


A new study published in Nature Medicine on Monday found that a sugar replacement in artificial sweeteners, used in popular weight-loss diets, is linked to a higher risk of heart attacks and strokes.
Erythritol, commonly found in keto diets to sweeten stevia or monk fruit products, is used as a sugar replacement because it does not cause a spike in blood sugar and contains zero calories. But the study found that diabetics and other people with an increased risk of heart disease were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their system.
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“The degree of risk was not modest,” Dr. Stanley Hazen, the lead author of the study, told CNN. “If your blood level of erythritol was in the top 25% compared to the bottom 25%, there was about a twofold higher risk for heart attack and stroke. It’s on par with the strongest of cardiac risk factors, like diabetes."
The danger comes from the appearance that erythritol causes platelets in the blood to clot more easily. Although clotting is normal in the case of an injury, blood clots can break off in the bloodstream and travel to the brain, which would cause a stroke, or the heart, causing a heart attack.
“For people who are at risk for clotting, heart attack, and stroke — like people with existing cardiac disease or people with diabetes — I think that there’s sufficient data here to say stay away from erythritol until more studies are done,” Hazen said. “I normally don’t get up on a pedestal and sound the alarm, but this is something that I think we need to be looking at carefully."
The team on the study discovered the correlation between increased erythritol levels and major cardiac events when analyzing 1,157 blood samples in people at risk for heart disease collected between 2004 and 2011. Their findings were confirmed after testing another batch of blood samples from over 2,100 people in the United States and 833 samples in Europe through 2018.
“Following exposure to dietary erythritol, a prolonged period of potentially heightened thrombotic risk may occur," the study said. "This is a concern given that the very patients for whom artificial sweeteners are marketed (patients with diabetes, obesity, history of [cardiovascular diseases] and impaired kidney function), are those typically at higher risk for future cardiovascular events."
An examination of eight healthy volunteers, who drank a beverage containing 30 grams of erythritol, found there was a “heightened” risk for blood clotting, according to Hazan.
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Approximately 75% of the study's participants in all three groups had a coronary disease or high blood pressure, and a fifth had diabetes. More than half were men and in their 60s and 70s, Hazan said.
Although the new study found a correlation between the sweetener and an increased risk of cardiac events, the Food and Drug Administration generally perceives erythritol as safe and has not set an accepted daily intake of the sweetener.