Sugar replacements, also called artificial sweeteners, are often found on grocery store shelves in the sugar aisle. They are marketed to shoppers by offering the same sweetness as sugar, without the addition of carbohydrates and calories. The results of a new study suggest sugar replacements aren't as beneficial as previously thought.

According to research published in the journal of Nature Medicine, the popular sugar replacement called erythritol is linked to stroke, heart attack and even death.

People with existing heart disease risk factors, such as diabetes, had twice as high a risk of heart attack or stroke if they had high erythritol levels.

The study also discovered that erythritol has a direct link to blood clotting in people with pre-existing risk factors. The clots can break off and travel to the heart, triggering a heart attack, or travel to the brain, triggering a stroke.

“A high sugar intake has always been associated with heart disease, strokes and heart attacks,” says Michael Trybula, M.D., an independent cardiologist on the medical staff at Elmhurst Hospital.

“Even though more research is needed to understand the effects of erythritol, patients should continue to limit their consumption of both sugar and sugar alternatives.”

What is erythritol?

Erythritol is an artificial sweetener used in low-sugar and sugar-free foods. Known as a sugar alcohol, erythritol is sometimes used to sweeten stevia and monk fruit or as a keto sweetener. People who are diabetic, ketogenetic or who follow a low-calorie diet often rely on erythritol as a sugar substitute.

Fruits and vegetables such as grapes, peaches, pears and watermelons naturally contain a small amount of erythritol. Some fermented foods such as beer and cheese, also contain erythritol.

The study warns erythritol is often combined with other sugar substitutes to help add bulk to sweeteners.

The U.S. Food and Drug Administration approved erythritol for use as a food additive in 2001. The results of the study conflict decades of scientific research showing reduced-calorie sweeteners like erythritol are beneficial as a sugar replacement.

What are safe sweetener alternatives?

The healthier alternative to artificial sweeteners is natural sweeteners like honey and maple syrup. Fresh or frozen fruit can also be used to sweeten cereal, yogurt or baked goods.

Until more research is conducted on erythritol and other sugar replacements, experts recommend keeping an eye on the amount of sugar you consume, while also following a healthy diet and exercise plan.

To find out if you’re at risk for heart disease, take an online HeartAware assessment.

Learn more about heart and vascular services at Edward-Elmhurst Health.