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This Artificial Sweetener Can Raise Your Risk of Heart Attack and Stroke

March 10, 2023

Zero calorie claims on food labels seem like a huge win, but new research shows one ingredient may be hiding a dangerous secret.

New research from the Cleveland Clinic links Erythritol – an artificial sweetener without the calories of sugar – with blood clots that trigger heart attack and stroke. And the results can be deadly.

“While artificial sweeteners, generally considered safe by the Food and Drug Administration, help people avoid excess dietary sugar, which is associated with obesity, diabetes and cardiovascular disease, this evidence shows they can still increase risk for cardiac events,” says Steven Borer, DO, a Hartford HealthCare Heart & Vascular Institute cardiologist.

Dr. Borer shares what you need to know about erythritol, the risks, and how you can protect yourself.

Erythritol is a natural sweetener, but manufacturers use very large quantities of it.

Erythritol – a popular type of sugar alcohol – occurs naturally in very low amounts in some fruits and vegetables.

“It has a texture similar to sugar and is actually 30% less sweet than sugar. As a result, manufacturers use large quantities in foods to mimic the same sweetness,” Dr. Borer explains.

In fact, when manufacturers use erythritol, the quantities are sometimes up to 1,000 times higher.

People with high levels of erythritol in their blood were most at risk.

Cleveland Clinic researchers discovered the trouble by accident. While examining blood samples of more than 1,100 patients undergoing cardiovascular screening, they determined erythritol was the substance in artificial sweetener most strongly connected to heart attack and stroke.

“The people with the highest levels of erythritol were twice as likely to have cardiac events as compared with those having the lowest levels of erythritol,” Dr. Borer notes.

The reason is the chemical’s effect on platelet function and clotting, he explains. If platelets are more “reactive,” they are more likely to stick together and form clots. Clots in arteries can cause heart attack and stroke. The research demonstrates that erythritol increases the reactivity of platelets, he says.

> Related: Not-So-Sweet Link Between Sugar and Heart Disease

Key ingredient

Foods labeled “keto” or “sugar free” often contain Erythritol as a sweetener. But companies are not required to list it in their ingredients, making it more difficult to find.

“Erythritol is often combined with other artificial sweeteners like Splenda or monk fruit, so it may not be as easy to tell which foods contain a lot of it,” he says.

In general, he recommends people avoid consuming large quantities of artificial sweeteners. Instead, he suggests:

• Eating smaller portions of sweets, both those with added sugar or artificial sweeteners.
• Opting for naturally occurring sugar in fruits and vegetables. These, he says, do not negatively impact blood sugar levels since they also contain fiber and water. “Diets high in fruit and vegetables can actually improve blood sugar and diabetes and help lower risk of cardiovascular issues,” he says.

More trouble

In addition to affecting cardiovascular health, Dr. Borer says artificial sweeteners like erythritol can adversely impact:

• Insulin levels, similar to that seen with sugar
• The microbiome, which is the billions of bacteria living in the gut and, when altered, can increase inflammation in the body.
• Obesity. The sweeteners contain no sugar, but they still stimulate the brain to want more sweet foods.

“The Food and Drug Administration considers artificial sweeteners generally safe, although we do not have long-term data regarding their safety,” he explains. “With that said, I would certainly recommend caution for anyone consuming large quantities of erythritol, especially people with increased risk of cardiovascular disease.”