CNN – A sugar replacement called erythritol — used to add bulk or sweeten stevia, monk-fruit, and keto reduced-sugar products — has been linked to blood clotting, stroke, heart attack and death, according to a new study.
“The degree of risk was not modest,” said lead author Dr. Stanley Hazen, director of the center for cardiovascular diagnostics and prevention at the Cleveland Clinic Lerner Research Institute.
People with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their blood, according to the study published Monday in the journal Nature Medicine.
“If your blood level of erythritol was in the top 25% compared to the bottom 25%, there was about a two-fold higher risk for heart attack and stroke. It’s on par with the strongest of cardiac risk factors, like diabetes,” Hazen said.
Additional lab and animal research presented in the paper revealed erythritol appeared to be causing blood platelets to clot more readily.
“Erythritol is the largest ingredient by weight in many “natural” stevia and monk-fruit products.”
Clots can break off and travel to the heart, triggering a heart attack, or to the brain, triggering a stroke.
“This certainly sounds an alarm,” said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health, a hospital in Denver, Colorado, who was not involved in the research.
“There appears to be a clotting risk from using erythritol,” Freeman said. “Obviously, more research is needed, but in an abundance of caution, it might make sense to limit erythritol in your diet for now.”
In response to the study, the Calorie Control Council, an industry association, told CNN that:
“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 foods and beverages … “