Erythritol, commonly found in items like protein bars and energy drinks, has generally been seen as a safe sugar alternative. However, emerging research indicates it might be adversely affecting one of the body’s key protective mechanisms, potentially raising the risk of heart issues and strokes.
A study from the University of Colorado revealed that erythritol might harm cells within the blood-brain barrier, which serves as a sort of defense for the brain, keeping out toxins while allowing essential nutrients to pass through.
This study builds on earlier observational research linking erythritol intake with higher incidences of heart attacks and strokes.
In this latest research, scientists exposed blood-brain barrier cells to typical erythritol levels found after consuming a sweetened soft drink. They observed that this exposure initiated a cascade of cell damage that could increase susceptibility to blood clots, a primary cause of strokes.
The sweetener led to oxidative stress, bombarding cells with reactive molecules called free radicals, while simultaneously impairing the body’s natural defenses against such damage. This dual attack diminished the cells’ operational capability and, in certain cases, caused cell death.
Perhaps even more troubling was how erythritol affected blood vessel functions related to blood flow regulation. Healthy blood vessels should expand when more blood is needed—like during exercise—and constrict when less is needed.
This process relies on two crucial molecules: nitric oxide, which helps blood vessels relax, and endothelin-1, which causes them to constrict.
The study found that erythritol impaired this balance, decreasing nitric oxide levels while increasing endothelin-1 levels. Such a disruption could leave blood vessels too constricted, potentially depriving the brain of necessary oxygen and nutrients.
This imbalance is often seen as a warning sign for ischaemic strokes, where clots block blood vessels in the brain.
What’s even more alarming is that erythritol may also thwart the body’s mechanisms that dissolve blood clots. Typically, when clots form, cells release a “clot buster” called tissue plasminogen activator to break down the blockage. Erythritol seems to interfere with this process, allowing clots to potentially cause issues.
The lab results coincide with concerning evidence from human studies, which suggest that individuals consuming erythritol regularly may face significantly increased risks for cardiovascular problems, including heart attacks and strokes. A significant study monitoring thousands of participants indicated that those with elevated erythritol levels in their blood were roughly twice as likely to suffer a major heart event.
Despite these findings, there are limitations to the research. The experiments were conducted on isolated cells in lab dishes, not complete blood vessels, meaning that the cell behavior might differ in a living organism. Researchers note that more advanced testing using “blood vessel on a chip” systems is essential for confirming these effects.
This research is significant because erythritol is distinct in the sweetener landscape. Unlike artificial sweeteners such as aspartame or sucralose, erythritol is classified as a sugar alcohol and occurs naturally in small quantities within the body.
This natural classification allowed it to escape recent World Health Organization guidelines that discouraged artificial sweeteners for weight control.
Erythritol has gained traction among food producers, as it mimics sugar’s properties more closely than other alternatives. While sucralose is 320 times sweeter than sugar, erythritol is only about 80% as sweet, making it versatile for recipes without dominating the flavor. It appears in many “sugar-free” and “keto-friendly” products.
Trade-off
Regulatory bodies like the European Food Standards Agency and the US Food and Drug Administration have deemed erythritol safe for consumption. Yet, this new evidence adds to the growing concern that even “natural” sugar substitutes may have unforeseen health implications.
For consumers, these findings raise complex questions regarding the trade-offs of sugar alternatives. Erythritol can indeed help with weight management and diabetes prevention by reducing caloric intake and controlling blood sugar spikes.
However, if regular intake may weaken the brain’s protective barriers and elevate cardiovascular risks, the trade-offs might be more significant than previously assumed.
This research highlights a broader dilemma within nutritional science: how to understand the long-term effects of relatively new food additives becoming common in our diets.
While erythritol might help individuals avoid the immediate dangers of excess sugar, its impact on the blood-brain barrier raises concerns that frequent usage could be slowly compromising that very protection over time.
As more studies explore these worrying connections, consumers might need to reassess their relationship with this seemingly benign sweetener and question whether any sugar alternative is genuinely risk-free.
