Experts are warning against consuming a zero-calorie sweetener used in stevia and keto diet products as new research shows it may increase one's risk of blood clots and other cardiovascular problems. The study of 1,157 volunteers undergoing cardiac risk assessment, published Monday in Nature Medicine, found those with the highest levels of erythritol in their blood had twice the risk for heart attack, stroke, blood clot, and death compared with those with the lowest levels, per USA Today and CNN. The research suggests the sugar substitute promotes blood clots, which can travel to the heart and trigger a heart attack, or travel to the brain and trigger a stroke.
Alarmingly, "the very group of people most vulnerable to experiencing adverse cardiac events are the ones we're recommending these kinds of dietary foods for," Dr. Stanley Hazen of the Cleveland Clinic, who led the research, tells USA Today. He notes federal guidelines don't require that erythritol—which he calls "the sweetheart of the food industry," per CNN—be disclosed as an ingredient in products that might simply be described as "zero sugar" or "artificially sweetened with natural products." The body naturally produces erythritol—a sugar alcohol also found in fruits, vegetables, beer, and wine—but at very low levels compared to what's found in the sweetener.
Hazen—who set out to determine why people treated for high cholesterol, high blood pressure, obesity, diabetes, and smoking cessation continued to have heart attacks and strokes—found erythritol was "at the very top of the list" of blood compounds that predicted who among study participants were at highest risk. This was confirmed among a second batch of blood samples from nearly 3,000 people, the majority of whom had coronary disease or high blood pressure, per CNN. Subsequent lab tests of erythritol in human and mice blood found it was "provoking enhanced thrombosis," or blood clotting, Hazen tells the outlet. A 2017 study also linked erythritol and weight gain.
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Robert Rankin of the Calorie Control Council, which represents the low- and reduced-calorie food and beverage industry, says the study contradicts decades of research showing erythritol is safe and the results shouldn't be applied to the general public given the participants' health issues. Still, "at the current knowledge we have, I would not recommend people use it," says biochemist Karsten Hiller of the Braunschweig Institute of Technology, who authored the 2017 study. Hazen, meanwhile, advises those with cardiovascular issues to "stay away from erythritol until more studies are done." (More sweetener stories.)
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