Quick Summary tl;dr

Recent studies suggest that erythritol might increase the risk of blood clots, especially in people with pre-existing conditions like cardiovascular disease, diabetes, or clotting disorders.

However, the research has its limitations: the study involved a relatively small group of participants, tested a higher amount of erythritol (30g), involved the consumption of erythritol in isolation, and measured blood levels only once rather than at multiple intervals. Additionally, the study focused solely on short-term effects.

As someone with Factor V Leiden, a condition that raises my risk of clotting, I’ve personally cut back on erythritol, balancing it with other sweeteners like allulose and stevia. While I’m not eliminating it entirely, I’m mindful of how much I use.

For many, erythritol is still a useful option in low-carb and keto recipes, but it’s important to stay informed and make choices based on your own health.

In recipes, erythritol plays a crucial role in providing bulk, sweetness, and texture—especially in baked goods. It’s not always easy to replace, but alternatives like allulose, xylitol, monk fruit, and stevia can work, depending on the recipe.

Table of Contents

Have you ever found yourself rethinking something after hearing more about it? That’s exactly where I’ve been with erythritol lately. After writing about it before, I’ve taken some time to really think through the latest research and what experts have been saying. So, if you’re like me and want to get to the bottom of things—especially when it comes to something that’s in our food—stay with me.

Now, this might be a bit longer, but I promise it’ll be worth your time (and if you’re short on time, there’s always the TLDR!). You’ll hear a lot about erythritol online, from health influencers to food bloggers, but the real question is: Should you be worried?

As I’ve always said, I’m not a scientist, just someone who loves science, trying to understand what’s out there. I've done my best to carefully weigh the findings without jumping to conclusions. This isn’t about telling you to love or leave erythritol, but about sharing what the latest study says, and whether it might change the way we think about it in our keto recipes.

The First Erythritol Study: A Recap of Previous Concerns

So, before we dive into the new study from August 2024, let’s quickly revisit what had us all talking in the first place. Last time, we discussed how  this study from 2023 showed a possible link between high erythritol levels and an increased risk of cardiovascular events—think heart attacks and strokes. The idea was that erythritol might make your platelets (those tiny blood cells that help clots form) more “sticky,” potentially increasing the risk of clots.

I know, it sounded a bit alarming. But at that point, I urged caution instead of panic. After all, while the findings were concerning, the real-world implications weren’t totally clear. Was erythritol really the cause? Or could it be that people with higher cardiovascular risks were just more likely to consume it? That’s where the debate really began.

The New Erythritol Study: What’s New?

Now, here’s where things get interesting. The new study looked at what happens when people consume erythritol versus glucose. They took 20 healthy volunteers and gave them either 30 grams of erythritol (yep, that same amount you might find in some of your favorite keto treats, or at least the sweeter ones) or glucose, then measured how their platelets responded.

The results? Erythritol led to significantly higher platelet activity, which means it could increase the risk of blood clots. Glucose didn’t have the same effect, making erythritol the one under the spotlight here.

What does that mean for you and me? Well, it suggests that erythritol could affect how our blood clots, especially if we consume it in larger amounts. It’s a bit of a red flag, but as always, there’s more to the story.

Breaking Down the Methods

Let’s take a quick peek at how the researchers figured all of this out. They didn’t just make assumptions—they got into the nitty-gritty. The study involved 20 healthy volunteers, split into two groups: one drank a solution with 30 grams of erythritol, and the other had glucose. Then, the researchers measured platelet reactivity before and after.

This point is important because  unlike the previous study, which primarily examined participants with cardiovascular conditions, this study focused on healthy individuals. The earlier research raised some questions about whether pre-existing health issues could have influenced the results. This new study provided clarity by showing that even in healthy people, erythritol could lead to an increased risk of clot formation.

What did they find? Erythritol led to a big spike in platelet activity, meaning those platelets were more likely to form clots. The results were pretty consistent across participants.

But here’s an important note: the study only looked at what happened over a short period of time, just 30 minutes after consumption. So, while it’s telling us something about immediate effects, we don’t yet know how erythritol might affect us in the long run.

Study Limitations: What’s Missing?

As with any study, there are a few limitations worth noting—some mentioned by the researchers, and others that become clear when we dig deeper.

1. Highly Controlled Consumption

In this study, participants fasted overnight and consumed either erythritol or glucose on an empty stomach. This doesn’t exactly mirror how we typically consume sweeteners in real life. Most of us include erythritol in foods or drinks that also contain fat, protein, or fiber—nutrients that can slow down the absorption process. Consuming erythritol in isolation gives us limited insight into how it affects our bodies when it's part of a balanced meal.

2. Single Blood Test Timing

The study measured the participants’ blood levels only once, 30 minutes after consumption. This doesn’t give us the full picture. Blood sugar levels, for example, fluctuate at different times after eating, so it’s likely erythritol levels would too. Testing at additional intervals—like 1 or 2 hours post-consumption—would have provided more comprehensive data about how erythritol behaves in the bloodstream over time, similar to what they did in the previous study in 2023.

3. Short-Term Focus

The focus was on immediate, short-term effects, which are useful but don’t tell us much about what happens over longer periods. We still don’t know how moderate, repeated erythritol consumption affects the body after days, weeks, or even months. This makes it difficult to draw conclusions about its safety for regular, long-term use.

4. Relatively Small Sample Size

The study only involved 20 participants, which is a relatively small group. While the results were consistent, a larger sample size would give us more confidence in the findings and allow for a broader range of health conditions and lifestyles to be factored in.

Is 30 Grams of Erythritol a Lot?

Some critics of this study argue that 30 grams of erythritol is too much—but is it? The amount consumed in the study—30 grams—may seem high to some, but for those who regularly consume erythritol, it’s not that uncommon.

From my experience creating low-carb recipes, certain keto treats can contain close to this amount. For example, a chocolate mug cake with frosting could easily have 30 grams of sweetener if you eat the whole thing. Of course, not everyone would eat that much, especially after getting used to low-carb eating, when sweet cravings tend to fade.

And it’s not just homemade recipes. Ready-made products like bars and drinks often contain significant amounts of sweeteners, and the total can quickly add up. So, while 30 grams might sound like a lot, for regular consumers of keto desserts or sweetened snacks, it’s not entirely unrealistic.

Bottom line: These limitations don’t erase the findings, but they remind us that there’s still a lot more to understand about erythritol’s role in our diets—especially in real-world settings.

Who Should Be Concerned About Erythritol?

Now, this is where things get personal. Should you be worried about erythritol based on this study? Well, I’m not here to give you definitive answers—after all, that’s not my place, and it’s a decision that’s deeply personal, depending on your own health situation.

The study does raise concerns, particularly for people who already have health conditions that make them more prone to blood clots or cardiovascular issues. If you have a history of heart disease, diabetes, or clotting disorders, it might be worth paying closer attention to your erythritol intake. It’s also something to consider for those at higher risk of cardiovascular events due to age or other factors.

My Approach: A Balanced Perspective

As for myself, with  Factor V Leiden (a genetic condition that increases my risk of blood clots), this puts me in one of the groups who might need to be more careful. During my pregnancy and a few months postpartum, I was on blood thinners to manage this risk. While I haven’t noticed any adverse effects from my erythritol use, it’s something I’ve kept in mind ever since the initial studies came out in 2023.

Since then, I’ve cut back on my erythritol consumption—not eliminating it completely, but balancing it with other sweeteners like allulose, monk fruit, or stevia extract. And just to be clear, I never consume erythritol in large quantities anyway—certainly not the 30 grams they tested in the study. But I do use it moderately in recipes, and I’m comfortable with that for now. Just to give you an idea, I still have the same bag of erythritol from 2023 when the last study came out.

Ultimately, we all have to evaluate our own comfort level with the potential risks. For some, cutting back might be the right move; for others, the occasional use in moderation might feel fine. As always, it's a matter of understanding the science and making informed choices that suit your own health and lifestyle. As I said before, for me Erythritol is not an essential ingredient.

The Role of Erythritol in Recipes: Is it Easy to Replace?

For those of us who enjoy low-carb or keto baking, erythritol is more than just a sweetener—it’s a crucial ingredient in achieving the right texture and taste in many recipes. Unlike some other sugar substitutes, erythritol brings a unique combination of properties that make it particularly valuable in baking and desserts.

1. Sweetness with Bulk

Erythritol is about 60-70% as sweet as sugar, and unlike concentrated sweeteners like stevia or monk fruit, it adds bulk to recipes. This is especially important in baked goods where texture matters, like cookies, cakes, or muffins. Allulose and xylitol also provide sweetness with bulk.

2. No Bitter Aftertaste

One of erythritol’s biggest selling points is that it has little to no aftertaste, unlike some sweeteners that can leave a lingering bitterness. This makes it a popular choice in desserts where flavor is key. However, it does have a cooling effect, which some people notice as an aftertaste, though most don’t mind it.

3. Crucial for Crunch

In recipes like Keto Shortbread Cookies or crunchy biscuits, erythritol is what provides that crisp texture we all love. If you swap it for something like allulose, you’ll end up with a chewier result, which may or may not be what you’re looking for. There is no alternative to Erythritol that would help you achieve the same crunchy results. If you use allulose or xylitol, you will end up with softer, chewier cookies.

4. Less Expensive

While allulose is gaining popularity for its similar properties, it’s still more expensive than erythritol or xylitol. If you're using sweeteners regularly in your recipes, erythritol is generally a more budget-friendly option, making it accessible for everyday use.

5. Widely Available

Another big advantage of erythritol (and also xylitol) is that it’s widely available in most countries, whereas allulose is still relatively new and not yet sold everywhere. If you live outside the U.S., you may find it harder to get your hands on allulose, whereas erythritol can usually be found in most supermarkets and online. That said, Allulose was recently approved in Australia, which is great news for its growing availability.

6. Almost Zero Calories

Compared to xylitol, which is also commonly available, erythritol has the benefit of being almost calorie-free (just like allulose). It contains about 0.2 calories per gram, whereas xylitol contains 2.4 calories per gram—much closer to regular sugar. Also, while xylitol is toxic to dogs, erythritol is considered safe for pets, which is something to keep in mind if you have furry friends at home.

In short, while erythritol plays an important role in low-carb recipes, it’s not irreplaceable. Depending on what you're baking or cooking, you can experiment with substitutes that suit your needs while balancing any health concerns you may have. Just be mindful of how different sweeteners affect the final outcome in terms of sweetness, texture, and availability.

Conclusion

Erythritol remains a popular choice for many following a low-carb or keto lifestyle, but the recent studies have raised some important questions, especially for those with specific health concerns. While the research has limitations, staying informed and making thoughtful choices is key. Whether you continue using erythritol or explore alternatives like allulose, monk fruit, or stevia, the best approach is to choose what works for your health and personal preferences.



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Is This the End of Erythritol? What This Study Means for Low-Carb Recipes

I’m so excited to share something special today! If you’re a fan of my Classic Keto Tiramisu (which received rave reviews!), you’ll love this fruity twist. This Low-Carb Strawberry Tiramisu is light, creamy, and bursting with fresh strawberry flavor. It’s the perfect dessert for any occasion and, of course, it’s keto, sugar-free, and gluten-free. Our newsletter subscribers got a sneak peek, and now it’s time for everyone to enjoy!

Why This Recipe Is So Good

  • Low-Carb & Keto-Friendly: Made with keto ingredients to keep carbs low.
  • Fresh Strawberry Twist: Uses fresh strawberries and sugar-free syrup for natural sweetness.
  • Creamy & Light: Mascarpone, whipped cream, and sour cream create a perfect balance of texture.
  • Gluten-Free Ladyfingers: Almond and coconut flour-based, making them gluten-free and keto-friendly. They are just as light and sweet as regular ones!
  • Caffeine-Free and Alcohol-Free: Unlike traditional tiramisu, this version skips the coffee and booze, making it ideal for everyone!

Recipe Tips and Swaps

This Low-Carb Strawberry Tiramisu is already packed with great flavors and keto-friendly ingredients, but there are always a few ways to customize it based on your preferences or what you have on hand. Here are some tips and easy swaps:

  • Sweetener: Allulose works well here for a smooth texture, but you can also use powdered Erythritol or monk fruit sweetener. Just be mindful that different sweeteners may vary in sweetness, so adjust to taste. Also note that Allulose won't make these ladyfingers as crunchy as Erythritol but in this case it doesn't matter as they will be soaked in syrup anyway.
  • Flour Options: The combination of coconut and almond flour gives the ladyfingers the perfect structure. If you're out of coconut flour, swap it with more almond flour, but increase the amount by about four times since coconut flour is more absorbent.
  • Strawberry Syrup: If you don't have time to make the Sugar-Free Strawberry Syrup (which is really easy!), you can blend fresh strawberries with a little keto sweetener for a quick alternative. This keeps it fresh and fruity!
  • Mascarpone Substitute: If you can't find mascarpone, cream cheese can be used instead. It will slightly change the flavor, closer to a cheesecake, but it will still work well in the cream layer.
  • Berry Powder Topping: The optional topping of strawberry, beetroot or dragonfruit powder adds a pop of color, but if you don't have those, just skip it or use extra fresh strawberries for garnish.

Tips for the Best Low-Carb Strawberry Tiramisu

To make sure your tiramisu turns out just right, here are a few helpful tips:

  • Whip the Cream Properly: Make sure to whip the mascarpone, heavy cream, and sour cream until they form soft peaks. Over-whipping can make the mixture too stiff. Under-whipping would not firm up properly.
  • Don’t Overbake the Ladyfingers: Almond flour burns easily. Keep an eye on the ladyfingers while they bake to prevent them from becoming too dry. They should be golden to light brown. Anything over that might make them bitter. Rotating the tray once or twice will help you avoid a disaster.
  • Chill for Best Results: Super important! Allow the tiramisu to chill for at least 2 hours (longer is better). This helps the flavors meld and the texture firm up.
  • Cut Clean Slices: For cleaner slices, use a sharp knife and wipe it between cuts to avoid dragging the cream layer.

Storage Tips

Store the tiramisu in the fridge, covered, for up to 4 days. For longer storage, freeze it for up to 1 month and thaw in the fridge before serving.

Low-Carb Recipes You Will Love

Love anything tiramisu? Here are more keto recipes you should try!

Preparation time

Hands-on:     30 minutes
Overall:     3-4 hours

Nutritional values (per serving, 1 slice)

Total Carbs 10.1 grams
Fiber 2.3 grams
Net Carbs 7.8 grams
Protein 9 grams
Fat 32.7 grams
of which Saturated 17.8 grams
Energy 371 kcal
Magnesium 36 mg (9% RDA)
Potassium 248 mg (12% EMR)

Macronutrient ratio: Calories from carbs (9%), protein (10%), fat (81%)

Ingredients (makes 8 servings)

Ladyfingers:
Strawberry soak:
Cream layer
  • 1 pack mascarpone cheese (250 g/ 8.8 oz)
  • 1 cup heavy whipping cream (240 ml)
  • 1 3/4 cups sour cream (400 g/ 14.2 oz)
  • 1/4 cup powdered low-carb sweetener like allulose (40 g/ 1.4 oz)
  • Fine zest from 1/2 organic lemon
  • 1 tsp sugar-free vanilla extract
  • 400 g fresh strawberries (14.1 oz)
  • Optional for topping: freeze-dried strawberry powder, beetroot powder, or dragonfruit powder (I used a mixture of 1/2 tbsp beetroot and 1/2 tbsp dragonfruit)

Instructions

  1. Before you start, make sure you've got the Sugar-Free Strawberry Syrup. You can prepare it now or while the ladyfingers are baking. If Prepare the ladyfingers. Preheat the oven to 160 °C/ 320 °F (fan assisted), or 180 °C/ 355 °F (conventional).
  2. Line a baking tray with parchment paper. Separate the egg whites from the yolks. Cream the yolks with the powdered sweetener until pale and creamy.
  3. In another bowl, whisk egg whites with cream of tartar (or lemon juice) until stiff peaks form.
  4. Fold the egg yolk mixture into the egg whites, followed by the vanilla. Sift in the coconut and almond flour, then gently combine.
  5. Spread the mixture onto the lined tray (26 cm x 26 cm/ 10 inch x 10 inch) and bake for 15 minutes.
  6. Lower the oven temperature to 140 °C/ 285 °F (fan assisted), or 160 °C/ 320 °F (conventional), and bake for another 30 minutes, rotating the tray halfway.
  7. Let the ladyfingers cool for 5 minutes before cutting into 24 pieces.
  8. Prepare the cream layer by whipping mascarpone, whipping cream, powdered sweetener, lemon zest, and vanilla until fluffy.
  9. When ready to assemble, start by layering half of the ladyfingers drizzled with half of the strawberry syrup in a 30 cm x 20 cm (12 inch x 8 inch) dish.
  10. Add half of the sliced strawberries, and half of the cream mixture.
  11. Repeat the layers. Add the remaining ladyfingers drizzled with the remaining strawberry syrup. Top with the remaining strawberry slices, and finally add the remaining whipped cream mixture.
  12. Smoothen with a spatula. Dust with berry powder if desired, or use more sliced strawberries for topping. Chill in the fridge for 2 hours before serving, and enjoy!


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The Best Low-Carb Strawberry Tiramisu

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