This Keto-Friendly Sweetener Has Been Linked to Heart Attack and Stroke—Here Are the Top Products To Avoid

Kaitlin Vogel
·3 min read
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Dietitians share their tips along with healthy sugar substitutes to try instead.

Many people opt for artificial sweeteners due to their low-calorie benefits. However, there is growing evidence to suggest that there are negative long-term effects of incorporating artificial sweeteners into your diet.

One of the most commonly used sweeteners is erythritol, and according to a new study, erythritol is tied to increased cardiovascular risk, including blood clotting, stroke, heart attack and death. Researchers also found people with diabetes were twice as likely to have a heart attack or stroke if they had erythritol in their system.

Erythritol and Cardiovascular Risk

“It has long been believed that used sugar substitutes such as erythritol will reduce calories from carbohydrate intake while still allowing food to taste good,” says Dr. Yu-Ming Ni, MD, a cardiologist at Orange Coast Medical Center in Fountain Valley, California. “However, we have seen in repeated studies that sugar substitutes have side effects that go beyond simply imitating the taste of sugar.”

Here, this group of individual studies on erythritol demonstrates a mechanism by which this widely used sugar sweetener can increase the risk of heart attack or stroke by increasing the risk of blood clotting in the bloodstream, and showing that in observations of people consuming this artificial sweetener, the risk for heart attack or stroke was increased.

This study is most useful in showing a potential mechanism by which artificial sweeteners can harm blood vessels, Dr. Ni adds. However, we cannot say for certain that erythritol is the cause of increased heart disease unless this finding can be replicated in larger studies. Until then, it is unclear whether it is necessary to stop all consumption of artificial sweeteners.

“I often advise my patients to eat food as naturally as possible, as that reduces the risk of exposure to potentially harmful chemicals like artificial sweeteners, and to consider sugar substitutes if it serves as a means to help overweight people with weight loss since overall weight loss has clearer evidence for health improvement,” says Dr. Ni.

Related: New Study Links Artificial Sweetener Ingredient to Increased Cardiac Risk Factors

Products To Avoid

Many products that are marketed as low-carb/sugar will contain erythritol, such as cookies, ice creams and certain beverages, Amy Davis, RD, LDN, explains. That’s why it’s important to read the ingredients panel of nutrition labels to determine whether or not erythritol is in food or beverage.

Polyol (sugar alcohol) sweeteners such as erythritol are widely used in products labeled as sugar-free, low-calorie and light. Common sources include certain types of yogurt, ice cream, puddings, candy, gum, baked goods, diet beverages and processed “keto” products, Kelsey Costa, MS, RDN, registered dietitian nutritionist of MIDSS, states.

Before purchasing a product, you may want to check to make sure to check the ingredient list on the nutrition facts label and watch out for the terms erythritol or "sugar alcohol" to avoid any potential risks.

Related: What to Watch For on Food Labels When You're Following a Low-Fat Diet

Healthy Sugar Substitutes

Natural sweeteners are the best option when it comes to your health and safety.

“Pure grade A honey, pure maple syrup and dates are all great options for sweetening foods and drinks,” says Costa. “If you are looking for alternative low-calorie options, opt for 100 percent pure extracts of stevia or monk fruit. Be wary of sweeteners ‘made with’ stevia or monk fruit, as these usually contain other artificial ingredients.”

Next up: Calorie-Free and Packed With Antioxidants, Monk Fruit Sweetener May Be the Best Natural Sweetener Available—Here's What to Know

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