Common artificial sweetener linked to higher rates of heart attack and stroke

Popular artificial sweetener erythritol has been linked to an increased risk of heart attack and stroke, according to a new study.

Those with higher blood erythritol levels were at elevated risk of experiencing an adverse cardiac event such as heart attack, stroke or death, found researchers, including those from the Cleveland Clinic in the US, who assessed over 4,000 people in the US and Europe.

The study, published recently in the journal Nature Medicine, also examined the effects of adding erythritol to either whole blood or isolated platelets and found that erythritol made them easier to activate and form a clot.

“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,” said senior study author Stanley Hazen.

“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,” Dr Hazen said.

Erythritol has found increasing use as a replacement for table sugar in low-calorie, low-carbohydrate and “keto” products.

Such products are being widely recommended for people who have obesity or diabetes and those looking for options to help manage their sugar or calorie intake.

Erythritol is a chemical that is about 70 per cent as sweet as sugar and is produced through fermenting corn.

After ingestion, however, researchers said it is poorly metabolised by the body as some erythritol molecules go into the bloodstream and leave the body mainly through urine.

“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,” Dr Hazen said.

Citing a limitation of the study, researchers said the findings demonstrated association and not causation.

They called for follow-up studies to confirm their new findings in the general population.

“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,” Dr Hazen added.