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According to a study, a common artificial sweetener raises the risk of heart attack and stroke.

Erythritol, a popular artificial sweetener, has been linked to an elevated risk of heart attack and stroke, according to new research from the Cleveland Clinic. Results were released in today’s issue of Nature Medicine.

A severe adverse cardiac event, such as a heart attack, stroke, or death, was found to be more likely in persons with higher blood erythritol levels, according to research done on more than 4,000 people in the U.S. and Europe. Also, they looked at what happened when isolated platelets or whole blood were given erythritol. Platelets are pieces of cells that cluster together to halt bleeding and help form blood clots. The outcomes showed that erythritol facilitated platelet activation and clot formation. Pre-clinical research proved erythritol consumption increased clot formation.

Table sugar is frequently swapped out for artificial sweeteners like erythritol in low-calorie, low-carb, and “keto” products. Those who have obesity, diabetes, or metabolic syndrome and are looking for solutions to help regulate their sugar or calorie intake are frequently advised to try sugar-free goods containing erythritol. Also, those who have these disorders are more vulnerable to harmful cardiovascular events including heart attacks and stroke.

Erythritol is about 70% as sweet as sugar and is produced through fermenting corn. After ingestion, erythritol is poorly metabolized by the body. Instead, it goes into the bloodstream and leaves the body mainly through urine. The human body creates low amounts of erythritol naturally, so any additional consumption can accumulate.

Measuring artificial sweeteners is difficult and labeling requirements are minimal and often do not list individual compounds. Erythritol is “Generally Recognized As Safe (GRAS)” by the FDA, which means there is no requirement for long-term safety studies.