Consumers of sugar-free treats were in for a shock when a study began circulating last month noting that the use of erythritol a popular sweetener used in everything from cereal to sugar-free sodas is associated with an increased risk for heart issues. This could prompt people to reevaluate many kitchen items, from coffee sweeteners to granola bars to baking sugar substitutes.

This isnt the first study that has linked artificial sweeteners to health problems research has called them out for many possible side effects. So is it time to ditch them entirely?

As with anything nutrition-related, there are factors you should take into consideration (like how often you consume artificial sweeteners, for example). We spoke with experts about what to know about the new study and previous research, plus got their tips on alternative ways you can sweeten your food if youre looking to make a switch.

Cardiovascular Issues

The recent erythritol study analyzed the amount of the sugar alcohol in the blood of around 4,000 people, mostly over the age of 60. Those with high levels were said to be at a higher risk of having a heart attack or stroke.

The research also showed that higher levels of erythritol in the body were likely to make it more prone to blood clots . Some participants in the study had preexisting heart issues , which experts say may have impacted the results. But the clotting risk has been enough for Leah Groppo , a clinical dietitian at Stanford Health Care.

Groppo noted that sugar alcohols like erythritol have a better flavor profile than pure monk fruit and stevia, which are also used as sweeteners. This means that in addition to being added to foods on its own, erythritol is commonly found in blends of monk fruit and stevia.

Additional research has linked other artificial sweeteners , including aspartame, acesulfame potassium and sucralose, to increased cardiovascular disease risk as well.

Cancer Risk

There is debate as to whether consuming artificial sweeteners causes cancer, but some research suggests there may be a link.

The biggest indicator comes from a large cohort study of 102,865 French adults. The research found that those who consumed higher amounts of aspartame had 1.15 times the risk of developing cancer overall compared to those who did not. Those who consumed higher amounts of the sweetener acesulfame-K had 1.13 times the risk of cancer.

That said, other studies have shown there isnt a consistent association between artificial sweeteners and cancer, according to the National Cancer Institute .

Cognitive Issues

There may be some evidence that artificial sweeteners could have an effect on the brain over time. One 2017 study found that artificially sweetened drinks were associated with a higher risk of both strokes and dementia. Additional research has linked aspartame to mood disorders, depression and mental stress. Sweeteners also have been linked to headaches and dizziness .

Gut Issues

Some research has suggested that certain artificial sweeteners may alter the gut microbiome in both mice and humans who eat foods containing them. Studies also show that non-nutritive sweeteners could impair glucose tolerance . And some sugar alcohols may cause digestive upset .

While we dont know the long-term effects from consuming non-nutritive sweeteners, we do know some sugar alcohols such as sorbitol and xylitol can cause digestive distress such diarrhea and bloating, explained Melissa Hooper , a registered dietitian nutritionist and founder of Bite-Size Nutrition.