Washington (PTI): Consumption of popular artificial sweetener, erythritol, is associated with an increased risk of heart attack and stroke, according to a study which calls for further safety research to examine the long-term effects of such products.

Researchers at Cleveland Clinic studied over 4,000 people in the US and Europe and found those with higher blood erythritol levels were at elevated risk of experiencing a major adverse cardiac event such as heart attack, stroke or death.

They also examined the effects of adding erythritol to either whole blood or isolated platelets, which are cell fragments that clump together to stop bleeding and contribute to blood clots.

The study, published in the journal Nature Medicine, found that erythritol made platelets easier to activate and form a clot. Pre-clinical studies confirmed ingestion of erythritol heightened clot formation.

Artificial sweeteners are present in thousands of food and beverage brands worldwide, however they remain a controversial topic and are currently being re-evaluated by the European Food Safety Authority, the World Health Organization, and other health agencies.

The findings from a large-scale study published in the British Medical Journal in September last year found a potential direct association between higher artificial sweetener consumption, especially aspartame, acesulfame potassium, and sucralose, and increased cardiovascular disease risk.

"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 study author Stanley Hazen, 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," Hazen said in a statement.

Artificial sweeteners, such as erythritol, are common replacements for table sugar in low-calorie, low-carbohydrate and "keto" products. Sugar-free products containing erythritol are often recommended for people who have obesity, diabetes or metabolic syndrome and are looking for options to help manage their sugar or calorie intake.

People with these conditions also are at higher risk for adverse cardiovascular events like heart attack and stroke.

The researchers noted that erythritol is about 70 per cent as sweet as sugar and is produced through fermenting corn. After ingestion, erythritol is poorly metabolised by the body.

Instead, it goes into the bloodstream and leaves the body mainly through urine. The human body creates low amounts of erythritol naturally, so any additional consumption can accumulate.

Measuring artificial sweeteners is difficult and labelling requirements are minimal and often do not list individual compounds.

Erythritol is "Generally Recognised As Safe (GRAS)" by the US FDA, which means there is no requirement for long-term safety studies. The authors of the latest study note the importance of follow-up research to confirm their findings in the general population.

The study had several limitations, including that clinical observation studies demonstrate association and not causation.

"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," said Hazen.

"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," Hazen added.

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Hyderabad (PTI): Talks between employees of Telangana State Road Transport Corporation (RTC) who were on strike and the state government concluded successfully on Friday as the government agreed to the key demands of the workmen.

Following a day-long marathon of talks between the leaders of the employees' Joint Action Committee (JAC) and the cabinet sub-committee, the government announced after midnight that it acceded to the demands, including a merger of RTC with the government, 11 per cent pay revision and elections to the employees' unions.

A committee comprising officials and employee leaders would be appointed over the merger of RTC with the government, it said.

The RTC management has also agreed to address the remaining issues as well, an official release said.

The employees would call off their strike and the RTC buses would hit the roads shortly, it said.

The employees had been on an indefinite strike since April 22 over a series of demands, including the merger of RTC with the government.

Earlier in the day, a driver of the RTC, who attempted suicide on April 23 during the strike, died at a hospital here in the early hours of Friday.

Shankar Goud, a 55-year-old driver, set himself ablaze by pouring petrol at Narsampet in Warangal district when the employees were staging a protest on Thursday in support of their demands.

Goud suffered serious burns, was initially admitted to a state-run hospital in Warangal, and later shifted to a super-speciality hospital in Hyderabad for advanced treatment.

"He succumbed (to injuries) at about 1.30 am on Friday," a senior official said.

The driver’s body was taken to his relative’s village, Muttojipet in Warangal district, for funeral rites.

Tension prevailed in Muttojipet as his family members and RTC employees attempted to take the body to the Narsampet bus station, where he worked, to enable his colleagues to pay their last respects. However, police did not permit this, citing law-and-order concerns.

This led to a deadlock before the funeral could proceed.

Union Minister Bandi Sanjay Kumar criticised the Telangana government for not allowing the body to be taken to the Narsampet bus station.

Kumar, Minister of State (Home), visited Muttojipet village in Warangal district, where the funeral was held, and paid homage to Goud.

“They (family members) want to take the body to the bus depot for five minutes. Is the RTC bus depot in Pakistan or Bangladesh? They are emotionally attached to taking the body there. The government is hurting sentiments and creating fear among RTC employees,” Kumar told reporters.

He also expressed anger at the police for not allowing the body to be taken to the bus station and staged a protest, according to a release from his office.

RTC employees and BJP workers attempted to take the mortal remains in an ambulance to Narsampet, but were stopped by the police.

Later, after discussions with the police, the family members and RTC employees agreed to conduct the funeral in the village.

Sanjay Kumar, stating he would abide by the family’s decision, left the village after the funeral was conducted there.

Transport Minister Ponnam Prabhakar said an ex gratia of Rs 10 lakh, a house, and a government job would be provided to the kin of Goud.

Chief Minister A Revanth Reddy expressed shock over the employee’s death and conveyed deep condolences to the grieving family, according to the release.

The RTC employees’ JAC had earlier announced an agitation programme from April 24 to 29, including silent marches and submission of memorandums to MLAs and other leaders.