Erythritol written in artificial sweetener pile


CLEVELAND, Ohio — A popular artificial sweetener common in keto diet products may increase heart attack and stroke risk, a new study claims. Erythritol is a common substitute for sugar in low-calorie, low-carb, and keto diet products, but researchers from the Cleveland Clinic now say it could be doing more harm than good.

A keto diet, short for ketogenic, is low in carbohydrates and high in protein. Actresses Halle Berry and Gwyneth Paltrow and influencers Kim and Kourtney Kardashian are among the growing number of people trying these diets. However, when scientists added the sweetener to blood platelets — the cell fragments that clump together to stop bleeding — erythritol made platelets clot faster.

Pre-clinical studies support the Cleveland Clinic’s revelation that consuming the substance causes clots to build faster. Erythritol is often recommended to manage calorie and sugar consumption in people with obesity, diabetes, or metabolic syndrome.

Current health guidelines call erythritol ‘safe’

Despite the evident risks, researchers note that it’s hard to measure erythritol. Labelling requirements are minimal for all artificial sweeteners, and they do not list individual compounds.

Moreover, erythritol is categorized as “Generally Recognized As Safe” (GRAS) by the U.S. Food and Drug Administration. This means the use of these products does not require long-term safety studies. Fermenting corn creates the product, which is 70 percent as sweet as sugar. However, the body does a poor job of metabolizing the sweetener.

Instead, erythritol enters the bloodstream and leaves mainly through urine. The human body also produces erythritol naturally and any additional consumption can accumulate. Likewise, the causes of cardiovascular disease build over time. It is currently the leading cause of death across the globe.

Sugar in a spoon
Photo by Sharon McCutcheon on Unsplash

“Sweeteners like erythritol, have rapidly increased in popularity in recent years but there needs to be more in-depth research into their long-term effects,” says senior author Stanley Hazen, M.D., Ph.D., chairman for the Department of Cardiovascular & Metabolic Sciences in Lerner Research Institute and co-section head of Preventive Cardiology at Cleveland Clinic, in a media release.

Cardiovascular disease builds over time, and heart disease is the leading cause of death globally. We need to make sure the foods we eat aren’t hidden contributors.”

“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,” Dr. Hazen concludes.

“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.”

The authors add that follow-up studies among the general public are necessary to confirm the new findings, published in Nature Medicine.

South West News Service writer Pol Allingham contributed to this report.

Our Editorial Process

StudyFinds publishes digestible, agenda-free, transparent research summaries that are intended to inform the reader as well as stir civil, educated debate. We do not agree nor disagree with any of the studies we post, rather, we encourage our readers to debate the veracity of the findings themselves. All articles published on StudyFinds are vetted by our editors prior to publication and include links back to the source or corresponding journal article, if possible.

Our Editorial Team

Steve Fink


Chris Melore


Sophia Naughton

Associate Editor