A widely used artificial sweetener is linked to higher heart-attack and stroke risk

New research reported in late August 2026 has linked a widely used sugar substitute to a higher risk of heart attack and stroke, adding to a growing body of evidence questioning the long-term cardiovascular safety of some popular sweeteners. The substance at the center of the findings, erythritol, is found in a wide range of keto-friendly and diabetic-friendly foods marketed as healthier alternatives to sugar.

What the New Study Found

Researchers reported an association between the sweetener and a higher risk of cardiovascular events, a category of outcomes that typically includes heart attack, stroke, and related complications. The findings add to a series of studies published in recent years that have examined how commonly used sugar substitutes interact with the cardiovascular system, an area of nutrition science that has drawn increasing scrutiny as sugar-free and reduced-sugar products have exploded in popularity.

Why Erythritol Ended Up Under Scrutiny

Erythritol is a sugar alcohol that occurs naturally in small amounts in some fruits and fermented foods, but the vast majority found in packaged products today is manufactured industrially through fermentation of corn-derived starches. Food manufacturers favor it because it has close to zero calories, does not spike blood sugar the way table sugar does, and closely mimics sugar’s sweetness and texture, making it a common ingredient in low-carb baked goods, sugar-free candies, and beverages aimed at people managing diabetes or following ketogenic diets.

Unlike some other sugar substitutes that are only partially absorbed or metabolized differently in the body, erythritol is largely absorbed into the bloodstream rather than passing through the digestive system unchanged, which has made researchers curious about how directly it might interact with blood vessels and clotting mechanisms once consumed. That absorption pathway is part of why the substance has become a specific research target rather than being lumped in generally with all artificial or low-calorie sweeteners.

How Sugar Substitutes Affect the Body

Sugar substitutes as a category work through a range of different mechanisms depending on their chemical structure, from sugar alcohols like erythritol and xylitol to high-intensity sweeteners like sucralose and aspartame that taste sweet at a fraction of the concentration of table sugar. Because they are chemically distinct from one another, findings about one sweetener’s cardiovascular effects do not automatically apply to all the others, which is part of why researchers have increasingly studied specific substances individually rather than treating artificial sweeteners as a single uniform category.

Cardiovascular researchers examining erythritol specifically have focused on how elevated blood levels of the compound might influence platelet activity, the small blood cells responsible for forming clots. Changes in how readily platelets clump together could plausibly influence the risk of the blood clots that trigger heart attacks and certain types of stroke, offering one possible biological explanation for the association researchers have observed between higher erythritol levels and cardiovascular events.

What This Means for Consumers

For consumers, the findings do not necessarily mean occasional consumption of erythritol-sweetened products poses an acute danger, but they do add to a growing case for moderation, particularly among people who already carry other cardiovascular risk factors such as high blood pressure, diabetes, or a prior history of heart disease. Because erythritol is used so widely across sugar-free and low-carb product lines, many consumers may be eating more of it than they realize, especially if they regularly buy multiple products marketed around reduced sugar content.

Nutrition researchers generally recommend checking ingredient labels for erythritol and other sugar alcohols if cardiovascular risk is a personal concern, and discussing sweetener choices with a doctor or dietitian for anyone managing existing heart disease. As with many nutrition findings, additional long-term studies will likely be needed to fully clarify how much risk regular consumption actually carries, but the accumulating research has been enough to shift some public health messaging toward caution rather than treating sugar substitutes as an automatically safer choice.

The Rise of Sugar Alcohols in Everyday Food

Sugar alcohols as a category have become a fixture of the modern food supply as low-carbohydrate, low-sugar, and diabetic-friendly eating patterns have grown in popularity, with erythritol emerging as one of the most widely used because of how closely it mimics sugar’s taste and texture. Food companies have steadily expanded its use across categories ranging from protein bars and flavored yogurts to sugar-free chocolate and baking mixes, often in combination with other sweeteners to fine-tune sweetness and mouthfeel.

That widespread adoption partly reflects erythritol’s favorable safety profile in earlier research, which generally found it to be well tolerated in the digestive system compared with other sugar alcohols like sorbitol or maltitol, which are more likely to cause bloating or a laxative effect when consumed in larger amounts. That comparatively gentle digestive profile is part of why erythritol became a default choice for food formulators even as newer research has begun raising separate questions about its cardiovascular effects.

How Researchers Study Sweetener Safety

Long-term studies on sweetener safety typically follow large groups of people over extended periods, tracking their reported diet alongside health outcomes like heart attacks, strokes, and other cardiovascular events, then using statistical methods to control for other risk factors such as body weight, existing health conditions, and overall diet quality. That observational approach can reveal associations between a substance and a health outcome, but establishing that the substance actually causes the outcome, rather than simply appearing alongside it, generally requires additional experimental research that more directly tests the underlying biological mechanism.

Blood-level studies, in which researchers measure how much of a substance like erythritol actually circulates in a person’s bloodstream after consumption, add another layer of evidence by connecting real physiological exposure to the associations found in larger population studies. Combining that kind of mechanistic research with population-level findings gives scientists a more complete picture than either approach could provide on its own, which is part of why erythritol has drawn sustained research interest even as it remains widely used in food products already on store shelves.

This article was produced with the assistance of AI and reviewed by Morning Overview editors.

More from Morning Overview