Iron Gummies with Vitamin C

Witkowski et al. 2023 (Nature Medicine, PMID 36849732) reported elevated plasma erythritol associated with major adverse cardiovascular events (MACE) in two cohorts (n=4,000+), with in-vitro and ex-vivo evidence of enhanced platelet aggregation. Replication is ongoing; FDA and EFSA have not changed their safety positions, but the signal is real and the additive is purely cosmetic. Better-established concern: GI tolerance — single doses above ~50 g cause osmotic diarrhea. Lower threshold for children.

Worst GI tolerance of the common sugar alcohols — laxative effect at doses above ~10–15 g/serving in many adults; threshold is lower in children. Glycemic index (~52) is significantly higher than erythritol (0) or xylitol (~7) — meaningful blood glucose impact at typical serving sizes. The 'sugar-free' marketing claim masks real metabolic effects when consumed in quantity.

Juice or juice concentrate used primarily for natural color and flavor in gummies

Broad regulatory category of flavor constituents derived from natural sources. Composition is proprietary and not disclosed — 'Natural Flavors' can include several hundred different compounds depending on the target flavor profile, including hexane-extracted constituents and proprietary carrier solvents. 'Natural' is a regulatory definition (21 CFR §101.22), not a safety guarantee.

A gelling polysaccharide extracted from red seaweed

A galactomannan gum from carob tree seeds used as a thickener and stabilizer

Zero-calorie natural sweetener extracted from the leaves of Stevia rebaudiana

Water meeting USP specifications used as solvent/vehicle in gummies and liquids