Health Care

Zero-calorie sweetener popular in keto diets linked to strokes, heart attacks

A new study has found that a zero-calorie sweetener that is popular in ketogenic diets has been linked to strokes, heart attacks, blood clots and death.

The artificial sweetener called erythritol is often found in diet foods, such as Truvia, as a sugar replacement because it does not affect blood glucose levels and does not have any calories.

The new study, published in the journal Nature Medicine on Monday, found that higher levels of erythritol are correlated with a higher chance of heart attack, stroke or death in three years when analyzing blood samples from three different populations.

Researchers first found the correlation between increased erythritol levels and major adverse cardiac events when analyzing chemicals and compounds in 1,157 blood samples of those who were at risk for heart disease that were collected between 2004 and 2011. After discovering the link between the high levels and increased risk, the researchers confirmed their results by testing a larger sample of 2,100 people in the United States and 833 samples in Europe through 2018.

“Following exposure to dietary erythritol, a prolonged period of potentially heightened thrombotic risk may occur. This is a concern given that the very patients for whom artificial sweeteners are marketed (patients with diabetes, obesity, history of [cardiovascular diseases] and impaired kidney function) are those typically at higher risk for future [cardiovascular diseases] events,” the study reads.


The study also found that when a group of eight healthy volunteers drank a beverage with 30 grams of erythritol in it, there was “heightened” blood clotting risks.

Stanley Hazen, the director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute and lead researcher on the study, told CNN that “the degree of risk was not modest.”

“If your blood level of erythritol was in the top 25 percent compared to the bottom 25 percent, 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.

According to the American Heart Association, cardiovascular disease, which includes heart attacks and strokes, accounted for 874,613 deaths in the United States in 2019.