company that specializes in the sale of allulose-based products. And I'm 100% above board about that. I don't want to hide anything there. But I joined the science board because I found the science genuinely fascinating. The science of allulose is actually really, really cool. And I also respect fellow members of the scientific advisory board, maybe names you know, like Dr. Dominick D'Agostino, Dr. Benjamin Bikman, Dr. Andrew Kutnick, Dr. Richard Johnson, and many others. It's a really awesome team that I'm happy to be a part of, and I truthfully believe in the company's mission of displacing sugar from the food environment with a metabolically superior alternative, allulose. The data keep on leaning in that direction. Now, the big question: do you need sweet metabolically? No, of course you don't, but practically many people will choose to have it, and I think that allulose is the best option as far as sweets go. If data can convince me otherwise, I'll happily change my tone on that. But thus far, the metabolic health data, including this paper, ring in favor of allulose over other sweet molecules, as far as I'm aware. And if you are interested in trying RX Sugar products, you can use my discount code NICK20. And if you want more on the topic of allulose, in natural and artificial sweeteners, I'll provide a whole series of video links in the notes below to delve into the cellular biology and also the human randomized controlled trials on this topic of artificial and natural sweeteners, in case this video stimulated your craving for more knowledge.
