TAMPA, Fla. (WFLA) — A common artificial sweetener was linked to higher rates of heart attack, stroke, and death, according to research from the Cleveland Clinic.

The sweetener is called erythritol.

Researchers say the additive is one of the most common artificial sweeteners and a “very popular ingredient” in foods that are marketed for weight loss and diabetes management.

According to the clinic, erythritol is about 70% as sweet as sugar and produced through the fermentation of corn. Once ingested, erythritol is poorly metabolized by the body and carried into the bloodstream where it eventually leaves the body mainly through urine.

While the body naturally creates low amounts of erythritol, additional intake can build up in the body.

Researchers say artificial sweeteners, like erythritol, are common replacements for table sugar in low-calorie, low-carbohydrate, and “keto” foods.

Products containing erythritol and labeled as “sugar-free” are often recommended for those with obesity, diabetes, or metabolic syndrome and people who are looking for ways to manage their sugar or calorie intake.

“The very people who are being targeted for foods that contain erythritol are the same people who already are at increased risk for cardiovascular events,” said Stanley Hazen, MD, PhD, and senior author of the study. “So this is very concerning.”

In the study, researchers looked at 4,000 people across the United States and Europe. They found participants with higher blood erythritol levels were also at an elevated risk of a heart attack, stroke, or death.

To confirm their findings, researchers added erythritol to whole blood platelets and isolated platelets, which function by clumping together to stop bleeding. However, clumps can also contribute to blood clots, the clinic said.

The test revealed that “erythritol made platelets easier to activate and form a clot.” Pre-clinical studies also revealed that foods containing erythritol heightened clot formation.

“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,” said 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. “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.”

The authors noted the study had several limitations, including that clinical observation studies demonstrate association and not causation. They also recommend talking to a doctor or certified dietician to learn more about the healthy food choices you can take.

The study was partially funded by the National Heart, Lung, and Blood Institute and the Office of Dietary Supplements, both of the National Institutes of Health