In Germany, most people consume too much sugar. Per capita consumption in 2021/2022 was around 34.8 kilograms. So around 95 grams a day. That's 45 grams more than recommended. Most people know that too much sugar is bad for your health.

However, at least people should be able to completely avoid sweets and sugar. That is why some consumers turn to desserts, pastries or chocolate that are reduced in calories and do not contain table sugar. Instead of sugar, the food contains a sugar substitute such as erythritol. But researchers at the Cleveland Clinic have now found evidence that consumption of the sweetener could increase the risk of stroke and heart attack. They published their results in the journal "Nature Medicine".

Erythritol is a so-called sugar substitute. It can be recognized by the designation E 968 on the list of ingredients of a food. It can be found, for example, in sugar-free chewing gum, low-calorie foods with no added sugar, such as pastries, jams, confectionery or chocolate. It ensures that these light products taste sweet, but that the blood sugar level does not rise.

Erythritol also occurs naturally in cheese and fruits such as pears, grapes and melons. But the amounts in it are far too small for industrial production. This is why the sugar alcohol is usually obtained industrially by fermenting corn. It is less sweet than regular sugar and has almost no calories. Erythritol is one of eight sugar substitutes approved in the EU. However, the latest results from the research group now show that the consumption of erythritol could have a negative impact on health.

The lead author of the study is Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic. With his study, he actually did not want to examine the influence of the sugar substitute on the risk of heart attack and stroke. His research aimed to find unknown chemicals or compounds in a person's blood that could predict their risk of heart attack, stroke or death over the next three years. To do this, he and his team evaluated the blood samples of more than 1150 subjects.

"We found this substance that seemed to play a big role, but we didn't know what it was," Hazen told CNN. "Then we discovered that it was erythritol, a sugar substitute." The body itself also produces erythritol, but only in very small amounts.

The researchers examined further blood samples from more than 2,100 subjects from the USA and over 830 samples from Europe. More than half of the blood samples were from men in their 60s or 70s. About three quarters of the participants in all three groups had coronary disease or high blood pressure. In other words, people who generally have a higher risk of having a stroke or heart attack.

The result: The researchers found a connection between increased erythritol levels in the test subjects and the higher risk of stroke, heart attack or premature death.

To find the reason for this, the scientists carried out animal and laboratory tests. The erythritol apparently caused blood platelets to clump together. Consuming the sugar substitute appears to promote the formation of blood clots. And the blood clots can block the coronary arteries or cerebral arteries, causing a heart attack or stroke.

Robert Rankin of the Calorie Control Council, an industry association, told CNN about the study that "the results of this study contradict decades of scientific research showing that reduced-calorie sweeteners like erythritol are safe, supported by global regulatory approvals for their use in food and beverages."

Study author Stanley Hazen said: "For people who are at risk for blood clots, heart attack and stroke -- such as people with an existing heart condition or people with diabetes -- I think there is enough data to steer clear of erythritol until further studies are done become."

The scientist emphasized to "CNN" the great effect of small amounts of the sugar substitute on the erythritol level in the blood: "Thirty grams were enough to increase the erythritol level in the blood a thousandfold," says Hazen. "It remained elevated above the threshold necessary to trigger and increase the risk of clotting over the following two to three days." He demanded that the effect of erythritol must now be checked quickly and carefully.

However, in the study, the researchers only found a connection between erythritol and its influence on blood clotting. That means you can't prove that consuming erythritol increases the risk of a heart attack or stroke. Further research is needed for this.

Because sugar substitutes such as erythritol do not cause blood sugar levels to rise, there is a constant debate as to whether diabetics and people with weight problems should use light products. The consumer advice center recommends changing your diet over the long term. Ultimately, sugar alternatives are not a healthy alternative to household sugar.

Sources: Nature Medicine study, DGE, Statista, CNN, consumer advice center, shopping guide, study notification