Feb. 28, 2023 – A commonly used artificial sweetener called erythritol is strongly linked to a higher risk of heart attack and stroke, according to a new study.
The sweetener, which is made from fermented corn, is commonly used in products that are designed to be low-calorie, low-carbohydrate, or for people on keto diets. Some table sugar replacement products also use it, such as the product Truvia.
Sugar substitutes are commonly recommended for people with diabetes or obesity to control blood sugar levels or to lose weight. But there is little safety research on long-term use, said the authors of the study, which was by researchers at the Cleveland Clinic and published this week in the journal Nature Medicine. They found that people with the highest levels of erythritol in their bloodstreams had twice the risk of heart attack, stroke, or death within 3 years.
“Our study shows that when participants consumed an artificially sweetened beverage with an amount of erythritol found in many processed foods, markedly elevated levels in the blood are observed for days – levels well above those observed to enhance clotting risks,” senior author Stanley Hazen, MD, PhD, said in a statement. “It is important that further safety studies are conducted to examine the long-term effects of artificial sweeteners in general, and erythritol specifically, on risks for heart attack and stroke, particularly in people at higher risk for cardiovascular disease.”
Erythritol is considered safe by the FDA, so the agency does not require long-term safety studies of it.
The Cleveland Clinic researchers did lab tests that showed erythritol actually makes it easier for the blood to clot in ways that are known to add to heart problems. That said, the limits in their research mean that the researchers couldn't say for sure if erythritol caused the health problems; rather, it was associated with them. They recommended further study.
“Sweeteners like erythritol have rapidly increased in popularity in recent years, but there needs to be more in-depth research into their long-term effects,” Hazen said. “Cardiovascular disease builds over time, and heart disease is the leading cause of death globally. We need to make sure the foods we eat aren’t hidden contributors.”