Black licorice is a candy that should inspire caution

“What do you think of black licorice? sounds like a simple conversation starter question at a Halloween party or a silly internet battle. It’s a love-it-or-hate-it candy that inspires intense opinions.

But if you ask a health expert, expect serious conversation because eating lots of black licorice can lead to “seriously life-threatening” complications, said cardiologist Dr. Massachusetts General Hospital and Harvard Medical School in Boston.

No one says a twist or two once in a while is a problem. But before you dive in, you’ll want to know the dangers of overindulging.

The root of the problem is an actual root. Licorice, or Glycyrrhiza glabra, is a type of legume (like peas or beans) found in southern Europe, the Middle East and Asia. The root of the licorice plant has been valued since ancient times. Soldiers used licorice extract to quench their thirst in battle and on long marches. And large quantities were found buried in the tomb of King Tut. Depending on your feelings, that makes black licorice the most regal of treats, or something cursed that shouldn’t be bothered by mortals.

Licorice root provides the zesty sweetness black licorice lovers love and others hate. You won’t find it in red licorice, and some black licorice candies use artificial flavors or anise oil, which has a similar flavor. But some of the best-known black licorice candies use natural licorice extract, which also appears in some teas, root beers, and other products.

The traditional black licorice flavor comes from a chemical called glycyrrhizin, which is 50 times sweeter than cane sugar. “It’s pretty powerful,” Newton-Cheh said. And it can do more than just add flavor.

Consumed in large amounts, black licorice can significantly reduce potassium levels in the body. Potassium is important for heart health, and if levels drop, it can lead to problems like abnormal heart rhythms and congestive heart failure.

Or worse.

In 2019, Newton-Cheh helped treat a man who went into cardiac arrest after his potassium levels dropped to less than half normal.

Among his health problems were poor diet and smoking, according to a case report published in the New England Journal of Medicine. His family said he used to eat a bag or two of red licorice every day. But three weeks earlier, it had gone black.

He died, Newton-Cheh said, of a brain injury sustained due to responders’ difficulty getting his heart back to a normal rhythm – a problem Newton-Cheh says could be attributed to low levels potassium.

Even when the results aren’t as immediate and drastic, glycyrrhizin can cause long-term heart problems by causing the body to retain sodium. “So patients will have higher blood pressure as a result,” Newton-Cheh said.

Licorice is usually not fatal, but serious reactions are rare. Black licorice has also been linked to other problems. A 2009 study of women in Finland linked high drinking during pregnancy with poorer cognitive performance in their later children. And the Food and Drug Administration warns that black licorice may interfere with certain medications, herbs, and dietary supplements.

The American Heart Association says this includes certain diuretics and heart failure medications, so Newton-Cheh said people should check with their doctor for possible interactions.

But there’s no right answer to the question of how much black licorice is safe, he said. “It’s not well studied.”

The FDA “encourages moderation,” while warning, “If you’re 40 or older, eating 2 ounces of black licorice daily for at least two weeks could land you in the hospital with an irregular heartbeat.”

If you’ve eaten a lot of black licorice and you have an irregular heartbeat or muscle weakness, stop eating it immediately and see a healthcare professional, the FDA says.

Beyond the candy dish, black licorice in various forms is often promoted as a dietary supplement. Newton-Cheh said most claims about possible benefits have not been carefully considered. “It’s very difficult to separate the untested theories that people have in the alternative medicine field for the potential health benefits of licorice,” he said, so anyone who takes them should check with them. from his doctor.

So where does that leave licorice fans?

“I would say black licorice with artificial flavoring and red licorice are not dangerous,” Newton-Cheh said. That doesn’t make them healthy; they still contain sugar, which can lead to obesity and other health problems if you consume too much. Ingredients vary by brand, but a widely available variety pack contains 140 calories and 17 grams of sugar per 40-gram serving. (That’s just under 1 1/2 ounces.) The AHA recommends limiting added sugars to no more than 6 percent of calories per day, or about 100 calories per day for women and 150 for men.

The appearance of a few pieces of black licorice in a child’s sleight of hand is nothing to worry about, Newton-Cheh said. But overall, limiting the total amount of candy a child eats is a good idea, he said.

Newton-Cheh himself does not avoid black licorice. But he’s probably not going to raid his children’s Halloween stash either, for a more subjective than scientific reason: “I don’t particularly like the taste.”

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