A new study published on Monday links a zero-calorie additive that acts as a sweetener to an increased risk of cardiac events, including stroke and death.
The study, published in the journal Nature Medicine, examined the impact of the sugar substitute erythritol on patients undergoing a cardiac risk assessment. The study found that higher levels of erythritol were associated with a higher risk for “major adverse cardiovascular events.”
The study was done by the Cleveland Clinic, which studied more than 4,000 people in the United States and Europe. Researchers found that erythritol made platelets in blood 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,” Dr. Stanley Hazen, the lead author of the study, said in a statement. “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.”
The Calorie Control Council responded to the study, telling CNN, “the results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in food and beverages.” The council’s executive director warned that the study’s results “should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events.”
Erythritol is approximately 70% as sweet as sugar and is manufactured through fermenting corn. The human body creates low amounts of erythritol naturally, according to the study. Erythritol is also found naturally in low levels in foods like grapes, mushrooms, pears, watermelon, beer and cheese, USA Today reported. It is commonly used in products marketed for people on the ketogenic diet because it does not affect blood glucose.
Hazen told CNN that erythritol has become extremely popular in keto and low-carb items and said that some of the foods marketed towards people with diabetes “had more erythritol than any other item by weight.”
“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. “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.”
Current federal guidelines do not require erythritol, which is an ingredient in Truvia sweetener, to be included on a product’s ingredient list, USA Today reported. A product can simply say “artificially sweetened with natural products” or “zero sugar” to comply with federal requirements.