One of the cited studies (Khafagy et al., 2024) directly contradicts such claims. The study explicitly said "we did not find supportive evidence from MR that erythritol increases cardiometabolic disease".
The primary human study they reference (Witkowski et al., 2023) has a few issues:
- All subjects had a "high prevalence of CVD and risk factor burden" and represented the sickest patients in the healthcare system
- Erythritol was measured only once at baseline, despite data which shows that levels fluctuate dramatically with consumption
- It did not differentiate between dietary intake and erythritol produced by the body
- Seeing as they were already sick they the subjects may have been consuming more artificial sweeteners than the general population
There are two more human studies referenced but I didn't read them.
The article points out that similar observations have already been made in human subjects:
> Positive associations between circulating erythritol and incidence of heart attack and stroke have been observed in U.S. and European cohorts