A widely used artificial sweetener is linked to an increased risk of stroke and heart attacks, according to a new study.

Erythritol is a sweetener used in stevia, monkfruit and keto reduced-sugar products, according to CNN. It also is a risk for many populations, according to  Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute and the lead author of the study, CNN reported.

“The degree of risk was not modest,” Hazen said, according to CNN.

He said those with heart-disease risk factors, such as diabetes, are in the most danger if they had high levels of erythritol in their blood.

“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.

The substance is widely used by food companies as a sugar substitute, Hazen said, according to CNN.

“It’s become the sweetheart of the food industry, an extremely popular additive to keto and other low-carb products and foods marketed to people with diabetes,” he said. “Some of the diabetes-labeled foods we looked at had more erythritol than any other item by weight.”

But its risks to health may not be fully understood, according to the study.

“Artificial sweeteners are widely used sugar substitutes, but little is known about their long-term effects on cardiometabolic disease risks,” reported the study, published in January by the medical journal Nature Medicine.

“Our findings reveal that erythritol is both associated with incident MACE [major adverse cardiovascular events] risk and fosters enhanced thrombosis. Studies assessing the long-term safety of erythritol are warranted,” the study reported.

The study also said erythritol was linked to increased blood clotting. The danger of clots in blood vessels is that they can trigger a heart attack or stroke,

“This certainly sounds an alarm,” Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health, a hospital in Denver, told CNN.

Freeman was not involved in the study.

“There appears to be a clotting risk from using erythritol. Obviously, more research is needed, but in an abundance of caution, it might make sense to limit erythritol in your diet for now,” he said.

Hazen agreed.

“For people who are at risk for clotting, heart attack and stroke – like people with existing cardiac disease or people with diabetes – I think that there’s sufficient data here to say stay away from erythritol until more studies are done,” Hazen said.

New study suggests harm from low-calorie sweetener erythritol (https://t.co/nZ8uSM4zmY). Today’s published interventional data, though only in mice and in vitro, is concerning enough for me to urge everyone stop eating it until we know more. https://t.co/tHcE5ZQAbD pic.twitter.com/NcDH4lTQUM

— Michael Greger, M.D. (@nutrition_facts) February 27, 2023

However, Oliver Jones, a professor of chemistry at RMIT University in Victoria, Australia, said in a statement that the study should not trigger panic, according to CNN.

“Any possible (and, as yet unproven) risks of excess erythritol would also need to be balanced against the very real health risks of excess glucose consumption,” the statement said, according to CNN.

The Calorie Control Council, an industry group, pushed back against the study.

“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,” Robert Rankin, the council’s executive director, wrote in an email to CNN, the network reported.

The results “should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events,” Rankin said.

Freeman said the question of the risks of a widely used product deserves immediate answers.

“Science needs to take a deeper dive into erythritol and in a hurry, because this substance is widely available right now. If it’s harmful, we should know about it,” he said, according to CNN.

Hazen, the study’s author, agreed.

 “I normally don’t get up on a pedestal and sound the alarm,” he said. “But this is something that I think we need to be looking at carefully.”

In a news release on the Cleveland Clinic’s website, Hazen said the realm of artificial sweeteners needs a thorough review.

“Our study shows that when participants consumed an artificially sweetened beverage with an amount of erythritol found in many processed foods, markedly elevated levels in the blood are observed for days – levels well above those observed to enhance clotting risks,” he said.

“It is important that further safety studies are conducted to examine the long-term effects of artificial sweeteners in general, and erythritol specifically, on risks for heart attack and stroke, particularly in people at higher risk for cardiovascular disease," he said.

This article appeared originally on The Western Journal.