A new study has linked a popular zero-calorie sweetener to strokes, heart attacks, blood clots and death.

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Erythritol, an artificial sweetener commonly used as a sugar substitute in diet foods such as Truvia, is known for its zero-calorie and blood glucose level-neutral properties.

According to a study published on Monday in the journal Nature Medicine, higher levels of erythritol in blood samples from three different populations were found to be associated with an increased risk of heart attack, stroke, or death within three years.

In their analysis, researchers examined 1,157 blood samples collected between 2004 and 2011 from individuals at risk of heart disease and identified a correlation between elevated levels of erythritol and major adverse cardiac events. To validate their findings, the researchers conducted further testing on a larger sample of 2,100 people in the US and 833 samples in Europe through 2018. This confirmed the link between high erythritol levels and an increased risk of negative cardiac outcomes.

“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.

Furthermore, the study showed that consumption of a beverage containing 30 grams of erythritol by a group of eight healthy volunteers resulted in an increased risk of blood clotting.

Stanley Hazen, the lead researcher of the study and the director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute, stated in an interview with CNN that the risk associated with elevated erythritol levels was significant and 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.

In 2019, cardiovascular disease, which encompasses heart attacks and strokes, was responsible for 874,613 deaths in the United States, as reported by the American Heart Association.

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