A concerning new study has found that a widely available sweetener has been linked to the risk of heart attack, stroke, and even death.

The study, published in the journal Nature Medicine, found that a sugar replacement called erythritol causes blood clots in the body.

“The degree of risk was not modest,” lead study author Dr. Stanley Hazen, director of the Center for Cardiovascular Diagnostics and Prevention at the Cleveland Clinic Lerner Research Institute, said, CNN reported.

Moreover, the risk was double for people with existing heart disease risk factors, such as diabetes, if they had higher levels of erythritol in their blood, according to the study.

“If your blood level of erythritol was in the top 25% compared to the bottom 25%, there was about a two-fold higher risk for heart attack and stroke. It’s on par with the strongest of cardiac risk factors, like diabetes,” Hazen said.

On further analysis, it was found erythritol seemed to be causing blood platelets to clot easily. Blood clots can dislodge and move through the blood vessels and reach the heart, where they can trigger a heart attack. If the clots reach the brain, they can cause a stroke.

“This certainly sounds an alarm,” Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health, a hospital in Denver, who was not involved in the research, as per the outlet.

“There appears to be a clotting risk from using erythritol,” Freeman continued. “Obviously, more research is needed, but in an abundance of caution, it might make sense to limit erythritol in your diet for now.”

Erythritol is a sugar alcohol found naturally in many fruits and vegetables. The carb consists of about 70% of the sweetness of sugar and is known to be zero-calorie, according to experts.

Artificially manufactured erythritol has no aftertaste and does not increase blood sugar.

“Erythritol looks like sugar, it tastes like sugar, and you can bake with it,” Hazen, who also directs the Cleveland Clinic’s Center for Microbiome and Human Health, said.

“It’s become the sweetheart of the food industry, an extremely popular additive to keto and other low-carb products and foods marketed to people with diabetes,” Hazen further said. “Some of the diabetes-labeled foods we looked at had more erythritol than any other item by weight.”

Call it a serendipitous discovery as erythritol was never the focus of the study for the researchers. “We never expected this. We weren’t even looking for it.” Hazen noted.

The research started out with an aim to identify unknown chemicals or compounds in the blood that might increase the risk of a heart attack, stroke, or death in the next three years.

For the study, the research team initially analyzed 1,157 blood samples in people at risk for heart disease collected between 2004 and 2011.

“We found this substance that seemed to play a big role, but we didn’t know what it was,” Hazen said. “Then we discovered it was erythritol, a sweetener.”

However, the Calorie Control Council, an industry association, is skeptical of the results. “The results of this study are contrary to decades of scientific research showing reduced-calorie sweeteners like erythritol are safe, as evidenced by global regulatory permissions for their use in foods and beverages,” Robert Rankin, the council’s executive director, told CNN.

The results “should not be extrapolated to the general population, as the participants in the intervention were already at increased risk for cardiovascular events,” Rankin said.