A construction worker’s love of black liquorice may have contributed to his death.
The unnamed 54-year-old man from Massachusetts is believed to have eaten around one and a half bags of the treat every day.
He appeared healthy before suddenly going into cardiac arrest – which is when the heart stops beating – in a fast food restaurant.
Tests revealed he had dangerously low potassium levels, with glycyrrhizic acid – a key ingredient in liquorice – likely being to blame.
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Writing in The New England Journal of Medicine, medics from the Massachusetts General Hospital reported how the man suddenly gasped and lost consciousness.
Doctors managed to resuscitate him at the scene, but he later died in hospital.
The cause of death was a cardiac arrest associated with ventricular fibrillation – when the heart beats with rapid, erratic electrical impulses before stopping altogether.
“We are told this patient has a poor diet and eats a lot of candy,” study author Dr Elazer Edelman explained, according to the BBC.
“Could his illness be related to candy consumption?”
How can too much black liquorice be deadly?
While black liquorice may seem a harmless treat, its distinctive sweet taste comes from glycyrrhizic acid, which can throw the body’s mineral levels out of sync.
“Even a small amount of liquorice you eat can increase your blood pressure a little bit,” said co-author Dr Neel Butala, as reported by CBS Boston.
Studies have linked glycyrrhizic acid to high blood pressure, low potassium, elevated pH levels in tissues, an abnormal life-threatening heart rate and kidney failure – all of which occurred in the deceased man.
The ingredient has also been found to trigger limb swelling and fatigue.
A few weeks before his death, the man had reportedly switched from “red fruit-flavoured twists” to black liquorice.
“Further investigation revealed a recent change to a liquorice-containing candy as the likely cause of his hypokalemia [low potassium levels],” said co-author Dr Andrew Lundquist.
Glycyrrhizic acid can also be found in liquorice root extract supplements and teas, as well as jelly beans and certain beers.
The US Food and Drug Administration recommends people “don’t eat large amounts of black liquorice at one time”, regardless of their age.
Those who have overindulged and have an irregular heart beat or muscle weakness should stop eating liquorice immediately and contact a doctor.
If the consumption is curbed early enough, potassium levels should return to normal with no permanent health damage.