Declines in plasma erythritol and improvements in cardiovascular disease risk and atherogenic lipid profiles: a 2-year randomized weight-loss dietary intervention trial.
Yoriko Heianza, Jennifer C Rood, Catherine M Champagne et al.
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In 30 seconds
This observational analysis of a 2-year randomized dietary-intervention trial examined whether changes in plasma polyols tracked with cardiovascular risk and lipid changes in adults with overweight or obesity. Higher baseline levels of erythritol and two other polyol measures were associated with higher estimated 10-year ASCVD risk. Among polyols, only greater erythritol declines were associated with lower risk estimates; a 1-SD reduction corresponded to a 0.16% decrease at 6 months (SE 0.07%; P = 0.023). Early erythritol declines were also associated with 2-year improvements in estimated risk and apoC-III-containing lipoprotein cholesterol.
Key findings
- Higher baseline erythritol, arabitol/xylitol, and mannitol/sorbitol were each associated with higher ASCVD risk estimates (P < 0.001 for all).
- A 1-SD reduction in erythritol was associated with a 0.16% reduction in ASCVD risk estimates at 6 months (SE 0.07%; P = 0.023); other polyol changes were not significantly associated.
- Six-month erythritol declines were associated with 2-year ASCVD risk improvement (β: -0.26%; SE: 0.11%; P = 0.016) and lower cholesterol in VLDL + LDL containing apoC-III.
Why it matters
The findings connect changes in circulating erythritol during dietary weight-loss interventions with estimated ASCVD risk and atherogenic lipid subtypes. They suggest erythritol may be a marker related to cardiometabolic improvement, while the observational analysis does not establish that lowering erythritol itself produces these benefits.
What to keep in mind
Although the parent trial was randomized, this was an observational analysis of biomarker changes and outcomes; the reported associations do not establish causality.