WATCH — -4 pts

Erythritol

Flags: D-Y09

Also known as: E968, Sugar alcohol

Kids Beverages

What it is

Erythritol is a sugar alcohol (polyol) that occurs naturally in some fruits and fermented foods. Commercial erythritol is produced by fermenting glucose with yeast. It provides about 70% of the sweetness of sugar with minimal calories and no effect on blood sugar.

WATCH

A 2023 study published in Nature Medicine linked high circulating erythritol levels to increased cardiovascular events (heart attack, stroke, death) in adults. Pediatric data is extremely limited. While the study has limitations (observational, adult population), it raised sufficient concern for a WATCH flag in children's beverages.

Why it matters

Cardiovascular risk: 2023 Nature Medicine study associated high erythritol blood levels with major adverse cardiac events in adults
Platelet aggregation: erythritol enhanced platelet reactivity and thrombosis formation in mechanistic studies
Very limited pediatric safety data
GI disturbance at high doses (bloating, diarrhea), though less than other sugar alcohols

The research

The artificial sweetener erythritol and cardiovascular event risk

Witkowski M, Nemet I, Alamri H, et al. Nature Medicine, 2023. 29(3):710-718 PMID: 36849732 [Source]

"High circulating erythritol levels were associated with increased risk of major adverse cardiovascular events; mechanistic studies showed erythritol enhanced platelet reactivity and thrombosis"

Who should care most

Adults with cardiovascular risk factors (strongest evidence). Pediatric risk is uncertain due to lack of data. WATCH tier reflects precautionary concern.

How other countries handle it

Country	Status
United States	Permitted. FDA GRAS. No restrictions.
European Union	Permitted (E968). No restrictions.
Canada	Permitted.
Australia	Permitted.

Sources

The artificial sweetener erythritol and cardiovascular event risk. Witkowski M, Nemet I, Alamri H, et al. Nature Medicine, 2023. 29(3):710-718. PubMed 36849732

For informational purposes only. Not medical or dietary advice. Consult your pediatrician. Data current as of March 24, 2026.