Recently CNN.co.jp reported the following:
カロリーゼロの甘味料、心臓発作や脳卒中リスク増大と関係 米研究
2023.02.28 Tue posted at 14:43 JST
（ＣＮＮ） 砂糖の代替としてステビアなどの甘味料に使われている「エリスリトール」について、血栓や脳卒中、心臓発作や死亡リスク増大との関係を指摘する論文が、２７日の科学誌ネイチャー・メディシンに発表された。
論文は米クリーブランドクリニック・ラーナー調査研究所のスタンリー・ヘイゼン氏らのチームが発表。研究の結果、糖尿病など心疾患の危険を伴う基礎疾患がある人は、血中のエリスリトール濃度が高い場合、心臓発作や脳卒中のリスクが２倍になることが分かった。
「エリスリトールの血中濃度の値が上位２５％に入る人は、下位２５％の人に比べ、心臓発作や脳卒中のリスクが約２倍に増大する」とヘイゼン氏は解説する。
研究室や動物で行った研究では、エリスリトールに血小板の凝固を促進させる作用があるらしいことが分かった。血栓が飛び散って心臓に達すれば心臓発作を引き起こし、脳に達すれば脳卒中を引き起こす。
一方、業界団体のカロリー・コントロール・カウンシルはこの研究について、「エリスリトールのような低カロリー甘味料の安全性を示す長年の科学的研究に反している。安全性は、食品や飲料への使用を認めた世界中の規制によって裏付けられている」と反論している。
エリスリトールは、ソルビトールやキシリトールと同じような炭水化物の糖アルコールで、多くの果物や野菜に含まれる。専門家によると、甘さは砂糖の７０％程度で、ゼロカロリーと考えられている。
人工的に大量生産されたエリスリトールは、他の糖アルコールに比べて後味が残らず、血糖値の上昇を引き起こさず、緩下剤効果は低い。
ヘイゼン氏によると、そうした特徴のためにエリスリトールは食品業界が好んで使うようになり、低炭水化物製品や糖尿病患者向け食品の添加物として重宝されるようになった。「我々が調査した糖尿病患者向け食品の中には、どの商品よりもエリスリトールの含有量が多いものもあった」と同氏は話す。
「天然」ステビアやモンクフルーツ（ラカンカ）などの製品でも、成分に占める含有量はエリスリトールが最も多いという。ステビアやモンクフルーツは砂糖のおよそ２００～４００倍の甘さがあることから、どんな商品でもほんの少量しか必要とされない。そうした商品の大部分を占めるエリスリトールは、消費者が期待する砂糖のような外観や食感を加えられる。
もともとヘイゼン氏の研究の目標は、血中に含まれる未知の化学物質や成分を発見して、心疾患や脳卒中、あるいは３年以内の死亡リスク予測に役立てることにあった。その目的で同氏のチームは、２００４年～１１年の間に採取された心臓病のリスクをもつ人１１５７人の血液サンプルを調べた。
「我々は大きく関与しているらしい物質を発見した。だがそれが何なのかは分からなかった」とヘイゼン氏は言う。「やがて、それが甘味料のエリスリトールだったことが分かった」
エリスリトールは人体でも生成されるが、極めて少量にとどまる。研究チームが測定した量は、その水準ではなかった。
調査結果を裏付けるため、研究チームはさらに米国の２１００人あまりの血液サンプルと、欧州で採取された８３３人のサンプルを調査した。調査対象者は３グループとも、約４分の３に冠動脈疾患や高血圧の症状があり、約５分の１は糖尿病だった。半分以上は男性で、年齢は６０代から７０代だった。
調査の結果、３グループ全てで、エリスリトール濃度の高さと、心臓発作や脳卒中、３年以内の死亡リスクとの関係が判明した。
その理由を調べるため、研究チームは動物実験や研究室での実験を行い、エリスリトールに血液の凝固を誘発させる作用があることを発見した。
人体は傷口からの出血を止めるために、血液凝固を必要とする。ただ、血小板によって作られる血栓の大きさは、細胞を刺激するトリガーの大きさによって決まる。例えばトリガーが１０％であれば、血栓も１０％にとどまる。
「しかしエリスリトールがあると、血小板がスーパー反応を引き起こす現象がみられた。たった１０％の刺激で９０％～１００％の血栓ができる」（ヘイゼン氏）
「血栓や心疾患、脳卒中のリスクを持つ人は、心疾患や糖尿病の基礎疾患がある人と同様に、さらなる研究が行われるまで、エリスリトールを控えた方がいいことを裏付けるに足るデータが得られたと思う」とヘイゼン氏は話している。
Translation
(CNN) A paper published in the journal Nature Medicine on the 27th announced that Erythritol, a sugar substitute used in sweeteners such as stevia, could be associated with an increased risk of blood clots, stroke, heart attack and death,
The paper was published by a team led by Stanley Hazen of the Cleveland Clinic Lerner Research Institute. The study found that people with underlying health conditions that put them at risk for heart disease, such as diabetes, were twice as likely to have a heart attack or stroke if their blood levels of erythritol were high.
Hazen explained that "People with blood levels in the top quartile of erythritol have about twice the risk of heart attack and stroke as those with the bottom quartile."
Laboratory and animal studies had shown that erythritol appeared to promote platelet clotting. If a blood clot scattered and reached the heart, it would cause a heart attack; if it reached the brain, it would cause a stroke.
Andrew Freeman, an expert not involved
in the study, said that "there appears to be a risk of blood clots from
erythritol use," noting that "further research is needed, but it may
be better to limit erythritol in the diet for the time being, just in
case."
Meanwhile, the Calorie Control Council, an industry group, countered the study in saying that "it runs counter to years of scientific research demonstrating the safety of low-calorie sweeteners like erythritol, Safety is backed by regulations around the world in authorizing its use in food and beverages."
Erythritol was a carbohydrate sugar alcohol, like sorbitol and xylitol, found in many fruits and vegetables. Experts said it was about 70% as sweet as sugar and was considered to have zero calorie.
Erythritol, which was mass-produced artificially, compared to other sugar alcohols did not leave an aftertaste, did not cause a rise in blood sugar levels, and had a lower laxative effect than other sugar alcohols.
Hazen said that these properties had made erythritol a
favorite in the food industry, making it a valuable addition to low-carb
products and food for diabetics. He said "Among the diabetic foods we
investigated, some of the diabetic foods had more erythritol than another."
Erythritol was the most abundant ingredient in products such as 'natural' stevia and monk fruit. Stevia and monk fruit were roughly 200 to 400 times sweeter than sugar, so only a small amount of any product would be needed. Erythritol, which made up most of such products, had been added a sugar-like look and texture that consumers expected.
The original goal of Hazen's research was to discover unknown chemicals and constituents in the blood, and to use that to predict the risk of heart disease, stroke, or death within three years. To that end, between 2004 and 2011, his team looked at blood samples taken from 1,157 people who were at risk of heart disease.
Hazen said, "We found a substance that seemed to play a big role, but we didn't know what it was” ;"Eventually we found that it was the sweetener erythritol."
Erythritol was also produced by the human body, but in a very small amount. The amount the research team detected was not at that level.
To corroborate their findings, the researchers also examined more than 2,100 blood samples from the United States and 833 samples from Europe. About three-quarters of all three groups had symptoms of coronary artery disease or high blood pressure, and about one-fifth had diabetes. More than half were men, aged between 60 and 70.
The study found that high erythritol levels were associated with increased risk of heart attack, stroke, and death within three years in all three groups.
To find out why, the researchers conducted animal tests and laboratory experiments and discovered that erythritol has the ability to induce blood clotting.
The human body needed blood clotting to stop bleeding from wounds. However, the size of the clot formed by platelets would be determined by the size of the trigger that stimulated the cells. For example, if the trigger was 10%, the blood clot remains at 10%.
"However, when erythritol was present, a phenomenon was observed in which platelets elicited a super-reaction. A mere 10% stimulation can result in 90% to 100% blood clot." (Hazen)
Hazen said, "I think there are enough data to support the
suggestion that people at risk for blood clots, heart disease and stroke, as
well as those with underlying heart disease and diabetes should avoid
erythritol until further research is done".
So, a
research paper announces that Erythritol, a sugar substitute used in sweeteners
such as stevia, is associated with an increased risk of blood clots, stroke,
heart attack and death, and people at risk of these health hazards should avoid
erythritol until further research is done. This is a shocking discovery and I
think further research should be done urgently.
Note:
1. Monk fruit
is a small, green gourd that resembles a melon. It is grown in Southeast Asia.
The fruit was first used by Buddhist monks in the 13th century, hence the
fruit’s unusual name. Monk fruit sweeteners are made from the fruit’s extract.
They may be blended with dextrose or other ingredients to balance sweetness. Monk
fruit extract is 150 to 200 times sweeter than sugar. The extract contains zero
calories, zero carbohydrates, zero sodium, and zero fat. This makes it a
popular sweetener alternative for manufacturers who make low-calorie products. (https://www.healthline.com/health/food-nutrition/monk-fruit-vs-stevia)
2. Stevia is 200 to 300 times sweeter than sugar. Commercial stevia sweeteners are made from a compound of the stevia plant, which is an herb from the Asteraceae family. The use of stevia in foods is a bit confusing. Despite being used for centuries as a natural sweetener, the FDA considers them unsafe. They claim literature indicates stevia in its most natural form may affect blood sugar. It may also affect reproductive, renal, and cardiovascular systems. (https://www.healthline.com/health/food-nutrition/monk-fruit-vs-stevia#stevia)
3. Luo Han Guo (ラカンカ, 羅漢果, Siraitia grosvenorii) also known as monk fruit is native to southern China. The plant is cultivated for its fruit extract,
called mogrosides, which creates a sweetness sensation 250 times stronger than
sucrose. Mogroside extract has been used as a low-calorie sweetener for drinks
and in traditional Chinese medicine. (Wikipedia)
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