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Study Links Artificial Sweetener Erythritol to Higher Risk of Heart Attack, Stroke and Death

A new study published in Nature Medicine has linked the popular artificial sweetener erythritol to a heightened risk of heart attack, stroke and death.[0] Erythritol is used as a sugar substitute in many low-calorie, low-carbohydrate and “keto” products, and is about 70% as sweet as sugar.[1] It is added to many processed foods and beverages, and is commonly found in products targeting people on the ketogenic diet.[2]

In this study, researchers delved into the link between erythritol and the condition.[3] They examined the effects of adding erythritol to either whole blood or isolated platelets, which are cell fragments that clump together to stop bleeding and contribute to blood clots. The results indicated that erythritol had the effect of facilitating platelet activation and clot formation. Results from pre-clinical trials showed that taking erythritol led to an increase in clot formation.[4]

In a follow up feeding study with 8 volunteers ingesting 30 grams of erythritol a day, their blood levels of the sweetener peaked within hours and remained high for two days — high enough that it could potentially affect their blood clotting.[5] Results showed that the top 25% had twice the risk of heart attack, stroke and death compared to the bottom 25%, placing it on par with the strongest other cardiovascular risk factors, such as diabetes.[6]

Erythritol is “Generally Recognized As Safe (GRAS)” by the Food and Drug Administration (FDA), which means there is no requirement for long-term safety studies.[7] Robert Rankin, executive director of the Calorie Control Council, an association representing the low- and reduced-calorie food and beverage industry, said the results should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events.[2]

Dr. Stanley Hazen, lead study author and director of the center for cardiovascular diagnostics and prevention at the Cleveland Clinic Lerner Research Institute, called for more research into alternative sweeteners.[8] “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,” he said.[9]

0. “Artificial Sweetener Tied to Risk of Heart Attack and Stroke, Study Finds” Smithsonian Magazine, 2 Mar. 2023,

1. “Popular artificial sweetener linked to higher clotting risk | PBS NewsHour” MetroFocus, 5 Mar. 2023,

2. “Sweetener erythritol may increase risk for stroke, blood clot, death” USA TODAY, 27 Feb. 2023,

3. “Artificial Sweetener Linked to Blood Clots and Heart Attacks, New Study Finds” PEOPLE, 27 Feb. 2023,

4. “Popular artificial sweetener linked to heart attack and stroke” Medical Dialogues, 28 Feb. 2023,

5. “Artificial sweetener may increase risk of heart attack and stroke, study finds”, 1 Mar. 2023,

6. “Sweetener erythritol linked to heart problems | Research” Chemistry World, 6 Mar. 2023,

7. “A New Study Connected an Artificial Sweetener with Higher Heart Attack Risk—Here's What to Know” EatingWell, 1 Mar. 2023,

8. “Erythritol sweetener linked to heart attack, stroke risk, study finds” The Washington Post, 28 Feb. 2023,

9. “Health officials find link between popular drink and ‘deadly' health conditions” Irish Mirror, 27 Feb. 2023,

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